A ‘no gap’ private health arrangement sounds great, but you may not be able to choose your specialist. Here’s what else you need to know.
Articles on Specialist fees
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Knowing in advance what your specialist will charge is a good step forward. But we need fairer fees to start with.
The government has allowed private health insurers to raise premiums by an average of 4.41% from April. How are these set? And why is it higher than inflation?
Unlike other comparable nations, specialists in Australia can charge what they like. But higher fees don’t necessarily mean better care.
Specialists’ fees are high, vary across specialties and across geographical regions. And you can search for who’s charging what near you.
Health-care costs are continuing to rise faster than wages, so many Australian families are finding it increasingly difficult to keep up.
Specialists can charge patients what they want, and some doctors charge exorbitant amounts. A handful of services account for almost 90% of all medical gaps.
Seeking and making sense of specialist fees is an unfair burden to place on vulnerable patients. A website might be helpful for some – but health professionals need to be held to higher account.
Australia is the only country in the OECD that allows specialists complete freedom to set their own fees. This puts patients at risk – but the government can help protect them.
Poorer children in Australia are less likely to receive their share of Medicare funding, particularly in the first years of life.
To work out how to reduce the out-of-pocket costs for specialist care, we first need to identify why they are so high.
High specialist fees in this country, and what they mean for Australians’ access to health care, have been of concern for some time.
Why is it so difficult to find out exactly how much it’s going to cost to have that suspicious mole removed or to be admitted to hospital for that colonoscopy or hip replacement?
Top contributors
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Professor of Health Economics, The University of Melbourne
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Honorary Enterprise Professor, School of Population and Global Health, and Department of General Practice and Primary Care, The University of Melbourne
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Professor of Health Economics and Director, Centre for Health Economics, Monash Business School, Monash University
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Reader in Health Economics, Centre for Health Economics, University of York
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Associate Professor Health Economics, The University of Melbourne
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Research fellow, The University of Melbourne
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Associate Professor, Centre for Health Economics, Monash University
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Professor, School of Psychological Sciences, The University of Melbourne
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Foundation Fellow and Data Analyst, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne
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Professor, Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne
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Professor of Health Economics, The University of Melbourne
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Adjunct Associate Professor, Menzies Centre for Health Policy and Economics, University of Sydney
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Principal Fellow, Department of Paediatrics, The University of Melbourne