Australia’s universal health insurance scheme, Medicare, is designed to make healthcare available to all, no matter how wealthy or poor. And mostly, it achieves this goal. Public hospital care is free, and the vast majority of services outside of hospital are ‘bulk-billed’ – meaning the patient pays nothing out-of-pocket.

But Medicare is not perfect. Australia still relies more heavily on patients contributing to the cost of their care, compared to similar countries. In 2019-20, Australians spent a total of nearly $7 billion on out-of-hospital medical services and on medications listed on the Pharmaceutical Benefits Scheme (PBS).

Many Australians can’t afford needed care. In 2020-21, nearly half a million Australians missed out on seeing a specialist because of cost, and more than half a million deferred or did not fill a prescription because of cost.

The people who need the most healthcare – the poor and the chronically ill – miss out on care most. This is bad for those individuals, but also bad for taxpayers and the economy. It makes people sicker, widens inequities, and puts further strain on the health system down the track.

This report identifies which out-of-hospital services are putting a financial strain on Australians, and what should be done to bring out-of-pocket payments down, so that fewer Australians miss out on care because of cost.