Dr Rachel David spoke with Radio 6PR on price gouging and rising out of pocket fees

Station: 6PR
Program: Perth Live
Date: 7/2/2024
Time: 5:30 PM
Compere: Oliver Peterson
Interviewee: Dr Rachel David, CEO, Private Healthcare Australia


OLIVER PETERSON: There’s calls to name and shame the doctors who are gouging their patients. Specialist doctors’ fees should be published on the Government’s Medical Costs Finder website according to Private Healthcare Australia. As the ACCC has found that out of pocket fees charged by specialists – such as surgeons and cardiologists – have increased by more than 50 per cent over the last decade. Joining me now, the CEO of Private Healthcare Australia. Rachel David, good afternoon.
RACHEL DAVID: Good afternoon, Ollie.
OLIVER PETERSON: You must be pretty frustrated by all of this.
RACHEL DAVID: Well, yes. We’ve had a- now we’ve had a major speech by renowned economist and former chair of the ACCC Allan Fels, who has specifically called out price gouging by some medical specialists as being a major concern for the Australian community. He cited a couple of things. One is work done by the Grattan Institute which shows a [Audio skip] per cent increase in medical specialist costs over a decade. But he also mentioned our data as well, which shows that since the beginning of the pandemic, there’s been a 300 per cent increase in medical specialists’ out of pocket costs for people who’ve been treated in hospital. Now we need to get to the bottom of what’s going on here, number one. And number two, the Commonwealth Government five years ago promised that their medical costs finder website would make it easier for patients and consumers to see what specialists charge. And to date, progress with getting specialist costs up on that website has been frustratingly slow, and we’d like to see that fixed.
OLIVER PETERSON: Because it’s a voluntary website, Rachel, it’s not compulsory. So I went there a little earlier today. Chucked in knee replacement, chucked in a hip replacement. It’s about $500 or $600, it says, depending on your health insurance coverage, and then the hospital fees on top of that. But it’s obviously not very accurate.
RACHEL DAVID: Well, no. And it doesn’t actually tell you what individual doctors are likely to charge, in spite of the fact that number one, the Department of Health has that information. And, number two, doctors have been asked to provide that information, but we know only a very tiny number of doctors have agreed to do so. So look, we’re asking for a couple of things to happen. We know that medical specialists in Australia are entitled to set their own fees, and many of them do a pretty good job of that. So we are asking that the department makes that data available in a way that consumers can easily understand. But number two, we think that patients need- that doctors need to do a better job of telling patients in advance of the out-of-pocket costs they’re likely to receive. Preferably in the form of an upfront quote with all the costs on it. The same as they do for non-Medicare services like cosmetic surgery, and the same as you’d expect for home repairs or car repairs. It’s not that difficult, and that’s really what people expect. And so what we’ve asked for, and what Professor Fels reiterated in his speech, is that if doctors don’t do that and people are surprised by their bills after surgery, that they’re not legally required to pay them.
OLIVER PETERSON: And they’ve also suggested they could be named and shamed. Would you go that far, Rachel?
RACHEL DAVID: Well, look, I think the Medical Costs Finder website is the- is one of the ways in which that can be achieved. But if- there also needs to be a proper complaints mechanism, preferably involving the medical board, where if someone is really charging egregious fees to a patient who perceives they’ve got no choice, or they get a very large out of pocket cost, and it’s a surprise to them, then there needs to be a complaints process that can be called out. And the medical board is one avenue to do that. The other one is, of course, a surprise billing law, which would enhance the consumer law. And means that, you know, not only does the patient not have to pay if they didn’t know about it, but it would also put the onus on the doctor to review their behaviour.
OLIVER PETERSON: You said before it’s not that difficult to publish those fees. I mean, it’s just about transparency in the end. And the difficulty, Rachel, obviously, all patients have is the fact that it’s hard enough to see a specialist as it is, and it’s expensive. So it’s not affordable to go around and get multiple quotes like we might do with car insurance or home insurance or health insurance. It’s a little bit harder to go and pay those couple of hundred bucks to get three different specialist opinions. No, well, that’s exactly right. And so what you want to happen is you want to be able to talk about it with your GP and not get onto that merry go round in the first place. So when- you know, at the point where somebody is told by their GP that they might need surgery, they need to be able to have a discussion, be comfortable to say, look, you know, price and cost is a concern for me. And have the GP be able to look up a website and say, okay, well, look, there are five people in this area I can refer you to. And here’s one that either bulk bills or who charges a reasonable out of pocket cost. And that’s what we need the Medical Cost Finder website to do. At the moment, it’s got some useful information in there, kind of in aggregate. But it doesn’t really help the individual who’s sitting in front of their GP, and by the time they’re sitting in front of a specialist, most people are too intimidated to even start that discussion.
OLIVER PETERSON: Yeah. So we’ve got to find a way to compel the doctors to put their fees up there on that comparison website. And that might go some way to sorting out a few of the people who might be overcharging.
RACHEL DAVID: Well, look, that’s what we’d like to see.
OLIVER PETERSON: Rachel, thanks for your time.
RACHEL DAVID: Thanks, Ollie.
OLIVER PETERSON: Private Healthcare Australia CEO Rachel David. It makes sense to me to name and shame these rip off surgeons and publish their specialist fees on the medical website.
* * END * *