Publishing specialist fees on a national website is welcome—but patients need to know full costs of care

Monday, March 4, 2019

‘The Government’s proposed national website to provide Australians with transparency on specialists’ fees is very welcome, but patients need more information in advance on the potential full costs of specialist care’, says Australian Healthcare and Hospitals Association (AHHA) Acting Chief Executive Dr Linc Thurecht.

Dr Thurecht was commenting on a Government announcement following publication of the Ministerial Advisory Committee on Out‑of‑Pocket Costs report, released at the weekend.

‘Something has to be done to address exorbitant and/or unexpected out-of-pocket costs charged by some specialists, particularly, as identified by the Committee, in the management of pregnancy, assisted reproductive services, radiation oncology and intraocular injections.

‘Also, the Committee’s exposure of the charging of extra “booking” or “administrative” fees by some non-GP specialists to get around fixed gap or no-gap arrangements with health insurers is unconscionable.

‘Also unconscionable is the issue raised by some consumers that some specialists will charge a “first consultation” fee every time a GP referral is renewed when the consultation is for an ongoing condition.

‘This Medicare loophole must be closed because it results in additional cost to the taxpayer as well as possible extra out-of-pocket costs for the patient.

‘Regular dermatologist visits, surgery follow-ups, and ongoing care for cancer and other chronic diseases are all examples of where this practice could occur’, Dr Thurecht said.

While the report found evidence that specialist out-of-pocket costs net of private health insurance and Medicare benefits can be enough to make some patients need to take out a second mortgage or apply for early access to their superannuation, this is not the only area of potential bill shock.

‘More needs to be done to ensure patients know the potential full costs of all the unanticipated ‘extras’ —which can include a wide variety of diagnostic and other tests, and the costs of other healthcare team members such as anaesthetists, assistant surgeons and nurse practitioners.’

‘Also to be considered are the cumulative costs to patients undergoing treatment over an extended period with private medical specialists—for example for treatment of cancer or heart disease.

‘The Ministerial Advisory Committee on Out‑of‑Pocket Costs acknowledged in its report that medicine is complex, and it can be difficult to provide detailed costings ahead of the start of treatment—but consumers deserve to know the possible scale of out-of-pocket costs in advance’, Dr Thurecht said.

‘The Committee also acknowledged that informed financial consent has been done well by many medical specialists. However, this happens after the first consultation, by which time many patients feel “locked in” and are unwilling to get another opinion and fee estimate.’

More information about the AHHA is available at ahha.asn.au

The Ministerial Advisory Committee on Out‑of‑Pocket Costs report is available here.

The Australian Healthcare and Hospitals Association is the national peak body for public and not-for-profit hospitals, and community and primary healthcare services.

Media enquiries:  Dr Linc Thurecht, A/Chief Executive, AHHA

0401 383 729