{"id":348405,"date":"2025-12-14T23:19:08","date_gmt":"2025-12-14T23:19:08","guid":{"rendered":"https:\/\/www.newsbeep.com\/au\/348405\/"},"modified":"2025-12-14T23:19:08","modified_gmt":"2025-12-14T23:19:08","slug":"australias-medical-specialist-fees-are-out-of-control-mark-butler-says-heres-why-and-how-to-fix-it-health","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/au\/348405\/","title":{"rendered":"Australia\u2019s medical specialist fees are \u2018out of control\u2019, Mark Butler says. Here\u2019s why, and how to fix it | Health"},"content":{"rendered":"

The health minister, Mark Butler<\/a>, says he is \u201cdetermined\u201d to make specialist fees his government\u2019s second-term priority.<\/p>\n

After a first term prioritising general practice bulk-billing rates<\/a>, Butler told ABC Melbourne<\/a> he will be focusing on the fees charged by non-GP specialists \u201cbecause they are, frankly – I don\u2019t use these words lightly – in some areas getting out of control\u201d.<\/p>\n

It comes after Guardian Australia\u2019s series<\/a> highlighted specialist care is a \u201csystem without guardrails\u201d<\/a>, with limited access to public hospital clinics pushing those who cannot afford it into the private system, where there is huge fee variation.<\/p>\n

In March<\/a>, Butler committed to more transparency on medical fees and this month has indicated the government will explore other options, including to \u201cpotentially control fees\u201d themselves.<\/p>\n

So why haven\u2019t governments regulated them in the past? And how could they fix specialist fees now?<\/p>\n

What has the government committed to doing?<\/p>\n

Butler has committed to publish individual specialists\u2019 average fees to allow patients to see what specialists in their area are charging and shop around.<\/p>\n

The government already has access to this information, but needs to pass a law in parliament to be able to make it public on the Medical Costs Finder website.<\/p>\n

The former Coalition government introduced the website in 2019 asking specialists to volunteer to display their fees, but only 70 did so.<\/p>\n

\u201cEveryone else is still keeping it secret. We\u2019re going to publish them for them,\u201d Butler says.<\/p>\n

But what about the fees themselves?<\/p>\n

Experts have pointed out that providing cost information alone isn\u2019t enough.<\/p>\n

The Grattan Institute recommends<\/a> the government also train more doctors, creating national targets to train specialists where they are most needed and tying funding to meeting those targets.<\/p>\n

They say the government also needs to rein in excessive fees (charged by less than 4% of specialists) by requiring them to repay the government the value of the Medicare rebate.<\/p>\n

Butler has said the government is \u201cgoing to look at \u2026 options to potentially control fees\u201d.<\/p>\n

Sign up: AU Breaking News email<\/a><\/p>\n

Earlier this year, he consulted with doctor\u2019s groups \u2013 including the peak medical body, the Australian Medical Association (AMA) \u2013 as well as patient groups.<\/p>\n

\u201cI said to them, from my point of view, all options were on the table,\u201d Butler said.<\/p>\n

However, he acknowledged a barrier to reform could be \u201crestrictions in the constitution on what we can do, what we can force doctors to do\u201d.<\/p>\n

Why haven\u2019t governments regulated them in the past?<\/p>\n

Luke Beck, a professor of constitutional law at Monash University, explains Butler is likely referring to Section 51(xxiiiA), which was added to the constitution through the 1946 Social Services Referendum<\/a>.<\/p>\n

\u201cThe provision is intended to allow the commonwealth to fund various social services schemes. Before then there were federal payments like unemployment benefits, child endowment and widow\u2019s pensions \u2013 but there was no proper constitutional basis for them,\u201d Beck says.<\/p>\n

\u201cThe new provision fixed that gap in constitutional power and is now the basis for things like Medicare, the Pharmaceutical Benefits Scheme and the various payments available through Centrelink.\u201d<\/p>\n

It includes the power to make laws providing for \u201cmedical and dental services (but not so as to authorise any form of civil conscription)\u201d.<\/p>\n

Prof Brendan Murphy, the former chief medical officer, says the intention was that the commonwealth government could not direct doctors to work in various parts of the country, but the power has been interpreted to include the regulation of fees.<\/p>\n

A paper published in the federal law review in 2023 found \u201csection 51(xxiiiA) probably does not inhibit politically feasible policy options to improve medical services in Australia\u201d.<\/p>\n

Beck says based on a 2009 case, \u201csetting conditions on specialists receiving Medicare payments would seem to be one mechanism available to the federal government to bring down specialist fees\u201d.<\/p>\n

How have doctor groups reacted?<\/p>\n

Assistant Prof Sanjay Jeganathan, the chair of the Council of Presidents of Medical Colleges \u2013 the umbrella body for the 16 specialist colleges \u2013 says they \u201centirely support\u201d improving patients\u2019 access to specialist care.<\/p>\n

\u201cBecause when people are suffering gaining access to seeing a specialist in a timely manner, and that is costing an arm and a leg for some patients, that is not acceptable. Every person in Australia should be able to access affordable, high-quality specialist care,\u201d Jeganathan says.<\/p>\n

Issues need to be addressed including fee transparency and the fact that \u201cin many parts of the country, there aren\u2019t any existing outpatient clinics in public hospitals<\/a>\u201d.<\/p>\n

Dr Danielle McMullen, the president of the AMA, said \u201cblaming doctors for decades of Medicare neglect and hospital underfunding isn\u2019t the answer\u201d.<\/p>\n

While the AMA does not support \u201cegregious\u201d billing, McMullen said Australians should be asking why Medicare rebates are not keeping pace with cost of care and hospitals are failing to provide adequate outpatient services.<\/p>\n","protected":false},"excerpt":{"rendered":"The health minister, Mark Butler, says he is \u201cdetermined\u201d to make specialist fees his government\u2019s second-term priority. After…\n","protected":false},"author":2,"featured_media":348406,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[64,63,137,500],"class_list":{"0":"post-348405","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-au","9":"tag-australia","10":"tag-health","11":"tag-healthcare"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/348405","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=348405"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/348405\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/348406"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=348405"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=348405"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=348405"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}