Medicare austerity reforms and patient out-of-pocket costs: The experience from Australian cancer patients

Maryam Naghsh-Nejad, Kees Van Gool, Phil Haywood and Jane Hall
Authors registered in the RePEc Author Service: Maryam Naghsh Nejad

Health Policy, 2025, vol. 155, issue C

Abstract: In this paper, we examine trends in provider fees charged, government expenditure on private out-of-hospital medical services, and out of pocket costs following policy changes intended to reduce government expenditure. We examine the experience of a high-need patient group: people diagnosed with cancer. The Australian system for these services is predominantly publicly funded under fee for service; with no government control on the fees charged by providers. We calculate out of pocket costs for patients in the 12 months following a cancer diagnosis and find a large variation in these costs according to the type of treatment received as well as the place of residence and presence of additional government protection. We find that volumes of services, provider fees, and out of pocket costs rose over time. These findings are especially important for a high-need patient group as out of pocket costs are considered a barrier to access to healthcare. Governments may respond to the long-term fiscal challenges by attempting to constrain benefits it pays; our results demonstrate that careful consideration of the full impact of such policies is needed.

Keywords: Out of pocket costs; Cancer; Public health insurance (search for similar items in EconPapers)
JEL-codes: I11 I13 I14 (search for similar items in EconPapers)
Date: 2025
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Working Paper: Medicare Austerity Reforms and Patient Out-of-Pocket Costs: The Experience from Australian Cancer Patients (2024)
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Persistent link: https://EconPapers.repec.org/RePEc:eee:hepoli:v:155:y:2025:i:c:s0168851025000521

DOI: 10.1016/j.healthpol.2025.105296

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