When it comes to health care, it matters where you live.
The prevalence of chronic disease in the Northern Territory is higher than anywhere else in Australia, yet it receives the smallest share of Medicare funding, a new report has found.
People living in the most remote regions of the Northern Territory, where rates of heart disease, diabetes, cancer and rheumatic heart disease are at crisis points, receive the smallest amounts.
Instead, funding is clustered in Australia's cities.
Researchers from the Mitchell Institute at Victoria University have found the Northern Territory is missing out on $82 million in its share of Medicare funding.
Just 65 cents in every $1 of Medicare spent per person in Australia is spent in the Northern Territory, despite a disease burden 40 per cent higher than the national average.
Associate professor Melinda Craike from the Mitchell Institute said the unfair distribution has resulted in a system which does not address the needs of Territorians.
"Our specialists are primarily located in inner city areas, so rural and regional people need to travel long distances to access services, which is a barrier in itself," she said.
"Rising out of pocket fees charged by specialists are also restricting access for low income Australians, many of whom live in rural and remote areas, while allowing those who have or can find the money to access the healthcare they need."
Over 80 per cent of Australians receive a Medicare insurance benefit each year and the rate of disease is well know in each state and territory, yet the Medicare dollar is not being spent where it is most needed, researchers say.
People in New South Wales received the highest Medicare payments per capita averaging $1.07 per person compared to people in the Northern Territory who receive just 65 cents.
The ACT and South Australia had the highest proportion of registered medical specialists, while the NT and Western Australia had the fewest.
With increasing pressure on hospitals to treat acute and chronic conditions, professor Melinda Craike said the government needs to create an accessible healthcare system for all Australians, and shift the focus to disease prevention.
"A third of chronic disease is preventable - yet less than 1.3 per cent of our healthcare budget focuses on disease prevention," she said.
"There is increasing pressure on our hospitals to treat acute and chronic conditions which could have been managed and treated in the community before they escalated to an emergency."
Almost 50,000 more Australians on lower incomes die each year from chronic diseases - such as diabetes, heart disease and cancer - before the age of 75, compared to those on higher incomes.
"Australia prides itself for having a healthcare system for all, believing that people don't end up with poor health or early death because they can't afford healthcare, but this report clearly shows our system is failing to provide this, benefiting the wealthy and it is overdue for reform."
While the public system might be well equipped to respond to trauma and acute conditions in emergency departments, the researches say it is failing to respond to the high rates of chronic illness which now affect one in two Australians.
"At the moment clinicians are paid to treat the disease. We need a system where they are paid to treat the whole patient which can include preventing illness in those that have risk factors such as obesity, poor diet or limited exercise.
"Medicare funding should provide for multidisciplinary and continuing treatment for people with chronic conditions."
But there are simple solutions which could be implemented quickly to address the problem, professor Craike said.
"We need a large investment in telehealth to allow rural and regional patients to speak to specialists without needing to travel," she said.
"It needs to be a national systematic program not implemented in an ad-hoc way which is the case at the moment.
"Medicare provider numbers could be allocated by location encouraging specialists, particularly graduates, to work in rural Australia rather than capital cities."
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