Has your medical bills risen over the years? Report targets medical professionals engaging in price gouging
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Healthcare is something that has to be accessible to everyone, especially seniors who have to manage conditions brought on by age.
If you have opened a bill from a specialist recently and felt your jaw hit the floor, you're not alone.
A research institute's findings painted a worrying picture of specialist care in Australia.
A new report from the Grattan Institute revealed that more than one in five Australians who visited a specialist in 2023 were hit with 'extreme' fees.
These fees were even three times more than what's indicated in the official Medicare schedule.
With these findings, there has been a call for naming, shaming, and even stripping federal funding from doctors who charge sky-high prices.
According to the report, access to specialist services has become a 'postcode lottery'.
It means that if a patient lives in a wealthier area, they are likely to receive 25 per cent more specialist services than those in less affluent communities.
This 'lottery' could affect rural and regional communities despite having greater health needs.
This means that where you live can have a significant impact on the quality and timeliness of your healthcare.
Many Australians only have two options: pay exorbitant out-of-pocket fees for a private specialist, or join the ever-growing queue for public clinics.
Public hospital outpatient clinics only provide about a third of all specialist care, which could force most Australians to go to private specialists who charge whatever price they like.
The report found that the average out-of-pocket cost for an initial consultation with an 'extreme-fee' psychiatrist could go up to $671.
For an endocrinologist, it was $372, meanwhile, a consultation with a cardiologist could cost up to $369.
Even general medicine specialists charged an average of $292 for a first visit if they were in the extreme-fee category.
These prices only cover initial consults.
Follow-up appointments, tests, and procedures could add thousands more to the patient's bill.
The Grattan Institute's health program director, Peter Breadon, stated that the system is 'pretty much broken' and has been on autopilot.
Out-of-pocket costs have soared by nearly 75 per cent since 2010.
While only four per cent of specialists were caught charging these extreme fees, the impact of their practice continues to grow.
One of the key issues is that the Medicare rebate has not kept up with inflation or the rising cost of providing care.
This could force patients to cover the ever-widening price gap.
The consequences of this broken system are not just financial—they can be life-changing.
Take the story of Angus Witherby, a regional NSW resident diagnosed with prostate cancer in 2022.
Witherby had to wait six months to see a private specialist in Sydney, then another two months for surgery.
By the time he was treated, the cancer had spread beyond his prostate, making the operation more complex and increasing his risk of recurrence.
Angus had spent about $1,500 on initial consultations and tests, with only a few hundred dollars reimbursed by Medicare.
He then faced a choice between paying $5,000 out-of-pocket for surgery or paying his tax bill.
'If I didn't have the operation, well, the ATO wasn't getting any money. I wasn't going to be here,' Angus said.
The Grattan Institute has called for strict measures against specialists who charge extreme fees, including shaming doctors who overcharge, boosting funding to public specialist clinics, and increasing the number of training places for new specialists.
Another medical body, the Australian Medical Association (AMA), agreed that out-of-pocket costs are a problem.
However, the AMA also pointed to a range of contributing factors, such as workforce shortages, underfunded public clinics, and stagnant Medicare rebates.
'The AMA has never supported egregious fee setting, but what we do support is that balance of public and private care that makes Australia's healthcare system so unique,' AMA president Dr Danielle McMullen stated.
Health Minister Mark Butler acknowledged the issue and highlighted recent government efforts to increase transparency around specialist fees and grow the specialist workforce.
'All Australians deserve access to affordable healthcare,' Minister Butler said.
Have you ever paid a specialist fee so high that it stressed you out? Have you had to delay or skip care because of the cost? Do you think shaming overcharging doctors is the answer, or is there a better way to fix the system? We would love to hear your stories and opinions in the comments below.
READ MORE: Proposed Medicare reforms spark discussions online. Can these proposals help Aussie seniors' healthcare concerns?
If you have opened a bill from a specialist recently and felt your jaw hit the floor, you're not alone.
A research institute's findings painted a worrying picture of specialist care in Australia.
A new report from the Grattan Institute revealed that more than one in five Australians who visited a specialist in 2023 were hit with 'extreme' fees.
These fees were even three times more than what's indicated in the official Medicare schedule.
With these findings, there has been a call for naming, shaming, and even stripping federal funding from doctors who charge sky-high prices.
Many Australians have delayed essential check-ups over rising costs. Image Credit: Pexels/Kampus Production
According to the report, access to specialist services has become a 'postcode lottery'.
It means that if a patient lives in a wealthier area, they are likely to receive 25 per cent more specialist services than those in less affluent communities.
This 'lottery' could affect rural and regional communities despite having greater health needs.
This means that where you live can have a significant impact on the quality and timeliness of your healthcare.
Many Australians only have two options: pay exorbitant out-of-pocket fees for a private specialist, or join the ever-growing queue for public clinics.
Public hospital outpatient clinics only provide about a third of all specialist care, which could force most Australians to go to private specialists who charge whatever price they like.
The report found that the average out-of-pocket cost for an initial consultation with an 'extreme-fee' psychiatrist could go up to $671.
For an endocrinologist, it was $372, meanwhile, a consultation with a cardiologist could cost up to $369.
Even general medicine specialists charged an average of $292 for a first visit if they were in the extreme-fee category.
These prices only cover initial consults.
Follow-up appointments, tests, and procedures could add thousands more to the patient's bill.
The Grattan Institute's health program director, Peter Breadon, stated that the system is 'pretty much broken' and has been on autopilot.
Out-of-pocket costs have soared by nearly 75 per cent since 2010.
While only four per cent of specialists were caught charging these extreme fees, the impact of their practice continues to grow.
One of the key issues is that the Medicare rebate has not kept up with inflation or the rising cost of providing care.
This could force patients to cover the ever-widening price gap.
The consequences of this broken system are not just financial—they can be life-changing.
Take the story of Angus Witherby, a regional NSW resident diagnosed with prostate cancer in 2022.
Witherby had to wait six months to see a private specialist in Sydney, then another two months for surgery.
By the time he was treated, the cancer had spread beyond his prostate, making the operation more complex and increasing his risk of recurrence.
Angus had spent about $1,500 on initial consultations and tests, with only a few hundred dollars reimbursed by Medicare.
He then faced a choice between paying $5,000 out-of-pocket for surgery or paying his tax bill.
'If I didn't have the operation, well, the ATO wasn't getting any money. I wasn't going to be here,' Angus said.
The Grattan Institute has called for strict measures against specialists who charge extreme fees, including shaming doctors who overcharge, boosting funding to public specialist clinics, and increasing the number of training places for new specialists.
Another medical body, the Australian Medical Association (AMA), agreed that out-of-pocket costs are a problem.
However, the AMA also pointed to a range of contributing factors, such as workforce shortages, underfunded public clinics, and stagnant Medicare rebates.
'The AMA has never supported egregious fee setting, but what we do support is that balance of public and private care that makes Australia's healthcare system so unique,' AMA president Dr Danielle McMullen stated.
Health Minister Mark Butler acknowledged the issue and highlighted recent government efforts to increase transparency around specialist fees and grow the specialist workforce.
'All Australians deserve access to affordable healthcare,' Minister Butler said.
READ MORE: Proposed Medicare reforms spark discussions online. Can these proposals help Aussie seniors' healthcare concerns?
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l receive letter with appointment dates etc and please bring $500 with you . The scan takes all of 10 minutes . Than I have appointment with heart specialist 15 minutes another $ 495 then about week later I have to see another specialist to make sure my pacemaker is set and working properly and how many years life I have in the battery $495 .Medicare paid a lot less than half the total . That was 12 months ago . Think pacemaker will need to kick in when I open letter this time .
