It found that two million Australians delay or skip an appointment each year, around half due to the skyrocketing cost of seeing a specialist.
The analysis – submitted to the Inquiry into access to and affordability of medical specialists in Australia – recommends sweeping changes to the nation's health system, including the establishment of a specialist fee and affordability framework.
The research, conducted by Senior Postdoctoral Research Fellow Luke Slawomirski, also found the cost of seeing a specialist has risen faster than the rate of inflation, wage growth and other medical expenses.
Sadly, the analysis reveals that it's the people with the greatest need who are missing out.
Key findings:
- Australia now has a two-tier specialist system, where the rich get fast access to quality care, while others cannot access or afford the same care.
- Increasing Medicare rebates and improved fee transparency will help, but won't fix the problem.
- People on lower incomes, with chronic illness or disability, and those in rural and remote areas face the greatest barriers to specialist care.
Key recommendations:
- Establish a national specialist fee and affordability framework as well as a specialist workforce and capacity plan.
- Make working in the public system more desirable for specialists.
- Streamline care models and improve information sharing with patients and GPs.
"Seeing a specialist has become a luxury rather than a way for any Australian to receive treatment for a serious health conditions," said Luke Slawomirski, Postdoctoral Research Fellow at The Australia Institute.
"It has become a two-tier system where people who can pay often move quickly, while people who cannot pay are forced to wait or miss out all together.
"A universal health system should ask people to wait because someone else has greater clinical need, not because they can't afford the private alternative.
"Patients should not have to shop around for specialist care while they're sick, worried or in pain. They deserve clear information about the process, cost, waiting time, public options and outcomes before a referral is locked in.
"Public policy has created a market where patients often face high, unpredictable costs for care which they cannot safely refuse.
"Raising Medicare rebates without conditions risks pouring more public money into the same broken market. Patients need lower and more predictable gaps, not just bigger subsidies.
"Specialist expertise is scarce and valuable. We should use it better by supporting GPs with timely advice, strengthening public specialist work, and planning the workforce around need."
