Unfair Specialist Fees: A Growing Concern for Australian Patients
In a move towards greater transparency, the Australian government is proposing new legislation to shed light on specialists' fees. While this is a step in the right direction, our research reveals that transparency alone won't solve the issue of skyrocketing specialist charges.
The Medical Costs Finder website, costing a whopping A$24 million, aims to provide fee information voluntarily uploaded by specialists. However, with only a handful of doctors participating, it's clear that a different approach is needed.
But here's where it gets controversial... The proposed solution involves publishing billing data collected through Medicare claims, allowing patients to compare costs before booking. While this empowers patients, it may also lead to unintended consequences. Doctors might increase their fees, and the persistent belief that higher prices equal better quality could mislead some patients.
And this is the part most people miss... The website should also report quality healthcare measures, such as clinical outcomes and wait times, to ensure patients make informed choices. Otherwise, transparency might inadvertently encourage patients to choose more expensive doctors, assuming better care.
We Need a Fairer System
To truly fix the system, we must address the Medicare Benefits Schedule (MBS) fees. The government's decision to freeze indexation of MBS rebates for specialists in 2014-2019 was a failure, leading to a legitimate excuse for specialists to charge higher fees.
Take, for example, the rise in psychiatrist fees (code 296), which are a staggering 77% higher than inflation would predict.
To make Medicare fees sustainable, they should be calculated based on the actual costs of running a clinic, including rent, staff, training, and doctor's time. These fees should be updated annually to match inflation and rising medical technology costs.
So, what else can we do?
We propose a "fair fees" scheme, where specialists agree to charge the MBS fee or a set percentage above it. Participants would display a certification sign, and their patients would receive a Medicare rebate. Those opting out would need to inform patients upfront about the lack of Medicare rebate, using the public subsidy as a regulatory tool.
The government can further encourage fair pricing by offering higher subsidies to doctors in regional areas. Additionally, paying specialists a single fee for successful treatment outcomes, rather than per test or appointment, would reward quality care and successful results.
Even if the government's budget is tight, it can still control specialists' fees, as seen in other countries.
While past Australian government policies have focused on setting rebates, it's time to regulate fees effectively. This proposed legislation is a necessary first step, but it's just the beginning of ensuring a fair and affordable healthcare system for all Australians.
