Punish doctors who overcharge, says medical chief

Font Size:

As Australia’s chief medical officer vows to investigate the possibility of punishing doctors who charge unnecessarily high fees, the Actuaries Institute says high out-of-pocket costs and a lack of transparency around specialists’ fees are undermining the health system.

The Australian reports that Professor Brendan Murphy will determine whether there is a point at which billing becomes unethical and should be considered malpractice. Colleagues have noted the growing number of GoFundMe campaigns seeking donations to pay for life-saving surgeries and cancer treatments.

Pensioners taking out reverse mortgages, people raiding their superannuation and GoFundMe campaigns to cover out-of-pocket expenses indicated a serious problem, he said.

“We feel that is not consistent with ethical medical practice,” he told The Australian.

“One of the questions now is defining at what point it becomes egregious. You could argue that the causing of severe financial pain, material financial pain, is egregious.”

Prof. Murphy will discuss the issue with the Medical Board of Australia, specialist medical colleges and associated groups in a bid to develop a means to better protect patients.

The Royal Australasian College of Surgeons says overcharging patients breaches its code of conduct, but has not been able to determine a threshold for action.

A government website to be launched next year aims to at least partially address the problem. It will offer de-identified data on the range of fees being charged for procedures and professional groups, particularly in gynaecology, obstetrics and cancer services, will be encouraged to add their own information. The aim is to allow patients and GPs to compare specialists by name and price.

Prof. Murphy deplored a common view that the more expensive a specialist’s costs, the better the standard of treatment, adding, “the best guide is the referring GP who gets to know the surgeons or proceduralists they refer to.”

He is also seeking better-quality reporting and information on surgical outcomes, a view echoed by the Actuaries Institute, which says a lack of transparency around patient outcomes is undermining the system.

The institute also wants to see independent healthcare coordinators appointed to help patients navigate treatment options and manage out-of-pocket expenses.

It advocates that all costs associated with a treatment be combined into a single total cost. “While inherently challenging in the private healthcare industry, [this] would be a game changer,” it said in a Green Paper, How to Make Private Health Insurance Healthier, at a summit in Sydney this week.

“This should help patients understand the total cost of their treatment and budget accordingly, target inefficiencies in the supply side of healthcare services and lower the total cost for the chosen healthcare pathway.”

The Green Paper presented a case study of a 57-year old prostate cancer patient whose specialist recommended robotic-assisted surgery. The patient, who had top-level private health insurance, had $20,000 in out-of-pocket costs. If he had undergone traditional surgery, with similar results, his out-of-pocket costs would have been closer to $3000.

It also stated that more than a quarter of patients with breast cancer had out-of-pocket costs for treatment of $10,000.

Private Healthcare Australia chief executive Rachel David said that almost half (44 per cent) of privately insured patients were left with a gap in private hospital bills and that 2 per cent had out-of-pocket expenses of more than $10,000.

Would more transparent fees make your life easier? Would you welcome an independent healthcare coordinator to help you navigate the system?

If you enjoy our content, don’t keep it to yourself. Share our free eNews with your friends and encourage them to sign up.

RELATED LINKS

The government needs to stop protecting private health insurers

The government saved private insurers, and now it needs to put them in the spotlight.

Health top fear for older Australians

Most older Australians fail to meet daily exercise targets: report.

Another health cover exodus feared with cost increases

Health forum seeks value for money with greater transparency around surgeons' fees.

Written by Janelle Ward



SPONSORED LINKS

Sign-up to the YourLifeChoices Enewsletter

continue reading

Food

Woo an Icelander in an Italian restaurant if you want a long marriage

"There are three kinds of lies: lies, damned lies, and statistics." Remember that phrase? Given the battering the truth has...

COVID-19

How one aged care provider beat Australia's slow vaccine rollout

Australia's progress in vaccinating some of its highest-priority citizens has been slower than anyone wanted, but one Melbourne aged care...

Lifestyle

'Super plants' could help reduce air pollution in your home and garden

We all know about poor air quality in towns and cities, what with traffic, lack of green spaces and gardens...

Food and Recipes

Flatbread Pizzas with an Asian Twist

Invented by Nepalese chef Rachana from Eat Offbeat, the New York catering company that employs refugee cooks, these mini flatbread...

Wellbeing

Wellness technique actually makes us selfish, say researchers

Mindfulness has been the new black for much of the past decade. It's a buzzword bandied about to promote self-awareness,...

Health Insurance

Ageing baby boomers are missing out on health cover savings

Most older Australians see their health insurance premiums rise every year but don’t realise these high costs can be for...

Travel News

Vaccination no guarantee of open borders, says health minister

Australia's international border could remain closed even after the vaccination rollout is complete, according to health minister Greg Hunt. As...

Travel & Motoring

Are 'smart' cars creating dumb drivers?

The prevalence of driver aids is increasing all the time, even into lower priced cars. Cameras and sensors can alert...

LOADING MORE ARTICLE...