Healthcare system failing young Aussies: Three in four forced to change care due to cost

Three in four Australians (76%) are now changing their healthcare decisions due to financial pressures, with young adults and women most affected, according to the latest Australian Healthcare Index.

Over the past year, healthcare has remained at the forefront of national concern, shaped by rising cost-of-living pressures, debates over primary care access, and growing scrutiny of surgery wait times, workforce shortages, and affordability. Responses from more than 8,000 Australians provide a clear-eyed view of how people are navigating the health system.

The top three challenges cited by consumers are increasing out-of-pocket costs to see a GP or doctor (46%), high cost of private health insurance (43%), and long emergency department wait times (42%). Two fifths of respondents (38%) continue to question whether their private health insurance is money well spent, while only one in four (24%) would actively recommend it. Notably, while lack of affordability was the top reason for avoiding private cover in 2024, this year it fell to second place, overtaken by the perception that coverage offers poor value for money.

Young Australians are being hit hardest by rising healthcare costs, with 86% reporting that they have altered healthcare decisions due to financial pressures, significantly higher than older age groups at 52%, highlighting a generational divide. In response, young adults are increasingly turning to alternative payment solutions, using buy now, pay later services, medical payment plans, or dipping into superannuation funds long before retirement to manage costs.

Lisa Robins, CEO of Patients Australia, said “This year’s findings represent an unmistakable shift in behaviour. It’s simply not acceptable that people are delaying treatment or accessing their superannuation early to cover medical costs. For young people especially, this creates devastating long-term financial consequences. We need urgent action to ensure equitable access for all.”

Women are also disproportionately affected, delaying care across multiple areas including dental treatment, mental health support, diagnostic tests, and allied health services. These delays compound existing health risks and highlight persistent inequities in access to care.

Access to Medicines

More than one in three Australians have skipped or reduced prescription medications due to cost, an increase despite recent government reforms. Thirty-five percent (35%) of respondents reported going without or reducing medication in the past six months, reflecting a steady upward trend from 30% in 2024, 27% in June 2023, and 22% in September 2022. Among respondents, 10% went without medication for three or more weeks, 15% for up to three weeks, and another 10% reduced dosages intermittently.

Wait Times for Elective Surgery and Emergency Department

Emergency departments continue to absorb significant demand, yet only half of patients report satisfaction with their visit, whether in public or private hospitals.

Wait times for elective surgery remain a pressing concern. One in four respondents reported waiting more than a year for surgery, 15% waited six to twelve months, and 16% waited three to six months. Just over one fifth were admitted within one to three months, and only 21% received surgery in under a month.

Higher-priority patients are particularly affected. Among those needing Category 1 surgery, which should be treated within 30 days, more than half (53%) had waited longer than the recommended timeframe, up from 42% last year, with 14% waiting over a year. For Category 2 patients, 56% exceeded the recommended timeframe, with 23% waiting over a year. In Category 3, 24% waited longer than the 365-day benchmark.

Satisfaction with elective surgery continues to decline. Among patients who had surgery in the past six months, 79% reported being satisfied, down from 82% in 2024 and 88% in 2023. Satisfaction dropped across both public and private sectors, with 69% of public patients and 83% of private patients reporting a positive experience, representing declines of six and four points respectively. Reasons for dissatisfaction varied: long wait times were the most common concern for public patients, while private patients cited financial stress from out-of-pocket costs. In both groups, poor communication from the surgeon or surgical team was frequently mentioned.

Dan Stinton, CEO of Healthengine, said “This report shows that access to care is fragmenting in Australia. There is a substantial wealth divide, where those with the means receive the best quality of care in the world, while those on low incomes – typically women and young adults – are falling behind. This calls into question the foundations of our universal healthcare system.”

As Australia continues to recover from the fallout of the pandemic and grapples with growing health inequities, the report shines a light on the personal and systemic pressures patients face. These statistics serve as a call to action for policymakers, health leaders, and industry stakeholders to reimagine healthcare delivery in a rapidly changing social and economic landscape.

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