Universal for some: specialist medical care

Article published 9 March 2022

Universal for some: specialist medical care

UNIVERSAL healthcare implies that everyone regardless of wealth and income has equal access to essential medical care.

But last year, about half a million people in Australia delayed or missed out altogether on seeing a medical specialist, because it was too expensive.

Delayed means they had to save up.

Missed out means that they couldn’t even save up for it.

This startling statistic is from a report Not so universal: How to reduce out-of-pocket healthcare payments

The Grattan Institute report says that Australia relies more on out-of-pocket payments for medical expenses than similar countries.

All up, Australians pay more than $1.3 billion out-of-pocket to medical specialists every year, the report says.

That’s money out of the pockets of patients who could afford to pay, even if a lot of them had to save up first.

Delaying getting the specialist medical care you need is like servicing your car every 20,000 kilometres instead of every 10,000 kilometres. Your car is going to break down more and it’s going to cost more to fix eventually.

The Grattan Institute report lists five things that state and federal governments must do to fix the problem.

First, states need to expand the number of public hospital outpatients, so there are more zero-out-of-pocket options for patients. Currently there are huge waiting times for treatment in medical specialist outpatient clinics, forcing people to go and see price-gouging medical specialists in private practice.

Second, governments need to provide more information to GPs so that they know how much each specialist charges. That way, GPs would be able to steer patients away from specialists who charge exorbitant rates.

Third, the federal Government needs to boost bulkbilling for specialist medical services. Only 46 per cent of visits are currently bulk-billed.

Fourth, the federal government needs to help GPs do more and so reduce referrals to specialists. It can do this by allowing specialists to be paid for giving specific over-the-phone advice to GPs about a patient without actually seeing the patient – a so-called secondary consultation scheme.

Some patients would ultimately still need to be referred on, but such a scheme would reduce many patients’ exposure to out-of-pocket payments for seeing a specialist.

Fifth, the supply of specialists has not kept pace with population growth. The number of dermatologists, for example, increased by 17 per cent between 2014 and 2019, whereas the population aged 70 and older – a good indicator of healthcare demand – increased by 25 per cent over that period.

Medical specialists are notorious price-gougers, and the reputations of the few who aren’t are tainted by the many who are.

Price-gouging needs to stop.

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