Specialist fees in Australia are out of control, according to a new Grattan Institute policy brief which calls on the federal government to protect patients by withdrawing Medicare funding from doctors who charge extreme fees.
The policy brief, Out of control: How to rein in runaway specialist fees, shows that since 2023, specialist doctors' fees have grown three times faster than inflation.
In the past year, the median fee for an initial consultation with a dermatologist went up by 7 per cent, on top of inflation. For a psychiatrist, the increase was more than 20 per cent, with fees rising $50 a year in real terms.
'Each year, more Australians pay far too much to see a specialist doctor,' says the policy brief lead author, Grattan Institute Health Program Director Peter Breadon.
'Well over two million Australians now pay at least one extreme specialist fee a year - more than double the number in 2020.
'This policy failure is hurting patients and exacerbating the cost-of-living crisis. Governments must train more specialists, expand public clinics, and step in to regulate extreme fees.'
The policy brief comes a year after a major Grattan report, Special treatment: Improving Australians' access to specialist care, found that some specialists charge more than three times the Medicare schedule fee.
The new policy brief shows that since then, fees have continued to go up.
More than 800,000 Australians a year skip or delay getting specialist care due to the cost. Missing out on timely care can mean missed diagnoses, avoidable pain, and added pressure on hospitals.
This broken system needs an overhaul, including penalising specialists who routinely charge patients more than three times the Medicare schedule fee.
'This small minority of doctors should be forced to repay the value of their Medicare funding at the end of each year,' Mr Breadon says.
'Reforms to build up public clinics, help GPs provide more care, and train more specialists are desperately needed. But that will take years to work. In the meantime, fees keep rising, and every year more Australians are paying extreme fees.
'The Albanese government is proud of its strong commitment to Medicare. It's time to demonstrate that commitment by making sure all Australians can afford the specialist healthcare they need, when they need it.'
