Website to combat specialist ‘bill shock’

The announcement comes just days after consumer peak body National Seniors called for greater transparency around out-of-pocket expenses, following a Ministerial Advisory Committee finding that more than one-in-three patients were stung with costs varying from a few hundred dollars to tens of thousands for specialist treatments.

“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,” National Seniors Chief Advocate Ian Henschke says.

“Seniors, who are often on low and fixed incomes, are particularly hard hit and are forced to put off medical treatment or cut their private health cover.

“And sometimes it’s not a case of a single specialist charging exorbitant fees that is bringing seniors to this point, but the cumulative effect of numerous ‘extra’ fees.”

Mr Henschke says he’s heard concerning stories from members.

“One of our members told us 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.”

Announcing the website over the weekend, Health Minister Greg Hunt says 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.

He says doctors charging huge fees were causing “enormous distress and financial hardship” and “undermining Australia’s private health insurance system”.

An education initiative will also 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.

Mr Henschke says if the website was to be of real benefit to consumers and GPs, it was essential it was not an ‘opt-in’ for specialists.

“The Government says the website will show data aggregated with the range of costs charged within a particular area. We would like to see more detail on how this will work to help patients avoid high-cost specialists.”

Mr Henschke says National Seniors also wanted to see GPs offering patients alternatives when they were referring to specialists.

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

“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.

“It’s time to fix the systemic problems leading to higher costs in the health system.”

Patient education and support crucial

Breast Cancer Network Australia (BCNA) Chief Executive Officer Kirsten Pilatti welcomes the initiative, saying it shows the Government is listening to Australians’ concerns around bill shock.  

“BCNA knows of too many cases where patients have not been informed of the expected out of pocket costs leading to complete financial devastation that lasts long after treatment has finished,” she says.

“We also hear from many people who have been diagnosed with breast cancer who have had to borrow money, access super early, sell investments, remortgage their home or increase their credit card limit just to cover their costs.”

“It is important that consumers are not left to have the responsibility of starting all the financial discussions.”

However, the proposed website will do nothing to inform patients about their likely out-of-pocket costs unless it also lists what patients can expect back from Medicare and their private health insurance fund, Australian Medical Association President Dr Tony Bartone says.

He says health funds have previously argued that the complexity of their many different insurance policies makes it difficult for them to provide their rebates on a comparison site.

“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,” he says.

“A website that does not have the full information is not in anyone’s interests.”