Australia & New Zealand

Health funds welcome plan to reveal thousands of specialist doctors’ fees for the first time

About 11,000 specialist doctors will be obliged to publish their fees on the Government’s Medical Costs Finder website in a big win for consumers.

After a long running campaign by health funds and patient groups, Health Minister Mark Butler has announced the Government will compel doctors – including surgeons and anaesthetists – to disclose their fees so consumers and their GPs have more transparency about how much specialists charge before they attend appointments.

Since the former Government launched the Medical Costs Finder in 2019, which has cost more than $24 million, fewer than 100 doctors have voluntarily published their fees on the website.

“This is a massive win for consumers who have been crying out for more information and competition between specialist doctors, so they don’t get hit by unexpected fees,” said Dr Rachel David, CEO of Private Healthcare Australia, which represents health funds.

“While most doctors charge appropriately, we know an increasing number of Australians have been charged exorbitant fees by specialist doctors, including more than $950 for first appointments with psychiatrists.

“Some anaesthetists have also allegedly waited until the day of procedures to disclose their fees, leaving patients powerless to contest how much they were being charged out of fear of procedures being cancelled. We need to stamp out this sort of price gouging, especially during a cost-of-living crisis.”

Dr David said in some regions with fewer doctors, such as the ACT, medical out-of-pocket costs had risen dramatically in recent years. Armed with better information about affordable specialists’ fees, consumers would be able to make more informed choices about where they received medical treatment.

“Transparency is the first step. We need more visibility of doctors’ fees so consumers know exactly how much they will be charged and can shop around. We hope all politicians will commit to this policy to ensure it proceeds regardless of the federal election result in May.”

“Paying more for a medical specialist in Australia does not guarantee better treatment or a better health outcome. The standard of training for Australian medical specialists is very high, and to meet that standard, the great majority are providing the best of care regardless of what they charge.”

Factors contributing to medical specialist charges include whether they practice in a high-income area, an area where there are fewer specialists and less competition, or decisions have been made by doctors to work fewer hours and charge more. There is no correlation between high charging doctors and better quality, Dr David said.

Last week a survey of more than 5000 people by Patients Australia and Latrobe University revealed one in five Australians were not attending appointments with specialist doctors such as paediatricians, cardiologists and surgeons due to concerns about the cost. Data released last year by the Australian Bureau of Statistics also showed an increasing number of people were putting off seeing specialist doctors due to cost.

Under Australian law, health insurers are not allowed to cover specialist doctor consultations if they do not occur during a hospital admission. But doctors can charge whatever they like.

“While there is no relationship between how much a doctor charges and their quality of service, some people have reported bills exceeding $10,000 for common operations such as prostate removal surgery. I want people to know that you do not need to pay that much to get a high-quality procedure in the private hospital system,” she said.

Dr David said people skipping or delaying treatment due to cost was also contributing to financial problems for some private hospitals that had empty beds.

Minister Butler has said the upgraded Medical Costs Finder website would include information showing the financial arrangements private health insurers have with specialist doctors and how often patients paid out-of-pocket fees for services not fully covered under their insurance policy.

Dr David said health funds would work with the Government to help consumers obtain reliable quotes before they proceeded with medical treatment in the private health system.

“Fifty-five per cent of Australians – 15 million people – are paying for private health insurance. These people are contributing to their own healthcare and taking pressure off our stressed public hospital system. They should be guaranteed protection from unanticipated medical costs,” she said.

“We hope today’s announcement is matched by the Opposition. Consumers deserve nothing less.”

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