Key Takeaways:
- The Australian government is planning to prioritize specialist fees in its second term, with a focus on making them more transparent and affordable.
- The government has committed to publishing individual specialists’ average fees to allow patients to compare prices and shop around.
- Experts recommend training more doctors, creating national targets to train specialists where they are most needed, and tying funding to meeting those targets.
- The government is exploring options to control fees, including requiring specialists to repay the government the value of the Medicare rebate for excessive fees.
- Doctor groups have reacted positively to the government’s plans, but also highlight the need to address underlying issues such as hospital underfunding and Medicare neglect.
Introduction to the Issue
The Australian government has announced plans to prioritize specialist fees in its second term, with Health Minister Mark Butler stating that he is "determined" to make specialist fees a key focus area. This comes after a series of reports highlighted the issue of specialist care being a "system without guardrails", with limited access to public hospital clinics and huge fee variation in the private system. The government has committed to publishing individual specialists’ average fees to allow patients to compare prices and shop around, but experts argue that this is not enough to address the underlying issues.
The Government’s Commitment
Butler has committed to publishing individual specialists’ average fees on the Medical Costs Finder website, which was introduced by the previous government in 2019. However, only 70 specialists volunteered to display their fees, and the rest have kept their fees secret. The government needs to pass a law in parliament to make this information public. Butler has also indicated that the government will explore other options to control fees, including requiring specialists to repay the government the value of the Medicare rebate for excessive fees. The government has already consulted with doctor groups and patient groups, and Butler has stated that "all options are on the table".
Why Haven’t Governments Regulated Specialist Fees in the Past?
The reason why governments have not regulated specialist fees in the past is due to constitutional restrictions. Section 51(xxiiiA) of the constitution, which was added in 1946, allows the commonwealth to fund social services schemes, including Medicare. However, it also includes a provision that prevents the government from authorizing "any form of civil conscription", which has been interpreted to mean that the government cannot direct doctors to work in certain areas or regulate their fees. However, experts argue that this provision does not necessarily prevent the government from setting conditions on specialists receiving Medicare payments, which could be used to bring down specialist fees.
Expert Recommendations
Experts, such as the Grattan Institute, recommend that the government train more doctors, create national targets to train specialists where they are most needed, and tie funding to meeting those targets. They also recommend that the government rein in excessive fees by requiring specialists to repay the government the value of the Medicare rebate. Additionally, the government needs to address the underlying issues of hospital underfunding and Medicare neglect, which are contributing to the high costs of specialist care.
Reaction from Doctor Groups
Doctor groups have reacted positively to the government’s plans, with the Council of Presidents of Medical Colleges stating that they "entirely support" improving patients’ access to specialist care. However, the Australian Medical Association (AMA) has cautioned that blaming doctors for decades of Medicare neglect and hospital underfunding is not the answer. The AMA argues that Medicare rebates are not keeping pace with the cost of care, and hospitals are failing to provide adequate outpatient services. The AMA president, Dr. Danielle McMullen, stated that Australians should be asking why Medicare rebates are not keeping pace with the cost of care and hospitals are failing to provide adequate outpatient services.
Conclusion
In conclusion, the Australian government’s plans to prioritize specialist fees are a step in the right direction, but more needs to be done to address the underlying issues. The government’s commitment to publishing individual specialists’ average fees is a good start, but experts argue that this is not enough to address the issue of excessive fees and limited access to public hospital clinics. The government needs to take a comprehensive approach to addressing the issue of specialist fees, including training more doctors, creating national targets, and tying funding to meeting those targets. Additionally, the government needs to address the underlying issues of hospital underfunding and Medicare neglect, which are contributing to the high costs of specialist care. By taking a comprehensive approach, the government can ensure that all Australians have access to affordable and high-quality specialist care.
