Cure prospects for out of pocket pain

The Consumers Health Forum welcomes the consensus now developing on measures needed to resolve the issue of out of pocket medical costs which are creating hardship for so many patients.

Last night’s 4 Corners report on gap costs follows the Out of Pocket Pain survey initiated by the Consumers Health Forum earlier this year which highlighted the heavy expenses people face despite having held private insurance for many years.

“We welcome the recent statements by Private Healthcare Australia, the Royal Australasian College of Surgeons and the Australian Medical Association, all of whom have acknowledged that the “egregious” level of fees demanded by some medical specialists leaving patients thousands of dollars out of pocket is unacceptable and well outside the bounds of the codes of conduct of the professions concerned,” the CEO of the Consumers Health Forum, Leanne Wells, said.

“The Consumers Health Forum has been calling for action on out of pocket costs for several years.  We know from our survey of over 1,200 people that one in six reported that out of pocket costs had a significant impact on their lives with many taking out mortgages, borrowing from family or drawing on their superannuation to pay for health care. 

“It is a significant development that at last both health funds and doctor organisations are acknowledging the need for action.

“The complicated nature and numerous expenses charged to private patients, on top of their private health insurance premiums, suggests there needs to be a better system of support for people in the way of advice and assistance that patients can call on during the referral process and well before their treatment.  This needs a whole-of-sector response, that is backed and supported by government policy and which involves consumers in its design from the start.

“The call by Private Healthcare Australia for transparency on out of pocket costs so consumers can choose specialists on price and quality before taking up a referral is in line with what CHF has been calling for: an authoritative website which patients can consult for information on fees and performance of doctors coupled with an information services that can help educate people about the private health system and help them navigate it.

“Reform needs to start with better transparency and we are encouraged by the steps taken by Minister Hunt to set up a Ministerial Advisory Committee chaired by Chief Health Officer Brendan Murphy, to provide him with solutions to this dilemma.

“However, other measures are also required. We also support the proposals for a clear complaints process with a single agency assisting consumers hit with excessive bills, and a crackdown on “booking” and other illegal fees not declared to health funds and/or Medicare.

“We also believe it is time for the medical profession to shoulder the responsibility to their patients and provide a single bill or estimate of the overall cost of a given course of treatment.  We know from our survey that informed consent matters to people: a third of our survey respondents told us that their costs were not explained to them before treatment.

“However, it needs to be said that the issues raised by the out of pocket cost problems raise deeper, systemic issues about the value, cost-effectiveness and sustainability of the current private health system and that is why the Consumers Health Forum has called for a Productivity Commission inquiry into private health care,” Ms Wells said.



Media contact

Mark Metherell
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