A recent report from the Grattan Institute found that now less than half of all specialist fees were covered by the Medicare Rebate. Essentially, Australians are paying more than ever out-of-pocket to seek specialist treatments.
**A quick explainer on how the rebate system works**
The government sets a rebate percentage for specialist fees, but only up to a capped price.
For example, the government may agree to pay 85% of a specialist fee up until $150. So, if a specialist charges you $150, you only pay $22.50. But if that specialist charges you more than $150 (which many do), you’d have the pay 100% of the difference.
So, if their fee is $300, you would have to pay 15% of the first $150 ($22.50), and then 100% of the second $150. Coming to a total of $172.50.
**Why things are getting worse**
What the Grattan Institute’s report found is that specialist fees go up every year with inflation, but the rebate cap isn’t keeping pace. In fact, it estimates that specialist fees are rising about 7% every year, whereas the rebate cap is rising just 1-2% (if at all).
The report found that more and more Aussies are delaying or avoiding care due to unaffordable specialist fees or having to dip into their super to afford treatments.
**Three suggested solutions**
The government does not have the power to regulate specialist fees, but the report suggests three possible solutions it could pursue:
1. Boosting the supply of specialists available. This would be costly and take time to see results, but would eventually place downward pressure on specialist fees.
2. Increasing the transparency of how much different specialists charge. It’s not clear how this would work, but it’s possible a public portal could be established in the same way Fuel Check provides consumers with information on the best priced fuel near them. The logic being that people would seek out the best priced specialists, and that would drive downward pressure on fees.
3. Expanding specialist treatment through public health care for those who can’t afford private care. This would be costly but directly help those most in need.
I think we’d all love cheaper specialist care, but the government has limited options available to them. If you had to pick one, which policy would you want to see prioritised?
Source: https://www.abc.net.au/news/2024-09-25/medicare-rebates-only-covering-half-of-specialist-costs/104389360
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7 Comments
Alternatively, the government could just insist on open/ exam based entry to the specialist colleges and transparent training courses like every other modern profession.
If you let professional groups control entry… they will always create artificial shortages and high barriers to entry, because of course they will.
Why shouldn’t any medical school graduate who has done their four years residency be able to pay for cardiology/ophthalmology training if they want to?
There’s no easy fix. Demand outweighs supply. I would assume nearly every country in the world is doing their best to import medical specialists to decrease the demand.
The government should invest in a long term strategy to encourage more people into the field, it won’t pay off for many many years but it would pay off in the end.
1. Open up Med School training, to become a Doctor, to EVERYONE that qualifies, rather than restricting supply. Thus massively increasing the supply of good Doctors.
2. Open up Specialist Training to any experienced Doctor that wants it, rather than requiring sponsorship through the old boys network.
3. Create more Specialist Clinics, that allow patients to receive assessment and treatment from a combination of Specialists, trained GPs, PA, and Nurse-Practitioners.
Honestly, people are talking about increasing the supply of doctors… Shouldn’t we focus on creating robots that can fix the demand? I notice that ai is taking jobs like coding or drawing, but we should focus on using ai for the better future. Although, I doubt people will allow ai to cure cancers…
My father, and many other individuals, have faced doctors who didn’t know what they were doing. If my father didn’t go to the right doctor, he wouldn’t have known about his heart condition. There are also perverted doctors too, look at the constant news about them – whether it be the doctors harassing the clients or taking inappropriate photos of them.
And with the decreased birth rates, it’s becoming less clear if there will be enough gen alphas to maintain the demand for doctors. We’re already concerned by the cost of medical specialists, yet soon we have another problem to face – who will be the aged care workers when gen z are the elderly?
Specialist charge you a $150 !!!! F@ck how long has it been since you seen a specialist ? Last 3 i seen cost me $800 minimum for the 1st consultation….and that was over 5yrs ago…
Is there an option to keep things as is and continue this slow smooth transition away from socialised Medicine?
If only there wasn’t certain scheme (NDIS) growing unsustainably every year, sucking up funding that could go to Medicare and help 100% of the country, instead of 2%.