Dr Rachel David spoke with 5AA radio in Adelaide about the rising cost to see a specialist doctor

14 Sep 2026Interviews and Transcripts

Transcript

Station: FIVEAA Adelaide
Program: Mornings with Graeme Goodings
Date: 14/9/2026
Time: 11:08 AM
Compere: Graeme Goodings

Interviewee: Dr Rachel David, CEO, Private Healthcare Australia

Graeme Goodings	Ordering. Have you seen a specialist lately? Been stunned by their fees? They’re not cheap. Well, the government plans to tackle excessive specialist fees through measures such as fee caps and bulk billing incentives. Joining us now from Private Healthcare Australia, CEO Dr. Rachel David. Dr. Good morning to you. Thanks for your time today.
Rachel David	Morning, Graeme. It’s my pleasure.
Graeme Goodings	Firstly, what is it about specialist fees? They seem to be outstripping cost of living rises in every area.
Rachel David	Look, we don’t know. We knew that they were tracking up slightly along the lines of CPI until about the pandemic happened, and then after the pandemic, we’ve seen some very deep increases in the median specialist fees for a number of specialist consults, particularly in anaesthetist fees, but also in some other areas. And this has really outpaced the growth in price of housing, food, and other services. So this is increasing at a rate that’s considerably higher than CPI, which is what’s prompted the government’s consultation paper on excessive fees, and which we argue I think needs to go into a little bit further to look at what’s happening with the market for medical specialist fees overall, so that we can better define what’s meant by excessive fees.
Graeme Goodings	I mean, it is a matter of shopping around to get a specialist that doesn’t charge an exorbitant fee, or are they across the board too high?
Rachel David	Look, it’s really difficult for people to do that at the moment. The way the system’s set up, people have to go to their GP, and then the GP could refer them to anybody, whether it’s they charge up a lot or not, and we’ve seen some pretty deep differences in what people are being charged for the same procedure. So, for knee replacements, for example, we have some people that have no out-of-pocket charges, and some that have 1000s of dollars for the same thing with same outcome. So, people find it very difficult once they’ve been referred and they’re already sitting in front of a specialist to be able to commence a discussion about fees, which is why the government made an election promise to introduce a some changes to a website that the Department of Health runs called the Medical Cost Finder website, and they are going to put up specialist fees on that site so people have the chance of seeing what they’re going to be up for at the time they’re seeing their GP and before a referral is actually being made, which we think is a very important first step towards getting this issue under control.
Graeme Goodings	Yeah, I mean, most certainly. I mean, if you go on the recommendation of your GP, you go there and you’re already in. You’ve got the specialist then to sort of say, oh, I want to get a second opinion and go on. I mean, you’re running up costs. So if you can go to a website and find out just what a specialist will charge, at least you can compare one with another.
Rachel David	That’s the idea, and you’re not sitting in front of someone who may have already charged you $500 for an initial consultation. Exactly. Which is you know the other reason why people can’t shop around.
Graeme Goodings	The specialists charging depending on what state they’re in, or you know what part of the city they’re in, or you know east, west, and suburbs. You know, is there any way you can sort of pin it down?
Rachel David	Yeah, look, there is that there is a strong correlation between doctors that work in. high income areas and doctors who charge a lot. There’s also a strong correlation between doctors who And regional areas where there are no other doctors to come in and compete with them. So in those situations, people are facing some higher out-of-pocket costs than they are for around the rest of Australia. And you’re thinking about neighborhoods like Canberra, the Gold Coast, and the Mornington Peninsula, where you’ve got a sort of older affluent population living there, but the number of doctors is constrained.
Graeme Goodings	Now you mentioned earlier anesthetist, so fees have seemed to have risen particularly sharply. Have you got any explanations from them? You know, there’s a profession sort of spoken out as to why.
Rachel David	Look, they haven’t, and although I’m sure we’re going to be hearing from them more as this process continues on, but one of the big issues that we have with anesthetist fees is patients not being told about them until the last minute before surgery. This is something that we’re hoping to change. That you know, at the time that the decision is made to have surgery, that’s the time when the anesthetist costs need to be discussed, not by text message on the day of the procedure.
Graeme Goodings	Exactly. How effective do you believe fee caps would be in practice? Are they going to work?
Rachel David	Look, I think it’s going to be quite difficult for the government to actually create legislation to bring in fee caps. But if there’s no other alternative, and you’d hope that the medical profession would step up so that there is they will provide alternatives to this, then it’s something that I think, like anything, it’s worth a try.
Graeme Goodings	So, what role should private health insurance play in trying to address this discrepancy?
Rachel David	Well, look, the private health funds are constrained because they can only cover the cost of medical care in hospital. Ideally, what we’d like to be able to do is, for some high-cost areas like maternity, provide a bundled payment so that provide a bundled payment to the patient, so that they don’t have to be facing 1000s of dollars for the management of the pregnancy in the community, for example. So we need to be thinking a lot more like that. Like where can health funds properly contribute to care, even if it’s not care that’s delivered in a hospital?
Graeme Goodings	Are you getting feedback that some people, you know, we’re living in tight times, no question about that, are actually putting off or delaying seeing a specialist because they just can’t afford it.
Rachel David	Yeah, look, we’ve done market research into this recently in a lot of detail, and we’ve determined that three in 10 people who’ve been referred to a medical specialist just aren’t going because of the cost or what they believe the cost is going to be, and that’s a lot of people who are putting off seeking care that could be pretty critical for them.
Graeme Goodings	So, Private Healthcare Australia, what would you like to see as is the next or the most important step?
Rachel David	The most important step is the medical cost finder website gets up and running, and so consumers have a really clear idea of what charges they’ll be up for. So, if you do live in Canberra and your specialist is charging 1000s of dollars. Maybe make the trip to Sydney and find somebody who’s similar, who’s more cost-effective. And then, unfortunately, I think that if we still are encountering excessive fees, then some punitive measures will need to be introduced.
Graeme Goodings	So this website isn’t up and running yet.
Rachel David	No, the legislation is going through the parliament as we speak.
Graeme Goodings	I mean, you would think it would get you know support from across the board because you know why would you want to oppose something like this? It just seems you know fair and practicable.
Rachel David	Yes, look, I think the medical cost finder website is broadly supported, so that’s a very important first step. But if there are groups of specialists that are continuing to charge excessive fees, particularly if they’re not telling the patient in advance, then that’s something that’s going to require more of a stick than a carrot to fix.
Graeme Goodings	Dr. Rachel David, thanks for your time today. Private Healthcare Australia CEO.
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