Australians are grappling with steep increases in medical fees for common procedures within private hospitals. New data from Private Healthcare Australia (PHA) reveals that costs for certain medical services have surged as much as nine times compared to five years ago. Between 2018-19 and 2023-24, the median out-of-pocket fees charged by specialists, including surgeons and anaesthetists, have escalated significantly.
The data highlights a troubling trend in the private health care system. The average out-of-pocket fees for hospital episodes have risen by 65% since 2020, according to the Australian Prudential Regulation Authority (APRA). Such drastic price increases are not only affecting the affordability of care but also influencing patient behavior.
Impact on Patients and Access to Care
Many Australians now face daunting medical bills. Reports indicate that the affordability crisis is leading up to 20% of the population to delay or forgo specialist appointments due to costs. Research from the Australian Bureau of Statistics, La Trobe University, and Patients Australia reveals that over a million people annually miss the opportunity to see a specialist because they cannot afford the fees.
Health Minister Mark Butler has referred to the rising costs of specialist fees as a “BBQ stopper” for households across the country. In response to these challenges, he has promised to enhance transparency by publishing more than 11,000 doctors’ fees on the Medical Costs Finder website. This initiative aims to help consumers make informed decisions regarding their healthcare options.
Future Reforms and Responsibilities
The rising costs of medical care have sparked discussions about potential reforms in the health insurance sector. Dr Rachel David, CEO of Private Healthcare Australia, emphasizes that while doctors have the right to charge fair fees, the sharp increases are unsustainable. She urged all parties involved to take responsibility for preventing excessive costs that burden patients.
Currently, health insurers are unable to cover specialist appointments outside of hospital settings, forcing some patients to pay upwards of $1,000 for initial consultations. This situation complicates access to ongoing treatment for those with private health insurance.
Dr David highlighted the vital role of private health insurance in providing timely access to care, reinforcing the need for a collaborative approach to ensure affordability for all Australians. The ongoing dialogue around reform and transparency is essential in addressing the challenges posed by rising medical fees, ensuring that quality care remains accessible without compromising financial stability for patients.
