Our Healthcare System Is Rigged for the Privileged
And No, the Government Doesn’t Care
This may be a longer read than usual, but it’s an important subject—one that will increasingly affect our healthcare system if stronger advocacy from the public doesn’t emerge. While this article draws from my experience in physiotherapy, the issues cross professions.
NDIS Cuts Are Hurting the People It Was Meant to Help
You may have seen recent news about the National Disability Insurance Scheme (NDIS) pricing review. For the first time in my 18 years as a physiotherapist, the government has cut billable rates to several allied health professions. We’ve seen freezes before—but never a reduction.
This is yet another chapter in the long story of government undervaluing allied health and relying on the goodwill of healthcare providers to continue delivering care.
Our business has no major financial stake in NDIS physiotherapy—less than 1% of our services fall under this stream. But we care about equitable access to good care.
On a personal level, I do have a stake in the NDIS. I’m a plan nominee for a family member with a degenerative condition, and we’ve had to take the NDIA all the way to the Administrative Appeals Tribunal (AAT) to fight for just $1,500 in funding that is critical to the management of their condition.
The legal battle left me thinking “If two people (my wife and I) with four university health degrees between them have to fight this hard for something critical and can barely understand the system, what chance does the average family have who may have no health-based knowledge at all?
Yes, there are success stories within the NDIS. But it still fails to deliver a system that treats people as individuals and maximises appropriate use of funding. Waste exists—but it’s not in the hourly rates of therapists or coordinators.
For example, in our case, the NDIA eventually paid the $1,500, gave additional funding, and covered our legal costs, extra reports, and their own representation. That’s the definition of waste.
Despite a 20.5% increase in the Consumer Price Index (CPI) over the past five years, NDIS physiotherapy rates have been frozen. That represents a real-world cut in hourly value—and now rates have actually dropped.
Executives at the NDIA aren’t suffering a 20% real loss in income. Healthcare providers are expected to shoulder that burden—out of professional obligation.
Veterans, People with Chronic Illness, and those with Disability: All Undervalued by Policy
The undervaluation of healthcare work isn’t unique to the NDIS.
In 2013, the rate for treating veterans under Department of Veterans’ Affairs (DVA) was $63.30. In 2024, it’s just $73.30—a 15% increase over 11 years, while CPI rose by 38.7%. There’s barely any variation in rate for home visits or initial consults, and administrative costs are rarely accounted for. This is despirte recommendation of changes following the Royal Commission into Veterans Suicide.
Medicare’s Chronic Disease Management (CDM) Plan fares no better. It offers $70.95 for a 20-minute consultation, which hasn’t kept pace with inflation for years. Worse still, the five sessions it offers per year are meant to be shared across providers—for example some patients only get 2 sessions of physiotherapy per year. That’s $140 total.
Practices are forced to either bulk bill and lose money, or charge gap fees many vulnerable patients can’t afford. Unsurprisingly, many patients stop engaging with the plan entirely.
Government Excuses Don’t Reflect Reality on the Ground
Government often defends low funding by saying fees are calculated for 20-minute consults—implying a decent hourly rate.
But healthcare has evolved. Most allied health practices now offer minimum 30-minute consults, with longer initial sessions. This slashes the hourly rate and increases the out-of-pocket gap.
That forces practitioners and owners into uncomfortable decisions:
- Reduce consult times
- Charge significant gap fees
- Decline to take CDM or DVA clients
None of these feel right when your priority is patient care.
Years ago, we increased our standard consults to 30 minutes at the request of our practitioners—who wanted to deliver better care, not just faster care. We didn’t raise prices significantly, and yes, it affected our profitability. But would you rather see a clinician rushed and burnt out, or one working in a system that allows them to care properly?
Current government funding models do not reward high-quality healthcare.
Women Bear the Brunt of a Broken Health Funding System
Here’s another truth that gets little attention: most healthcare workers are women.
Prime Minister Albanese and ministers like Katy Gallagher often speak proudly of lifting wages and supporting women’s workforce participation. But in 2024, the Fair Work Commission found that the Allied Health Award suppresses wages, disproportionately affecting women and recommended large increases to the award.
NDIS, CDM, and DVA underfunding hits female clinicians hardest—particularly those working in disability and chronic health care sectors.
Is It About Money? Or Something Worse?
One might think this is just about cost-cutting—but it’s more likely about lobby power.
Private health insurers push for above-CPI increases every year. Yet your extras cover hasn’t improved. Many insurers spend less and less on actual healthcare, funnelling more into admin and profit margins.
These funds also negotiate preferential rates with hospitals and pressure clinics to accept contracts below market value, often under the guise of “guaranteed referrals.”
This is a system that prioritises profit and control, not care.
This Impacts All of Us—Here’s What You Can Do
It’s time to speak up. It’s more than just being about the NDIS. In fact there are actually aspects of the NDIS that are far more favourable to practices and clinicians than some of these other schemes. The reality is that it is all underfunded and is leading to growing inequity in our country.
Below is a petition focused on the recent NDIS physiotherapy rate cuts, but this issue goes far beyond one profession or one funding stream.
📢 If you believe Australians deserve fair and equitable healthcare access, contact your local MP. Sign the petition. Share this article. Use your voice.
This is a systemic problem—and it’s not going away without pressure from both healthcare workers and the public.