Specialists’ fees fuel health care costs
An independent think-tank report echoes what NSA has been saying for years: the private health system is not fit for purpose and specialists’ fees must be reined in.
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National Seniors Australia’s research report highlights growing unrest about the unaffordability of private health care.
This must be addressed to preserve private health as an option for older people. That’s why NSA is calling for an independent inquiry into the private health system.
You can read our report and join our Health Costs campaign to support cheaper health care here.
It’s estimated that two million Australians delay or skip specialist healthcare, and escalating out of pocket costs for specialist treatment is a major reason.
Bulkbilling rates are far lower than for GPs: only a third of specialist appointments are free, compared to 78% of GP appointments.
According to the Grattan Institute, the average out-of-pocket costs amounted to $300 in 2023.
The Grattan Institute’s health program director, Peter Breadon, said specialist fees were a problem that was only getting worse.
The report found out-of-pocket costs had soared by almost 75% in real terms since 2010.
“It’s no surprise that some people report taking on debt or skimping on other essentials to pay for seeing a specialist,” the report suggests.
One in 10 people who paid to see a psychiatrist in 2023 paid $400 out of pocket for their initial consultation alone.
The other option is to visit a public specialist clinic, but wait times can extend months, or even years.
The report says governments should take charge. It calls for “comprehensive reform to tackle training bottlenecks, failures in planning and investment, inconsistent public services, and outrageous private fees”.
Easing the rising cost of health services, especially out of pocket costs, and addressing the failures of the private health insurance sector are the key focus of ongoing advocacy by National Seniors Australia (NSA) to government to bring down health costs.
Reducing the cost of medical care will ensure older Australians do not miss out on receiving the treatment they need.
This can be achieved through our priorities, which include:
Enlisting the Productivity Commission to conduct a full review the private health system to identify improvements and reduce costs
Increasing the Private Health Insurance Rebate for people on low incomes, including older people, to retain those most likely to leave private insurance and boost membership among those most likely to take it up
Establishing a Seniors Dental Benefit Scheme providing $500 per year towards interventions to improve oral health
More information about this and other Health Costs campaign solutions is available here.
Profit-driven radiology
At a time when we’re being warned of the “Americanisation” of our health system, a national audit of radiology practices has revealed that three in five private practices are now owned by large for-profit corporations.
The survey found these corporations are companies that are either listed on the stock exchange or owned by private equity investors. It also found that four corporations own more than half of all clinics that provide MRI.
On the ABC radio’s Health Report, the researchers expressed concern that the growing corporate dominance raised questions about the future of affordable, high-quality care.
Their concerns include:
A high concentration of clinics owned by one corporation tends to result in higher healthcare costs
Prioritising of expensive scans over cheaper scans that can provide similar information
Radiology clinics are a vital healthcare asset but are being treated as a financial instrument where investors buy and sell, with the health of patients and the overall system not necessarily a priority.
You can listen to the Health Report story here.
The report is especially critical of the inequity of specialist care across the nation, labelling it a "postcode lottery" with people in wealthy communities receiving about a quarter more services than those in poorer communities, despite being healthier.
Tasmanians are among the worst serviced – far below the national average for access to specialist care, the report says.
People living in the southeast, west, and northwest, plus Launceston and the northeast of the state get fewer specialist appointments per person, counting both private and public, virtual, and in-person appointments.
The reports says the major reason for the lack of regional and rural based specialists is insufficient training opportunities in those areas.
The report’s solutions to regional inequity and the general specialist healthcare malaise are:
Boost training and better long-term planning
Beef up public clinics to fill the gaps left by the private market
Government commitment to a national minimum level of specialist services and targeted public funding
Take pressure off the system by helping GPs to do more
Publicly name and shame specialists who overcharge and revoke their public funding.
Specialists are free to charge whatever they like, and with public hospital outpatient clinics providing just one-third of specialist care, most Australians are treated by private specialists.
The Federal Government sets a Medicare Schedule Fee for different medical services and then pays a percentage of that in the form of a rebate. But there can be huge disparities between the Medicare rebate and fees charged, leaving patients with high out-of-pocket costs.
The average cost of an initial consultation with specialists who charged extreme fees was about $670 for a psychiatry appointment, the report found, and about $370 for an endocrinologist.
Related reading: Grattan Institute, NSA, ABC, ABC audio
