Speech by Jasmin Witham at Anti-Poverty Network SA’s Cost-Of-Living Community Meeting in Kilburn, on Saturday June 1, 2024.
My name is Jasmin, I’m a volunteer with APNSA, working mostly with the campaign’s team. Once upon a time I did a midwifery degree – then health issues meant I needed to change my career path; so now I am working towards a public health degree. I am here to talk a little about what health equity means, how that relates to policy, and ultimately, how government funding decisions are failing our community.
I’m going to start with – why is health equity one of my interests? And I think that’s best explained by posing some questions that keep plaguing me – so, why are there huge, systematic disparities in the health status of different groups of people? In a country as wealthy, and progressive as ours, why is it that there can be a characteristic about a person, or something about the conditions in which they live, and that characteristic means “this person is going to have worse health outcomes than they could have had.”
In Australia, our most recent data shows that people living in poverty were more prone to developing almost all medical issues, and to then experience a higher burden from those illnesses. They are also more likely to die from these illnesses, and the average life expectancy for a person living in the lowest socioeconomic group is four to five years lower than those living in the highest.
And if everybody deserves to have the best health that’s possible for them, what could the government do to make that so? Governments are aware of the social determinants of health – that is, those characteristics that make outcomes unequal, some of the biggest of these being: socioeconomic status, geographic location, or belonging to a marginalised group.
Here, I’m going to focus on socioeconomic status and access to services, but need to point out that all these things interact with each other, and all could be addressed through changes to policy, funding, and our socio/cultural norms.
I think a few people here have probably heard me say this before, but I will keep repeating it until it’s no longer the case – poverty causes poor health, and poor health causes poverty. I’ll take a guess that every single person listening today knows of somebody, maybe themselves, that hasn’t been able to go to a doctor when they needed it because they couldn’t afford it.
We know that when you’re poor you have to make decisions about whether it’s more important to pay for your housing, your bills, your food, or your medicine. You don’t buy nutritious food, because groceries are too expensive. You don’t have a gym membership, because how on earth would you afford it? You have to scrimp and save to see a GP or specialist. And some types of healthcare, equally important but not adequately funded by government, like dental or physiotherapy or psychology, they’re just completely out of reach when you’re living on such a low income.
One solution would be to increase incomes, including social security benefits, to a rate that allows them to afford things like healthy housing or nutritious food, and to then just pay the out-of-pocket costs associated with healthcare. Government could raise the rate, but we didn’t see that in the budget.
A lot of groups are calling for changes to the Medicare Benefits Schedule – to see increases to the rebates, so that GPs, specialists, and other practitioners, are encouraged to bulk bill and make it more affordable for the consumer. There are also calls to include more services, like dental, and allied health care.
There are also calls to improve access to health services by increasing hospital beds, having more urgent care centres, and addressing workforce shortages especially in regional and remote areas. There has been some action in this area through the budget this year, but it’s a very complex issue, and probably beyond the scope of this little talk.
Another idea, is that targeted programs for specific population groups could receive more funding. We did see some of this in the current budget, with increased funding for Indigenous Health programs, for a new mental health online service, for school sports programs, and better access to HIV prevention, among a bunch of other things. Fingers crossed the programs are effective.
So yeah, in summary, government could:
• Improve the conditions in which we live – by getting everyone decent housing; and by increasing income levels, including welfare, so that nobody is living below the poverty line.
• They could make healthcare more affordable – by increasing Medicare rebates and expanding Medicare eligible services.
• They could address access barriers – by making sure services are physically available when and where they are needed, and by addressing workforce shortages
• They can implement (and fund) programs to address specific needs.
But, what can we do?
We can all keep calling on the government to make these changes. We can support advocacy groups and campaigns. We can contact politicians, share our stories, and demand action. We can give feedback to services, so that they know what our actual needs are, and how they can best meet them.
Please join me in the breakouts to discuss your solution ideas, and plan for how we can tackle the health system together.
Anti-Poverty Network SA 