Report criticises EMSN’s effectiveness

A report critical of the operation, effectiveness and implications of the Extended Medicare Safety Net (EMSN) has been released.

The report is a review by independent academic institution, the Centre for Health Economics Research and Evaluation at the University of Technology, Sydney, which examined the EMSN as required under the Health Legislation Amendment (Medicare) Act 2004.

The EMSN was designed to provide financial relief for those who incur high out-of-pocket costs and thereby make health care services more affordable.

High out-of-pocket costs are widely regarded as a barrier to health care, especially amongst poorer sections of the community, and are likely to lead to greater health inequities.

In Australia, people with high incomes are more likely to consult a specialist than those on low incomes. There is evidence that affordability (or lack thereof) is a key factor in explaining the use of specialist services.

The EMSN appears to have made services more affordable for some (people using assisted reproductive services, some patients with complex health conditions such as cancer), but has had little impact for those in more remote areas or in lower socioeconomic groups.

Despite the lower threshold for low and middle income households, the EMSN appears to be a relatively ineffective way to direct higher benefits to those households, with most EMSN benefits flowing to services that are more often used by wealthier sections of the community.

The EMSN is a poorly targeted policy because it has not addressed one of the main barriers to access that many patients on low incomes face. A copy of the report can be accessed from http://www.health.gov.au/emsnreview