Despite the Aboriginal and Torres Strait Islander population being the youngest in the country, their burden of disease is more than double the national average, a Senate inquiry has been told.
Remote healthcare teams have built a leading model of care to meet that urgent need, National Aboriginal Community Controlled Health Organisation senior medical advisor Jason Agostino said.
But Medicare only covers about a quarter of the cost of that work because incentives largely focus on time with a GP, not a patient's needs, Dr Agostino said.
As a result, the clinics staffed by doctors, allied health workers, nurses and midwives receive around $900,000 less in Medicare and workforce incentives than a similar-sized standard GP clinic, he said.
"Fund the whole team, not just the doctor, and write the rules with us with a clear line of sight to closing the gap," Dr Agostino urged the inquiry at Parliament House in Canberra on Friday.
The organisations, which have a unique model designed and controlled by Indigenous communities, provide about three million episodes of care across the nation each year.
Many of the clinics rely on short-term funding, including one remote service that survives by cobbling together 100 grants, Dr Agostino said.
The organisations have called for needs-based block funding rather than a fee-for-service model..
The inquiry is examining access to Medicare in rural areas, hearing how patients outside the cities are inadvertently penalised for where they live.
Some farming communities rely on fundraising to keep their medical clinic running, or pay for it through council rates, National Rural Health Alliance policy advisor Margaret Deerain said.
The NSW Mudgee region has run a successful campaign to attract GPs by offering incentives funded by mining companies, while a clinic in WA's wheatbelt is propped up by six shire councils
"They've done it off their own bat," Ms Deerain said of the WA model.
"They're paying for it out of their own rates, which is not ... what they should be doing in local government, but there's nothing there to reimburse them and there's no magic solutions."
Stephen Gourley, Alice Springs Hospital's director of emergency medicine, said Medicare funding does not cover the higher transport costs of equipment, including things as simple as cannulas.
While Dr Gourley welcomed the government's roll-out of Medicare Urgent Care Clinics, he said they were not yet easing pressure on emergency rooms.
"What we in emergency departments find quite challenging is the opening hours of other services," he told the committee.
"The need is almost always after-hours, particularly around domestic violence or acute injuries."
The federal health department's submission to the inquiry said its approach to improving health care outside the cities was "system-wide, long-term and reform-focused".
"It recognises that primary care service delivery models operating in our cities may not be viable in some parts of regional, rural and remote Australia."
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