Diabetes, doctor & medicine co-payments: a 'major' budget concern

29 May, 2014

The 1.7 million Australians with diabetes potentially face a dramatic increase in their healthcare costs as a result of changes announced in the 2014 federal budget.

Diabetes Australia said the $7 co-payment for GPs, pathology and X-ray; and the $5 co-payment for medicines were a double blow to all Australians with diabetes.

"The impact on older people and families is a major concern," said Diabetes Australia CEO Prof Greg Johnson. "More than 700,000 Australians aged 60 and over are registered on the National Diabetes Services Scheme. They not only need to see their GP regularly, but they need eye checks, kidney checks, heart and vascular checks, and regular monitoring to help prevent serious complications of diabetes.

"Older people with diabetes will commonly have another chronic condition as well as diabetes. They need to access a credentialed diabetes educator, a dietitian, a podiatrist; they need regular blood tests – and of course they will often be on multiple medications needing prescriptions and they need diabetes self-monitoring products and often needles and syringes for their insulin.

"Families will feel the burden. There are currently 13,000 families with dependent children who have type 1 diabetes. Caring for a child with type 1 diabetes is a highly stressful 24-hour-a-day, seven-day-a-week job and now these families face a lifetime of increased costs," Prof Johnson said.

"All types of diabetes are serious and complex and require multidisciplinary care and support if we want to maintain good health and productivity as we grow older," he said. "No diabetes is curable and all diabetes requires regular, ongoing management for life. That means people with diabetes may be charged the new $7 co-payment for GP visits and pathology, and the $5 increase for PBS-listed medications time and time again - for life.

"In the worst case scenario, people visiting their GP regularly and taking three or four different medications could be out of pocket for hundreds of dollars more per year for diabetes management alone. And diabetes runs in families and often there is more than one family member with diabetes," Prof Johnson said.

While the budget papers stated GP co-payments would "not be expected" for chronic disease management items, this is far from clear.

Diabetes Australia wants to see a strengthening of the primary care system to better manage the diabetes epidemic and particularly – to help reduce or prevent the complications of diabetes which include heart attacks, strokes, kidney damage leading to dialysis, eye damage and vision impairment, distress, anxiety and depression.

"We need to see the primary care system and prevention as the primary place to invest more – and we have to stop the continuing trend of spending more and more billions of dollars on expensive hospital based services treating these complications after they happen," said Prof Johnson.

"If people can't afford to go to the doctor or get essential medicines then the likelihood of developing these costly diabetes complications increases. This pushes up the cost to the Australian taxpayer later on."

Diabetes Australia said the budget proposals were causing confusion in the community. "We need clarification on when co-payments will take effect for people on Chronic Disease Management plans and we also need more detail on how this will affect medications on the PBS," said Prof Johnson.

Diabetes Australia is also concerned that efforts to prevent more people getting type 2 diabetes may be reduced by the health budget apparent cuts to prevention funding.

"The Coalition government has committed to developing a new National Diabetes Strategy and strengthening the prevention and management of diabetes in primary care and we congratulate the Government for this focus and look forward to this happening," said Prof Johnson.