Delivering health services to rural and remote Australia is bound to cost more and households face particular challenges in meeting the out-of-pocket costs relating to health care. This submission draws a distinction between the absolute level of out-of-pocket costs and their impact on particular families. People in regional areas pay more in standard, measured out-of-pocket costs than those in the Major cities, not taking travel and other costs into account. The absolute costs are kept at relatively low levels by poor access to health professionals and services. The impact of a given level of out-of-pocket costs depends in large part on the financial situation in which a particular household finds itself.