An exploration of the inverse care law and market forces in Australian primary health care
Elizabeth Harris A and Mark F. Harris A *
+ Author Affiliations
- Author Affiliations
A Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia.
* Correspondence to: M.F.Harris@unsw.edu.au
Australian Journal of Primary Health 29(2) 137-141 https://doi.org/10.1071/PY22160
Submitted: 27 July 2022 Accepted: 1 November 2022 Published: 21 November 2022
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
This paper examines the implications of the second sentence in Tudor Harts statement about inverse care – that its operation was strongest when exposed to market forces. In the Australian context, we briefly review some available evidence for inverse care in three groups – Aboriginal and Torres Strait Islander people and those living in remote and socioeconomically disadvantaged areas. We then discuss the extent to which these examples can be attributed to the operation of supply-and-demand within Australia’s hybrid fee-for-service system in general practice. Our analysis suggests disparities in workforce supply and the ability of disadvantaged groups to seek preventive and proactive care are critical factors. These, in turn, suggest the need to fund general practice to be responsible for proactive and preventive care of disadvantaged population groups alongside broader structural reforms in workforce, education and taxation.
Keywords: accessibility, equity, health services, healthcare reform, indigenous, market forces, primary care, rural and remote, socio-economic disadvantage, workforce.
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