The provision of health care in Australia is primarily the responsibility of state and territory governments, subsidised through federal funding. Access to health care is facilitated through subsidised health insurance and a universal health care scheme, ‘Medicare’. The Pharmaceutical Benefits Scheme subsidises payments for 80 percent of prescription medications506and community based services often provide services for mental health, drug and alcohol use and family planning.
However, services provided free through the public health system are often underfunded, under resourced and overprescribed, resulting in long waiting lists. People with disability in Australia “carry a huge burden of undiagnosed or poorly managed health problems”.507 For people with intellectual disability, 42 percent of medical conditions go undiagnosed and life expectancy is much lower.508 The poor health of people with disability is due to a number of factors, such as the cost of health care, barriers to health services, communication difficulties, the complexity of health problems, a lack of multidisciplinary focus and specialist skill in the health care system and a lack of research into the health needs of people with disability.509
Health service providers are prevented from discriminating against someone on the grounds of their disability by refusing to provide a service, altering the terms and conditions of provision of the service or providing the service in a different manner.510 However, the Disability Discrimination Act 1992 (Cth) (DDA) has an exemption for insurance companies who may discriminate on the basis of disability so long as the discrimination is “reasonable”.511 People with disability are often therefore unable to obtain life insurance, income protection or disability protection insurance.512
Consequently, a number of factors result in people with disability being unable to afford the services they need. For example, not all private or allied health services are covered by Medicare. Specifically, dental examinations and treatment, therapy (including occupational, speech, and physiotherapy), psychology and the cost of prosthesis are generally not included.513 Dental disease is up to seven times more frequent amongst people with intellectual disability than in the general population and dental care is often unaffordable for people on a disability pension.514
