Physician fees are a big burden, consumer survey finds


The cost of seeing a non-surgical specialist has emerged as one of the big worries facing Australian patients, according to a new survey by the Consumer Health Forum.

The survey of 1200 self-selected participants shows many patients face large gap costs, for example 38% of patients with autoimmune conditions and 26% of patients with cancer paid over $10,000 in out of pocket medical costs in the past two years.

In a report detailing the findings published this week the consumer peak body says many patients with and without health insurance “are facing harsh choices between long delays in treatment or exorbitant out-of-pocket costs”.

The cost of non-surgical specialists was singled out as a major concern, seen as a bigger issue that surgery because costs tend to be ongoing.

The concern was reported by 29% of the entire survey sample –  35% of those surveyed had incurred costs outside of hospital and 20.5% inside a hospital.

One NSW pensioner described being forced to sometimes skip the appointments she has scheduled with the three different specialists she is meant to see for ongoing treatment.

Each doctor charges between $320 and $360, of which Medicare refunds about $90.

Another participant commented on the challenge of finding ongoing care she could afford.

“You must pay for that initial consultation to get the information you need to decide whether or not you can afford further treatment. Then if you think the estimates to treat your condition are too high you would have even more large charges to get a second opinion from another specialist.”

The report cites past ABS data suggesting 45% of Australians who needed to see a specialist did not do so because of cost and warns “if we want to ensure that our hybrid public/private health system continues to meet Australians’ needs and deliver accessible quality healthcare then we need action by all parties otherwise we will move to a two-tier system where your income determines your health care.”

The cost of diagnostic imaging was the most frequently mentioned out-of-pocket cost, the report calling for the freeze on Medicare rebates for imaging to be lifted.

Unexpected costs associated with a single episode of care were also highlighted, with one participant describing an unexpected $2000 bill for anaesthetist fees, X-rays, ultrasounds and medication on top of the $4000 she had expected for a partial knee replacement.

Informed financial consent was also flagged, with more than a third of respondents reporting that no-one had discussed the possibility they would face significant out-of-pocket costs and had the right to shop around.

“The survey results graphically highlight a fundamental dilemma now besetting the public/private health system: Australians facing heavy medical bills are now shocked to find that the private insurance they have paid so much for over many years exposes them to yet more expense when they require treatment.”

The CHF recommends the Department of Health to work with health professionals to develop a process to deliver a single quote for any episode of treatment that includes all health professionals’ costs.

It also wants an independent website listing health professionals’ fees and a move to a system of unnamed referrals for doctors.

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