Older Australians are avoiding visiting the GP or specialist when they need to, skipping medications and going without dental care because of cost, according to new research.
Some people are waiting until their condition deteriorates to an extent they need treatment in hospital.
A damning new report by peak advocacy group National Seniors Australia, shows how Australia's universal health care is failing those it was supposedly set up to protect, in particular, the elderly and those on low incomes such as pensioners.
In a survey of more than 6000 people aged 50 and older, more than two thirds of respondents said they had recently gone without or hesitated to access essential healthcare because of cost.
The survey found only 32 per cent of respondents said cost had not affected their access to health care but some of those said they went without other things in their lives to be able to afford the medical care.
The dietician's appointments are free because of my diabetes plan. There are two medications I need which amount to $100 per month so I have left one out. The vitamins I need, I have stopped buying.- Survey respondent
Chief Advocate Ian Henschke said, unsurprisingly, older people with limited wealth have greater barriers to accessing health care. For those who missed out because of cost, almost a third said it had negatively affected their health or wellbeing.
"Most Australians expect to receive lifelong universal healthcare, but it is clearly not the case," he said.
Mental health care, dental treatment and dental checkups are the most likely to be forgone, with 20 - 26 per cent of respondents unable to afford them on one or more occasion.
I have missed taking diabetes medication, gout/ arthritis meds, depression meds, and blood pressure/ statin meds, as well as not being able to afford vitamins like probiotics and vitamin d, or c.All of these shortages have made me feel worse physically and mentally.- Survey respondent
Prescription medication and GP appointments were the least likely to be skipped because of cost, but even they were unaffordable for 5 to 7 per cent of older people with some saying they stretched out medication use to avoid having to see the GP for a repeat script or didn't seek treatment at all.
Other examples of medical care which respondents said they went without (or hesitated about) for cost reasons included skin specialists for cancer checks and cancer removals, oncologists, prostate cancer treatment, heart specialists, lung specialists, dermatologists, eye surgeons and opthalmologists, X-rays, ultrasounds, MRIs, hernia operations, physiotherapy, podiatry, dental surgery and other dental treatments, psychologists and other mental health professionals and medication of various kinds.
Most Australians expect to receive lifelong universal healthcare, but it is clearly not the case.- Ian Henschke, National Seniors Australia
Respondents also said they went without or hesitated over audiologists and hearing aids, optometrists and glasses, CPAP machines, dentures, appropriate shoes for foot pain, rehab, mobility aids and home help, hand therapists, massage therapists, myotherapists, exercise physiologists, alternative medicine practitioners, dieticians and nutritionists, preventative care such as exercise programs, gym memberships, tai chi groups, vitamin and mineral supplements, asthma treatments, shingles vaccination and pathology tests not covered by Medicare.
National Seniors Australia survey respondents reported various health and wellbeing consequences of going without care including untreated problems, undiagnosed conditions, worsening symptoms and mental health impacts.
Some reported having to wait until their conditions were bad enough to require hospitalisation, with an 81-year-old explaining because he can't afford minor medical treatment at a GP, he waits until he can be transported to hospital for other more serious incidents.
GP went from bulk billing to $80 per visit overnight. I've had to defer having a skin cancer removed because I just can't afford it.- Survery respondent
The situation is similar among the 832 respondents who had been on an elective surgery public waiting list, 46 per cent of whom could not afford to pay privately to speed things up.
Many suffered continuing pain, immobility, sensory disablement, mental health impacts or worsening symptoms while waiting, sometimes to the point of needing emergency care.
According to respondents the factors that make health care expensive included a lack of private cover, expense of private cover including when re-joining or joining for the first time, limitations of private cover, gaps despite private cover, changing PBS rules, unpredictable prescription costs, costs after losing access to the Seniors Health Care Card or Centrelink concession card, inadequate Medicare rebates, procedures not covered by Medicare, exorbitant specialist and surgery fees, and lack of bulk billing by GPs.
I suspect I may have conditions which I do not seek diagnoses & treatment for due to lack of income.- Survey respondent
Among strategies used to reduce costs were travelling long distances to access public hospitals, getting off treatments and painkillers as fast as possible to avoid further expense, stretching out painkiller usage over time to avoid needing a GP appointment to get a new prescription, stretching out appointments over longer periods of time, only using the five free care plan appointments when absolutely necessary, not seeking diagnosis and treatment for suspected health issues, putting off treatments altogether, putting up with the problem, sacrificing one's own healthcare expenses to ensure one's spouse or another person has the (often more urgent) healthcare they need, doing without one medication to afford another.
"Timely and affordable access to all types of health care helps prevent disability and promotes quality of life for older Australians," said Mr Henschke.