Australia is bathing in comparative adequacy on healthcare. Let's do better

But comparison so often breeds complacency.

Am I grateful that if I suffer a heart attack, my family won't be sent a bill for millions of dollars? That once you have a diagnosis, you may be able to apply for financial assistance to fund the costs of your therapies? D'oh.

But just because somewhere else has it worse, doesn't mean that we should "suck up" the inequalities in accessing the healthcare we have available here in Australia, and just "be grateful" that we don't live in America.

It has become the norm to bury the gaps in systems and gloss over holes in our services - heaven forbid we should complain when you can die without bankrupting your family through hospital bills.

A small consolation indeed.

Let's look at ADHD - the most common neurodevelopmental condition in children and adolescents - for example.

In November last year, the Senate Standing Committee on Community Affairs published the report following the Senate inquiry into assessment and support services for people with ADHD. This report acknowledged the inquiry submissions' "overwhelmingly" shared experiences of struggling to access a diagnosis due to the process being "generally long, difficult, expensive and time consuming, causing significant stress, anxiety and pressure on family relationships and school systems". This was shared in contrast to the acknowledgement of how an early diagnosis can be life-changing.

Accessibility to diagnosis was flagged in a 2020 survey administered by ADHD Australia as a key issue, and this was subsequently "loudly reaffirmed" by a 2023 survey. One family reported spending $20,000 a year on therapies, medications, appointments and lost working-time due to ADHD. Another family shared their experience of waitlists being long for all services from paediatricians to OTs, having waited two years to access a speech therapist. This family also shared the "astronomical" price tag of $1800 - without rebate - for the educational psychologist to administer an assessment.

Surprisingly, despite it being the most common neurodevelopmental condition our young people experience, and with it having significant (and researched) impact on both an individual's working and personal lives, ADHD is not usually funded on the NDIS as a standalone diagnosis due to those diagnosed struggling to meet the stringent NDIS eligibility criteria for a "severe and permanent disability".

So even if you can find the small fortune to be formally diagnosed, the financial assistance to help you navigate the neurotypical world as a neurodiverse individual is all but non-existent unless you have a co-morbidity that is funded under the NDIS. And that's for a disorder that one in 20 children in Australia have.

What isn't surprising is that ADHD Australia estimates that 75 per cent of people with ADHD remain undiagnosed. What makes this particularly worrying is that like autism spectrum disorder, it tends to run in families, which means that the costs of diagnosis and therapy is multiplied within the family unit. It's really no wonder that families without the means to casually drop thousands of dollars on a diagnosis that they won't be able to afford to treat moving forward anyway are left struggling to mask their disorder and function without the support they need in a neurotypical world.

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In 2019, Deloitte estimated that the cost of ADHD in Australia resulting from reduced workforce participation, absences from work and reduced productivity while at work, represent a financial burden of almost $10.4 billion per year. Surely supporting early diagnoses and intervention would be a better way for this cost to manifest than in the heartache and mental health decline of those left out in the cold?

The Albanese government is coming up to its three-month deadline to respond to the standing committee's report next month. If it can't accept the recommendations to improve funding availability for ADHD assessment and treatment because it's the right thing to do, maybe it will see the long-term fiscal responsibility that it represents.

Afterall, all the NDIS support in the world means nothing to any of us if we can't afford the diagnosis to prove our eligibility. We should be striving to set the bar for healthcare on the world stage, not bathing in comparative adequacy.