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Photo: Peter Braig

It was only through unyielding personal determination - and the help of a supportive partner - that Stedman Watts did not spend Christmas Day in hospital as he recovered from a hip replacement.

Stedman Watts, 36, is a stay-at-home dad. He and Katy Mutton have two children, Louis, 4, and Sophie, nearly 2.

Stedman grew up in Mildura and remembers, even as early as kindergarten, that he always found it difficult to sit cross-legged on the floor while the teacher read aloud from a book.

He also remembers being a very active child - he wasn't very good at it, but had a go anyway. ''I realised I couldn't run like other kids … but I played sport all the way through.''

He also remembers 10 years of being told to stop complaining about his pain. To just stop. That there was nothing wrong with him that any doctors could find. From the age of eight to the age of 20, he was told he had growing pains.

Then he left Mildura to study in Melbourne. Like all country kids, he had to work to support himself - they don't have the luxury of living at home while getting a tertiary education. He did long hospitality shifts.

One day, he was in so much pain he thought he'd visit a local Melbourne GP - maybe there would be different answers in the city.

That GP insisted on X-rays, the first ones Watts had had. And those who looked at the X-rays asked the young patient if he'd ever been in a car accident or had major leg trauma. Although he is more than 180cm tall, the doctors said his bone growth had been retarded. His major weight-bearing joints had worn away to nothingness - all on the watch of the overstretched rural health services.

By the time he had this diagnosis, he'd been living in pain for most of his 20 years - and then the doctors suggested he try to manage the pain for as long as possible because hip replacements themselves need replacing.

He hung out until 30. He had one hip done in a private hospital in Canberra with a gap of nearly $10,000 and the other done in a public hospital, also in Canberra.

Katy and Stedman had this romantic idea of moving back to Mildura to bring up the kids. As Stedman puts it, despite his pains, ''I adored my childhood.''

It worked well at first. Then last year, he began to get numbness in his limbs and he was losing his ability to grasp things. The family returned to Canberra to the news that both the replacement hips were faulty and were leaching metals into his bloodstream. The first was replaced at Canberra Hospital on December 20 and the other is scheduled for June.

Stedman is steadfast in his admiration of those who practise medicine in rural and regional areas, but the fact is there is no equality of access.

''There are some amazingly talented specialists who go into rural health,'' he says, ''but mostly the talent and the money and the accolades are all in the capital cities … In Mildura, I would have to wait for a specialist to fly over from Adelaide and they were always time-poor when they arrived.''

A few weeks ago, I wrote about a submission to the Commission of Audit. It suggested a co-payment of $6 for visits to GPs. There was a predictable response: those who say we are a nation of grasping malingerers who take their healthy children to the doctor just because it's free and that everyone who goes to the GP should be slugged with a co-payment to stop this behaviour; and the normal people who already recognise that Australians struggle with medical costs. There were some calls for private health insurers to start covering GP visits - or at least the gap.

Alan Castleman, chairman of the Australian Centre for Health Research, the think tank that sent the submission, recognises the flaws in our healthcare system: ''There is a great deal about it that isn't good … it's got to be balanced … we have a very good health system, but there is considerable scope for improvement,'' he says.

The way it looks from here, from my personal circumstances (our family has paid nearly $7000 in gaps to specialists in the past 12 months) and from those of the Watts-Mutton household, the balance is already in favour of those who have private health insurance - earlier appointments just so long as you can pay.

But the ultimate problem is that it also leaves us out of pocket. As Castleman concedes, the health funds have had limited success in capping the gap - the difference between what health funds pay and what your specialist actually charges.

Alison Verhoeven, chief executive of the Australian Healthcare & Hospitals Association, says there are proposed changes to the safety net that currently allows taxpayers to claim expenses over $2000.

''We actually think that is going to significantly disadvantage a large number of people and people with chronic illness will be particularly disadvantaged,'' she says.

And this is where we need to stop. We need to make sure that whatever the government decides to do to change our health services, it doesn't make any of us worse off.

Twitter @jennaprice or email jenna_p@bigpond.net.au