Critics slam $17m boost for ‘failed’ medical costs website

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Patient groups and doctors have again denounced the federal government’s ‘white elephant’ medical costs finder website, after doctor participation was left voluntary despite a $17 million funding boost.

Australian Patients Association (APA) chief executive Stephen Mason told Nine the website “won’t put an end to out-of-pocket bill shock for patients” and the massive spend would not “improve fee transparency”.

“We will be surprised if any additional doctors and specialists will voluntarily agree to sign up to list their fees,” Mr Mason said. “So, again, patients are the losers.”

The funding will reportedly develop the “individual fee disclosure component” of the site, launched at a cost of $2.5 million last year.

Australian Medical Association president Omar Khorshid labelled the site “a complete failure”, which should be abandoned.

“Until the website can actually give an individual patient confidence about what gap they might be facing compared with other practitioners, then it’s not going to be useful at all,” Dr Khorshid said.

In September, the APA reported the case of a mother who would be charged more than double the recommended fee for her daughter’s adenoid surgery.

It attacked “money-hungry surgeries” cunningly taking advantage of “known gap policies”.

“By manipulating the system, surgeons have been able to get away with charging Medicare, private health insurers and patients the maximum fee possible which is, in many cases, hundreds of dollars more than the services are worth.”

Mr Mason labelled the practices “abhorrent”.

The APA encouraged patients to check AMA recommended fees before proceeding with surgery to avoid excessive fees.

In July, YourLifeChoices reported that Consumers Health Forum (CHF) chief executive Leanne Wells had called for the site to be overhauled.

At that time, fewer than 10,000 people had accessed the site in six months. Ms Wells said out-of-pocket health costs would “hurt families more than ever as a result of the economic impacts of the pandemic” and called on surgeons to “take into account the financial stress on individuals and families” when setting their fees.

“We urge the government to address out-of-pocket costs as a priority,” she said.

The site was meant to reduce ‘bill shock’ but was launched without key features such as the ability for patients to search and compare specialist fees.

Henry Cutler, director of the Macquarie University Centre for the Health Economy, said the fact participation was voluntary meant it would be “impossible for patients to determine value for money” by using the website.

Australians spent $30 billion on out-of-pocket medical costs in 2017–18, according to Australian Institute of Health and Welfare data.

Grattan Institute health economist Stephen Duckett told Nine the Federal Budget provided “no real enhancement to ensure usable comparative information on all doctors will be available to the public”.

A Health Department spokesman said the website would help patients “better understand the costs associated with their healthcare”.

IT upgrades making it easier for practitioners to upload fee details are due to be completed in 2021. Only then will information on individual medical specialists’ fees be available – if doctors choose to upload it.

Private Healthcare Australia chief executive Rachel David welcomed the site’s funding boost but said further reforms were needed to rein in “escalating health industry costs” driving up health insurance premiums.

Australian Society of Anaesthetists president Suzi Nou said Medicare and health insurer rebates had failed to keep up with rising costs, and the government should address this “rather than spending millions of dollars for a website to document just how out of touch they are”.

Dr Khorshid called for private health insurance to be simplified so patients could determine gap costs more easily. Currently, insurers and surgeons have multiple fees for every procedure.

He urged doctors to follow the Australian Medical Association’s informed financial consent guide, to provide patients with accurate, detailed quotes.

Just before the site was launched, AMA vice-president Dr Chris Zappala blamed “insultingly low rebates” and government reductions in healthcare spending for patients experiencing out-of-pocket costs.

“As soon as the doctor charges over a known gap, the health funds receive a partial reprieve for reasons that defy understanding – and their rebate can drop even lower to only 25 per cent of the insufficient MBS benchmark. This then is perceived by the patient as the doctor over-charging – but in fact the root cause is the avaricious behaviour of the insurance funds to preserve handsome profits by offering low rebates and successive governments in attempting to reduce what they pay for each citizen on healthcare.”

Dr Zappala said the principal driver of doctors’ income and patient gaps are rebates and it was “unfathomable” that the website didn’t detail rebates of private health insurance funds.

He claimed the quality of medical care could decline if price was the primary driver of patient choices and “discounted services become the principle method to attract patients and earn a living”.

Have you used the medical costs finder website? Are you confident you can avoid overcharging for medical services?

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Written by Will Brodie

9 Comments

Total Comments: 9
  1. 0
    0

    Are you confident you can avoid overcharging for medical services?

    Hahahhahhah now pull the other one……….

    The answer is a big fat NO NO NO

  2. 0
    0

    We live in an area where a lot of doctors’ surgeries have closed their books (including ours) so shopping around for a better deal is not practical. We also have great faith in our doctor’s abilities and knowledge which also stops us shopping around.

  3. 0
    0

    A $12,000 (yes, twelve thousand) gap for prostate cancer surgery, despite having private health insurance. Nuff said.

  4. 0
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    Politicians need to pay that out of their own bank accounts.

  5. 0
    0

    The major issues of “out of pocket” costs are related to Specialist fees and Hospital Costs not GPs.
    I spent about 6 years as part of a team developing an internet based system called ECLIPSE. That was designed to ensure that patients gave “Informed Financial Consent” which is a Legislated requirement in addition to “Informed Medical Consent” for a procedure before committing to the procedure.
    The basic premise was that if you needed an “in Hospital” procedure you could receive an estimate of the “out of pocket” costs (and benefits) you may incur from ALL parties involved before committing. The system linked Specialists, Medicare, Hospitals and Health Funds. It was funded by a budget of $55m by the Federal Govmnt and went live in July 2005. I strongly suggest that if you attend a Specialist for medical treatment that you ask if they are party to the ECLIPSE system before committing to anything.

  6. 0
    0

    A failed component of a comprehensively failed hospital care policy. Even before CV-19, because of widening gaps, people were deserting private funds in droves, and the public hospitals were being hammered. Financial stringency must be making the situation more acute. The federal government has absolutely no plan to fix this worsening crisis. God help us from a future like the US, with medical care being the leading cause of bankruptcies. Let’s look to moving to a properly funded, dominantly public hospital system with private care for the very wealthy few. Expensive maybe, but that’s what taxes are for.

    • 0
      0

      The fundamental problem lies with the fact that we, the general population, treat Doctors as Demi-gods and put them on a pedestal Until we treat them as we would treat a Tradesman or other suppler of a “Service” Try reading my comment!


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