\u2018At a tipping point\u2019<\/p>\n
Dr Elizabeth Deveny, the chief executive of the Consumer Health<\/a> Forum (CHF), says the affordability of specialist care is a \u201clive issue\u201d.<\/p>\n \u201cThe feedback we get from Australians shows that we\u2019re really at a tipping point,\u201d Deveny says.<\/p>\n \u201cYou shouldn\u2019t have to win the lottery just to see a specialist for care. Knowing the fee isn\u2019t enough when you can\u2019t afford the service.\u201d<\/p>\n She says while specialists who bulk bill should be commended, action was needed against those charging high out-of-pocket costs.<\/p>\n \u201cWhen some fees climb much faster than inflation, and people go without care, we can\u2019t keep pretending it\u2019s all just \u2018business costs\u2019,\u201d she says.<\/p>\n Chart showing how out-of-pocket costs for specialists have increased faster than other services.<\/a><\/p>\n A CHF survey of 5,000 Australians showed that only 32% of people felt confident they could afford necessary care if they became seriously ill. About half (49%) reported they hadn\u2019t accessed the healthcare they needed at least once in the last year.<\/p>\n Cost and supply are intertwined too, according to Deveny. Since the Covid-19 pandemic began, she says, many doctors are working fewer hours and some are charging more money for their appointments.<\/p>\n In some parts of the country, specialist scarcity has been linked to higher prices.<\/p>\n Sign up: AU Breaking News email<\/a><\/p>\n Associate Prof Kudzai Kanhutu, the dean of the Royal Australasian College of Physicians, says there are \u201cbig care deserts\u201d because there is no national coordination of specialist training to ensure a pipeline of doctors where they are needed.<\/p>\n A Grattan Institute report published in June<\/a> affirmed a lack of training positions.<\/p>\n In Western Australia and in rural and regional parts of the country, people consistently struggle to access specialists \u2013 particularly paediatricians \u2013 due to a rise in neurodevelopmental diagnoses, Kanhutu says.<\/p>\n The blame game<\/p>\n Associate Prof Julian Rait, the vice-president of the Australian Medical Association, says the escalation in out-of-pocket costs has been driven by rising overheads, including wages, utilities and insurance fees. He says these costs are also affecting the public system.<\/p>\n \u201cWhere the system is broken down, I believe, is that the public system, which is supposed to provide that safety net, is not functioning that well any more and can\u2019t cope with the amount of demand,\u201d Rait says.<\/p>\n It really erodes trust \u2013 like what\u2019s happening here \u2013 are people rorting or gaming my health? Elizabeth Deveny, Consumer Health Forum<\/p>\n That demand then flows back into the private system, he says, meaning patients need to find ways to afford<\/a> private fees.<\/p>\n The most under-supplied specialties \u2013 including dermatology, obstetrics and gynaecology, and ophthalmology \u2013 have more applicants for vocational training each year than positions available, according to the Grattan report.<\/p>\n A chart showing the price range for medical specialists. <\/a><\/p>\n The training places at hospitals are funded by state governments and accredited by specialist colleges, according to Prof Anthony Scott, from Monash University\u2019s Centre for Health Economics.<\/p>\n \u201cSo they tend to blame each other for the lack of training places, because public hospital budgets are fixed,\u201d Scott says.<\/p>\n Tenfold price differences<\/p>\n Consultation fees charged by specialists have been increasing by 5% to 6% a year, which is faster than inflation and population growth while adding to cost-of-living pressures, Scott says.<\/p>\n The average out-of-pocket costs for specialist attendances have grown by 73%, in real terms, since 2010. According to the Grattan report, this rise is larger than for other Medicare services.<\/p>\n The report recommended that the federal government withdraw all Medicare funding from specialists who charge extreme fees, which they defined as being more than three times the schedule fee.<\/p>\n Deveny says consumers are reporting \u201ctenfold price differences for the same things\u201d.<\/p>\n \u201cIt really erodes trust \u2013 like what\u2019s happening here \u2013 are people rorting or gaming my health? Or \u2026 if I\u2019m getting the cheapest one, am I missing out on something important?\u201d<\/p>\n Scott\u2019s research examined the argument from doctors that they need to charge more to account for the increasing complexity of patients\u2019 conditions. \u201cWe found that only really accounts for about 7% to 8% for variation in fees.\u201d<\/p>\n In general, Scott says, doctors will charge richer people more and poorer people less.<\/p>\n Increasing Medicare rebates might not be a magic bullet. Evidence shows doctors will increase their fees along with any increase in benefits from the government, the Grattan report found.<\/p>\n Dr Nick Coatsworth, Patients Australia\u2019s ambassador for health reform, says there\u2019s a \u201ctriple whammy that is being put on Australians\u201d.<\/p>\n \u201cYou pay your Medicare levy through your working life, effectively forced through tax policy to have private health insurance from age 30, and now you\u2019ve got out-of-pocket costs skyrocketing,\u201d he says.<\/p>\n When it comes to fees for procedures, Coatsworth says the growing gaps are \u201cbasically eroding the value of private health insurance\u201d.<\/p>\n Price transparency is lacking<\/p>\n Many experts consistently refer to the lack of publicly available information around what fees specialists are charging, pointing to the failure of the much-derided Medical Costs Finder website<\/a> to provide that service.<\/p>\n Deveny says there is little transparency around how fees are set, so there is no way for patients to understand whether they are paying for better care.<\/p>\n![\"Pocock](\"https:\/\/www.newsbeep.com\/uk\/wp-content\/uploads\/2025\/11\/1633.jpg\")
Pocock baffled to learn only 20 doctors listing fees on $24m cost comparison website \u2013 video <\/p>\n