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Specialist Fees Soar: Australians Pay 5x Benchmark
13 Sep
Summary
- Australians paid over five times benchmark for specialist visits 1.24 million times.
- Specialist out-of-pocket costs doubled inflation over last decade.
- Millions delayed or skipped care due to high healthcare costs.
Australians incurred specialist fees exceeding five times the benchmark on 1.24 million occasions in the past year, with an additional 6 million services billed at three to five times the schedule fee. Department of Health findings reveal that specialist out-of-pocket costs have been escalating at twice the rate of inflation for a decade.
In the last year, out-of-hospital specialist fees rose by over 75 percent since 2019, totaling $4.17 billion. In-hospital gap fees for those with private health insurance also saw a sharp increase. The government is concerned about excessive fees charged by a minority of providers, which compromise access to care, particularly for those with chronic conditions.
Concerns are mounting as millions delay or go without healthcare due to costs, potentially leading to delayed diagnoses and more complex, expensive treatments later. The government is exploring measures like fee caps and incentives for bulk billing, aiming to increase transparency and control escalating out-of-pocket expenses for Australians.
