There is a gender gap that does not attract much attention and that is the one where males do worse on just about any health measurement. Life expectancy for a male born today is about two year less than that of a female. Cardiovascular disease, diabetes and various cancers including lung are more prevalent in males. Workplace injury and trauma are also far more common in males.
Some may say that this is in part related to choices men make and the tendency of men to present later and be less engaged with measures and advice to improve health. This has validity. However, men are far more likely to work in manual jobs where the risk of injury is greater.
There is no one solution to this issue and the life expectancy gap has narrowed slightly over the last decade. Generation Z males appear to be more focused on the importance of their physical and mental health than their forebears so perhaps we will see natural improvement over time. However, in the main, we are ignoring the current problem.
Step one may be to actually recognise that male health could do with improvement and that as doctors we are part of the solution.
Speaking of gaps AIHW data shows that people living in very remote areas used 8.5 services per person in 2022, with a subsidy rate of 85%, while people in major cities used 18.3 services with a subsidy rate of 76%. Nationally in April 2023 85.1% of GP fees (down from 95.2% at the Covid peak) and 53.5% of specialist fees were paid by Medicare. The latter down from a high of 88% in October 1984.
Step one may be to actually recognise that male health could do with improvement and that as doctors we are part of the solution.
Obstetric services were the “most expensive” with Medicare funding 38.3% (anaesthetics 38.6% surgery 49.1%) whilst pathology at 94.3% was the most covered (diagnostic imaging 85.6% GP 85.1%). Drill deeper and aside rural/metro divides there are significant differences across states with 69.4% cover in the ACT, 78.8% in Tasmania and 87.8% in NSW.
What does this data tell us? The overarching trend is a steady decline in the percentage of total medical costs covered by Medicare since its introduction. In my opinion this reflects that costs have gone up (e.g. inflation, new technologies) and government capacity to be the sole funder has declined.
Realistically, government cannot afford to pay all the health wants and needs of all. There will be gaps. The challenge is to be honest about it.