Calls from consumer advocates and private health insurers to create an online national directory of surgery and other healthcare costs

Station: Radio National
Program: The World Today
Date: 11/12/2017
Time: 12:17 PM
Compere: Thomas Oriti
Interviewees: Erin Turner (CHOICE), Dr Rachel David (CEO, Private Healthcare Australia), Dr Michael Gannon (President, Australian Medical Association)


THOMAS ORITI: If you’ve been doing your Christmas shopping online, you’re probably used to checking multiple sites to get the best deal but there’s no easy way to be sure of getting a good price when you’re heading into a surgeon’s office. Well now consumer advocates have joined healthcare companies in calling for an online medical directory to allow patients to find out the likely cost of surgery before they see the specialist.

Angus Randall reports.

ANGUS RANDALL: What’s the price of knee surgery? If you’re about to go under the knife and regardless of whether you have private health insurance or not, you want to know beforehand.

Erin Turner is from consumer advocacy group, CHOICE.

ERIN TURNER: Typically what happens is that someone will get a referral from the GP, they’ll wait and see that specialist and they’ll go into surgery, and only find out about the cost much further down the track; by then it’s a bit too late to go back because you’re sick and you often need treatment as soon as possible.
ANGUS RANDALL: The group is calling for more transparency on the cost of surgeries ahead of an expected Senate report on private health insurance later this week. CHOICE is suggesting an online medical directory where patients can hunt around for a better price. Erin Turner argues the uncertainty over surgery costs is not only hurting those who may find themselves paying more than expected, it can deter a generation used to shopping online from taking up private health cover at all.
ERIN TURNER: As part of the Senate inquiry, CHOICE gathered over a thousand case studies from consumers about their experience of private health insurance; the number one thing that came through was this real pain point with out of pocket costs. People are frustrated at paying thousands of dollars more when they thought they had top end health cover and they’re also frustrated that they didn’t know the costs were coming until really far down the track; not just surgeon’s costs, it’s also your anaesthetists, sometimes your hospital or an additional surgeon. It’s really hard to just get one price; how much is this surgery going to cost me?
ANGUS RANDALL: There are several medical directories online that provide details about the cost of surgeries, however none of them are comprehensive. Dr Rachel David heads the representative body for private health funds, Private Healthcare Australia. She’s echoing calls from CHOICE for a national online database, allowing patients to shop around.
RACHEL DAVID: Almost every part of the economy is subject to some kind of online market so that people have transparency into what they’re buying, the quality of the service and how much it’s likely to cost in advance so they can make valid comparisons. Private health has really lagged the rest of the economy in this space and I really believe that for consumers to continue to buy into it, they need access to this information.
ANGUS RANDALL: However, Dr David predicts a strong push back from older specialists who argue any conversation about the cost of surgery should stay face-to-face.
RACHEL DAVID: A lot of younger surgeons, but also across the medical specialist environment, a lot of doctors are really, really keen to share this information and to increase their referral base and increase their exposure to more consumers. So what’s really been holding them back is a single mechanism to enable them to do this and also to loop in the family doctor or the GP.
ANGUS RANDALL: Dr Michael Gannon is the president of the Australian Medical Association. He argues the number of decisions that must be made before a procedure takes place makes an online database unlikely.
MICHAEL GANNON: Not all knee replacements are the same, whether or not the patient needs it needs to be considered by the surgeon and there are various other elements to the team providing care; there’s an anaesthetist involved, there’s physio therapy involved, a surgeon might choose different hospitals based on different patient factors. The world of providing healthcare is a lot more complicated than buying a flat screen TV.
ANGUS RANDALL: And the AMA chief is accusing private health insurers of failing to acknowledge the complexities that could hobble a national online directory.
MICHAEL GANNON: The reality is that the private health insurers have created a deliberately confusing array of policy settings. We think that there is somewhere between 20,000 and 50,000 different operations. The insurers all pay different amounts for the same operation, they even pay out different amounts to doctors working in different states. Now, why that would be the case; you tell me.
THOMAS ORITI: Dr Michael Gannon, the president of the Australian Medical Association. Angus Randall was our reporter.
* * END * *