Specialists who charge too much should be called out and stripped of federal funding according to a new report, which reveals almost two million Aussies are delaying — or straight up skipping — specialist care because of the hefty price tag.
The new report by the Grattan Institute, published on Monday, finds specialist healthcare is pretty out of reach for most people. Patients are waiting months, or years in some cases, for an appointment, while some private specialist doctors charge two to three times more than the rate Medicare sets for the services.
On average, if you need specialist care, you’re looking at coughing up around $300 out-of-pocket each year — and those out-of-pocket costs have soared by almost 75 per cent since 2010. So yeah, it’s not just in your head, because healthcare’s really getting less affordable.
Speaking to ABC News, the Grattan Institute’s health program director Peter Breadon said the whole system is “pretty much broken” and has been “left on autopilot”.
“In Australia, far too many patients are left with a really difficult choice when they get a referral for a specialist doctor visit,” he said.
“They’ve either got to front up for really high out-of-pocket fees in a private clinic or wait months or sometimes even years longer than recommended in a public clinic.”
Two-thirds of specialist care comes from private practices, who are free to charge what they like. While Medicare helps cover part of the cost, the gap between that and what doctors actually charge can be significant, with patients having to pick up this difference.
Psychiatry topped the list of high-fee specialists, with Aussies shelling out up to $671 in average out-of-pocket costs for an initial consult to meet a psychiatrist charging “extreme” fees, per the report.
Other pricey specialties included endocrinology, cardiology, and paediatrics, which charged over $360 for an initial consult with an extreme-fee-charging specialist.
Breadon noted just about four per cent of specialists charge these extreme fees. But, more should be done to pull them up for this.
He argued these specialists should be named and called out, and the government should even withdraw Medicare rebates from them.
“We think those fees are far too high. There’s no justification for them. There’s no evidence that the doctors charging extreme fees are providing better care,” he told ABC News.
“That’s why we’ve said the government should claw back the government funding that’s given to those providers, because the government shouldn’t be subsidising care that most people can’t afford and that there’s no good reason for charging patients so much.”
Earlier this month, a number of young Aussies told PEDESTRIAN.TV how Medicare is failing to keep up with their medical needs.
Many young people are having to dipping into their hard-earned savings or, even worse, pushing back specialist care altogether. For Pamela, 25, getting slugged with an eye-watering $1,500 a year towards PCOS check-ups meant she’s axed those appointments to the endocrinologist.
Madi, 30, said she’s been putting off seeing a psychiatrist to access her ADHD medication because of the considerable $600 out of pocket cost and boy, do I feel you on that.
“I literally got quoted this back in October last year and I still haven’t booked it in,” she said.
“I tell myself I’ll make do until I have some extra money [to spend]. I’ve had a lot of other expenses, like moving homes or planning holidays, that I’ve prioritised over this because it’s just a lot of money to drop.”
So, what’s the fix? The Grattan Institute’s latest report has laid out a couple of recommendations. It’s called for the government to expand public specialist appointments, while removing Medicare funding from those who charge excessive fees.
“Specialist care is a postcode lottery: people living in the worst-served areas receive about a third fewer services than the best-served areas. Public clinics don’t do enough to fill the gaps. Spending $470 million a year would provide one million extra public appointments each year in the areas that get the least care,” it said.
It’s recommended setting up a system that can streamline the referral process by helping GPs get written advice from other specialists, which could avoid more than 60,000 referrals and save patients $4 million in special fees annually.
Plus, training numbers on some specialties like psychiatric and ophthalmology has been far too low for years, and there’s been little rural specialist training to help Aussies who live in remote or rural areas, it said.
“Governments must train the specialist workforce Australia needs. They should provide an extra $160 million to expand training, and the funding should be linked to targets for undersupplied specialties and rural training,” the report recommended.
Definitely not a fan of having to choose between mental health care and paying rent, so here’s hoping this is a pretty big wake-up call for change.
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