The latest report from the National Rural Health Alliance shows that the health expenditure gap between rural and urban Australians has widened by a further $880 million, from $6.55 billion in 2023, to $8.35 billion in 2025, and now $9.23 billion in 2026.
The latest findings in the Forgotten Health Spend: A Report on the Expenditure Deficit in Rural Australia 2026 call for urgent action from the federal and state governments to ensure health equity for the more than 7,4 million Australians living in rural, regional and remote Australia.
According to the report, each rural Australian is receiving, on average, $1,218 less in healthcare funding each year than city residents. This is up $138 from last year. Those living in small rural towns of 15,000 people or less, bear the greatest brunt of the systemic shortfall, receiving on average $6,368 less healthcare funding per person, per year.
‘We pay the same taxes and the same Medicare levy as people in the city. We just don’t get the same funding and access. When my husband Scott had a heart attack in Mildura, a town without a Cath lab, a medical evacuation was the only answer… but it was too late. This Australian system is just not equitable; we should not have to beg! The sad thing is, is that if he had a heart attack in the city, he would have lived,, and would have been there for our two beautiful children and me.’ Katrina Umback, Mildura VIC
Crisis
‘This is a health equity crisis. It’s appalling that the spending gap is widening each year, leaving millions of Australians further behind. Rural people are being let down by a universal health system that should support them when they need it most,’ said NRHA Chief Executive Susi Tegen.
‘Rural Australians keep the country’s economy running. They grow our food, power our industries and sustain communities. Yet, they have poorer health and die younger than city people. Despite governments knowing this, and solutions being provided, these communities do not receive the funding allocation and policy options they need to get care.
‘The figures demonstrate the consistent underprioritisation and underfunding of rural Australians and clinicians that support them, despite their vital contribution to the Australian economy across various sectors,’ said Ms Tegen.
‘This is no longer a health issue, but an economic and social issue. 70 per cent of Australia’s export income comes from rural communities, and 90 per cent of the food we eat, and 50 per cent of the tourism income, even though rural Australia only makes up 30 per cent of the population.’
Community support
The NRHA says communities are being left to pick up the slack where state and federal funding for rural health services and infrastructure falls short: communities that wish to expand services to surrounding areas must raise their own funds to expand and to maintain, essential services.
‘Community members are significantly contributing to Australia’s economic wellbeing, and are expected to travel long distances, go without care or raise up to $600,000 a year to keep clinics open and communities supported. This is not expected of urban communities,’ Susi Tegen said.
‘Even matching city spending dollar-for-dollar wouldn’t close the gap, because care costs more to deliver in the bush.’
The Forgotten Health Spend Report, produced in collaboration with Nous Group, calls for sustainable, long-term solutions that are tailored to rural Australia, including a holistic change to Medicare. ‘
Block and blended funding needs to be part of the solution for rural Australia. Bulk-billing alone is not sustainable long-term in these regions, as it is in the city, because of thin markets, leading to clinic closures and even further distances to necessary services,’ said Ms Tegen.
‘Communities have the solutions for rural training, supporting clinicians, housing and infrastructure, as well as models of service. They are not asking for much, as Australians they are only asking for equity and parity.’
