Specialists must be made to publish fees

Online publication of medical fees will help prevent bill shock but more needed

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TRANSPARENCY: Government website that will list the fees charged by individual medical specialists.

TRANSPARENCY: Government website that will list the fees charged by individual medical specialists.


One in four breast cancer patients incurred more than $10,000 out of pocket costs. But a new website aims to end the bill shock.


OLDER Australians have welcomed the announcement of a federal government website which will publish specialist doctors fees in an attempt to prevent exorbitant billing.

Health Minister Greg Hunt announced the searchable website after a Ministerial Advisory Committee found more than one in three patients were experiencing out-of-pocket costs varying from a few hundred dollars to tens of thousands.

A report from a Consumer Health Forum survey last year revealed one in four breast cancer patients and a third of respondents with chronic conditions such as multiple sclerosis had incurred out-of-pocket costs of more than $10,000.

National Seniors Australia chief advocate Ian Henschke said a survey of its members had established their biggest worry was the out-of-pocket expenses they faced for services and procedures not fully reimbursed by Medicare or private health insurance.

“We welcome the government’s commitment to make specialists’ fees more transparent, but we want to be assured all specialists will be obliged to list their fees on the website,” Mr Henschke said.

“National Seniors is gathering information from members about specialist fees as part of a broader health costs campaign.

"One of our members told us, for example, they had to pay $850 in out-of-pocket costs - after receiving their private health insurance rebate - just for an initial consultation with a surgeon to have a lump removed.”

Health Minister Greg Hunt.

Health Minister Greg Hunt.

Health Minister Greg Hunt said specialists would “initially be expected to show their fees” on the website to allow patients and GPs to consider costs when determining their choice of specialists.

An education initiative would increase understanding of out-of-pocket costs among consumers, their families and GPs, highlighting that higher fees did not necessarily mean higher quality of care.

"I am confident this website will improve transparency and choice for patients and families,"  Mr Hunt said.

"It will reduce the burden of ‘bill shock’ and allow patients to make informed choices.

"We will collaborate with clinicians and consumers to get the fee website right, with an initial focus on fees for gynaecology, obstetrics and cancer services. Major concerns have been raised about out-of-pocket costs in these areas".

It will reduce the burden of ‘bill shock’ and allow patients to make informed choices. - Federal Health Minister Greg Hunt.

National Seniors also wants to see GPs offer patients alternatives when they refer to specialists.

“Too often, GPs make a recommendation to their patients and don’t consider the costs involved,” Mr Henschke said.

“It should be standard practice to use this new website in consultation with their patients to identify a specialist who offers the necessary expertise at a price affordable to the patient."

The Australian Medical Association, however, said the proposed website would do nothing to inform patients of their likely out-of-pocket costs unless it also listed what patients could expect back from Medicare and their private health fund.

"The AMA supports and actively encourages full transparency of doctors fees, and unreservedly condemns egregious billing, which occurs in a very small percentage of cases," said AMA president Tony Bartone.

"But that transparency must extend to both the size of the MBS rebate and the private health insurance contribution to the cost of treatment."

Dr Bartone said health funds argued that the complexity of their many different insurance policies made it unworkable for them to provide their rebates for a comparison website.

“We agree that health insurance policies are unnecessarily complicated and opaque," he said.

"Each insurer sets the rebate amount that they are willing to pay. If the insurer’s rebate is low, the out-of-pocket cost to their customer will be high.

“Even when a doctor charges the same fee every time, and even when the patient has good private health coverage, out-of-pocket costs can vary by thousands of dollars because of the variation in what the insurer chooses to pay as a rebate.

“Informed financial consent requires total transparency.

"Unlike the growing range of privately-funded fees websites that now exist, a government-developed website must be impartial and backed by the Commonwealth’s extensive data set.

“However, a website that does not have the full information is not in anyone’s interests.

“While the government is saving money with the continuing freeze on MBS rebates for specialist procedures, allied health consultations, and diagnostic imaging, the growing gap between rebates and the cost of providing care is passed on to the patient."