So far, I’ve had three reminders from my GP clinic to make an appointment with my doctor. This is as a result of getting an ECG and having my bloods done in order to check one of the medications that I’m on isn’t affecting my heart.
Even though I love my GP, I haven’t made the appointment yet. Before you write to me with alarm and concern. I know. I will make the appointment soon. As soon as my bank balance allows, that is.
Last time I went to the GP to sort out some lady issues, it cost me $220 for a “long” GP appointment. Of course, some of the cost was Medicare rebated. But I still didn’t have enough cash left in the bank account to put a full tank of petrol in the car on the way home.
Compared to many Australians, I earn a decent income. I’m lucky. And yet I’m still a sole parent paying a huge mortgage alone. A mortgage that’s gone up 13 times and is a grind to pay each month. There’s no longer any financial buffer.
I’m not alone in delaying medical treatment. According to a new paper, based on ABS data from 2022-23 and published by the Medical Journal of Australia, “…many Australians struggle to afford the medicines they need and…cost barriers to access have increased” compared to the year before.
But it’s women who are most impacted. The report’s author, healthcare policy and bioethics expert Dr Narcyz Ghinea writes: “The data show that 9.4 per cent of women compared with 5.5 per cent of men reported cost-related non-adherence to medications…prescribed by their general practitioner in the previous 12 months.”
In plain English, many more women than men are not filling or delaying filling medication scripts due to cost. He then goes on to say that the situation is even worse for younger women. Nearly 15 percent of 15–24-year-olds and to 13 percent of 25–34-year-olds are affected by financial pressures which result in them not taking medications.
Dr Narcyz Ghinea notes that in reality, the numbers of women not taking medications due to cost is likely much higher because of the huge percentages of women who didn’t actually go to their GP or specialist in the first place.
The paper states 8.4 per cent of women “at least once delayed seeing or did not see a general practitioner and 12.2 per cent…at least once delayed or did not see a specialist due to cost.”
Again, this was much higher for younger women. A little more than 11 per cent of women aged 25–34 years delayed or didn’t see a GP at least once, and more than 20 per cent of that same cohort delayed or did not see a specialist due to cost.
Polly is a 49-year-old single mum from regional NSW who works for herself more-than-full-time to stay afloat financially. She says: “I have absolutely delayed visiting the doctor and the dentist due to cost. I have put my kids in for appointments, but my own health care has become a last priority.
“Once, my daughter had a procedure done at the GP for an infected toenail and I had had to save up to get the appointment scheduled, and when I went to pay it was $100 more than I quoted. I didn’t have the money and just burst into tears then cried all over the service manager!”
When I threw out a question on my social media channels to ask women if they had delayed or avoided medical care due to cost, dozens of women responded. There were some recurring themes:
- Women making impossible choices to pay for their kids’ healthcare needs first, but as result being unable to pay to address their own
- For many, specialist care was totally out of reach
- Women living with extreme pain but being unable to afford a whole spectrum of healthcare needs – appointments with healthcare professionals (including dentists and physios), medications and even specialist surgeries
- Women not addressing their mental health needs due to cost, which backfires and ends up making them more unwell
- Cancelling medical appointments at the last minute due to being unable to pay for them (and feeling ashamed of this)
- Proactive healthcare was completely unaffordable for most women who responded
- Disabled and chronically ill women regularly missing out on crucial medications and care due to cost
Susan, 39, falls into this last category. She tells me: “I often have to choose which pills I will buy and which I’ll go without.
“Specialist care is largely out of reach for me because of costs involved, despite the fact that my chronic illnesses would benefit from specialist advice. My teeth are also cracking as a result of these conditions, and I cannot afford to remedy the situation.”
Dr Danielle McMullen is president of the Australian Medical Association. She acknowledges more Australians are “skipping filling their medication or delaying a visit to the GP” and worries about the long-term impacts.
“We know that delaying care can lead to poorer health outcomes which is why it’s so important to seek care when you need it.
“Addressing poor Medicare Benefits Schedule [MBS] rebates for long consultations will improve some of the gender inequity inherent in the MBS,” she says.
On the upside, Dr McMullen notes that there have been some relatively recent policy changes – which the AMA pushed for – and these is likely to have a positive flow-on effect: “[I]t’s important to note that the data in this report are from before the tripling of the bulk-billing incentives and 60-day dispensing policies commenced.”
(Heads up! Not everyone is a fan of 60-days dispensing.)
Dr McMullen also points to structural healthcare issues that compound the issues for some cohorts of women: “Efforts to eliminate systemic discrimination and improve access to healthcare for marginalised groups of women are imperative.”
As examples, she points to racial disparities in maternal mortality rates for First Nations women and underscores the need for “…culturally competent care for Indigenous women.”
“Healthcare systems should provide comprehensive care that addresses the specific needs of women at different stages of life, including preventive screenings, reproductive healthcare, and support for healthy aging,” she says.