Chronic disease shouldn't equal economic hardship

For the increasing number of individuals living with chronic diseases, the cost of treatment and ongoing management is forcing many into economic hardship and poverty. In turn, financial stress promotes poor health, which exacerbates healthcare costs … and so the cycle of poverty and illness begins.

This is not about government health budgets and health systems, but about the burden of chronic disease and disability on individuals and their households. These are the people falling through the cracks, who urgently need support to break the catastrophic cycle of ill health and disadvantage.

Researchers from The George Institute and Menzies Centre for Health Policy at the University of Sydney are calling for a renewed focus on healthcare reform and targeted support to provide relief for patients.

In their recent review published in the Medical Journal of Australia, researchers revealed the expensive nature of chronic disease in Australia, highlighting hefty out-of-pocket expenses compared to many other high-income countries across the world. This is despite nation-wide healthcare and free public hospital system.

“Australians are spending more of their own money to try and maintain their quality of life and public health spending is lower than in comparable high-income countries. The most direct manner in which the economic impact of illness is felt is through out-of-pocket costs of care such as home modifications, equipment and transport. Among OECD countries, Australians pay the third highest level of such expenses, more than the UK, France and New Zealand”, according to lead author, Dr Stephen Jan of The George Institute.

Evidence is increasingly coming to light that suggests people with chronic illness are experiencing catastrophic levels of healthcare spending - defined as out-of¬pocket costs exceeding 10 per cent of income. Notably, of the 28,665 Australians who became bankrupt in 2009, 11 per cent cited ill health or absence of health insurance as the primary reason.

While the issue isn’t as marked as in the United States, where ill health was responsible for 62% of bankruptcies in 2007, healthcare reform has significant potential to address this hardship in Australia.

Dr Jan believes it is hard to justify maintaining current policies over the next decade, a position advocated by the National Health and Hospitals Reform Commission in Australia.

“Initially, priority needs to be given to developing a consistent approach to record costs associated with chronic illnesses and disabilities and how those costs impact on a person’s likelihood to maintain treatment. That way, we could rapidly implement effective remedies to catastrophic healthcare spending at the household level. Focused income support, intervention and subsidies for specific items such as home care, or bathroom modifications may save people from severe economic hardship, and transform lives”.

Meaningful improvement is also possible through small-scale targeted strategies. Such strategies would focus on populations where the financial stress is felt the most: retirees and those in low-socioeconomic groups.

“These measures would identify and help catch the individuals and households that are currently falling through the cracks”, added Dr Jan.