It's another opportunity to consider how best we can ensure the ongoing sustainability of quality health care, aged care, education and social services in rural and remote communities throughout Australia.

The tax take needs to increase through limits on concessions and changes in the mix and rates of tax. But where the tax burden falls is one of the key determinants of equity and fairness. People who are vulnerable must be protected, and they include a disproportionate number of the people of rural and remote communities.

People who live in rural and remote Australia earn on average 15 per cent less than people in the major urban centres. They face higher costs for goods and services due to transport costs and limitations on supply.

More than 90 per cent of Australians do not eat sufficient fruit and vegetables to maintain good health. Poor diet contributes about eight per cent to the national burden of disease and the situation is slightly worse in rural areas.

The cost of healthy, nutritious food in rural and remote areas is 30 per cent higher than in the major urban centres. But bearing in mind the lower average incomes, the relative cost of healthy food is 50 per cent higher for rural and remote people than for their city cousins.

The NRHA will continue its work to make sure these particular characteristics of rural and remote areas are known and accounted for. The capacity and sustainability of health and aged care services are already threatened by fiscal circumstances.

Much of Australia's wealth is from the agricultural and mining sectors in rural and remote regions. Governments at all levels must invest in the health and wellbeing of these communities so they can continue to provide the bedrock on which our economy is based.

Such investment can only be made with public revenues. Taxation reform is vital but must be fair. It must reduce inequalities and provide the impetus to grow employment and business opportunities for rural and remote communities, as well as for the major centres.

Gordon Gregory, Chief executive, National Rural Health Alliance.