Health funds back stronger transparency laws for specialist doctor fees
Private Healthcare Australia
Private Healthcare Australia has welcomed the Federal Government’s legislation to upgrade the Medical Costs Finder website, saying it is a critical step toward tackling Australia’s growing specialist fee crisis.
The reform will expand the information available about specialist doctors’ fees, allowing patients to compare typical costs before booking an appointment and better estimate their likely out-of-pocket expenses.
The move comes after PHA last week released its report, Restoring affordable access to specialist care in Australia, backed by a nationally representative survey of more than 4,000 Australians.
The report revealed an urgent affordability and access problem reshaping Australia’s health system. It found:
- Some specialist doctors such as psychiatrists and surgeons are charging $500–$1,000 upfront for a first appointment.
- The median in-hospital specialist gap fee has risen 22 per cent since 2022.
- One in two patients did not know their fee before attending an appointment.
- 38 per cent received an unexpected bill and nearly one in three reported being charged illegal “booking” or “admin” fees.
- Nearly 30 per cent of Australians have delayed or cancelled specialist care in the past three years due to cost pressures.
Private Healthcare Australia CEO Dr Rachel David said too many Australians are walking into specialist appointments “in the dark”- or worse – not going at all because they’re concerned about the potential cost.
“Greater visibility of specialist fees will help patients compare options, avoid bill shock and make informed choices about their healthcare,” she said.
The report identifies enhanced fee transparency on the Medical Costs Finder as a key reform, alongside stronger consumer protections to eliminate surprise billing, boosting specialist supply - particularly in regional areas - and workforce reforms to expand patient choice.
Dr David said health funds stand ready to contribute more data to the upgraded website to help consumers better understand typical charges and expected out-of-pocket costs.
“Health funds want their members to be able to compare fees and know what they are signing up for so they can access private healthcare with confidence,” she said.
“This legislation is an important first step in restoring affordable access to specialist care and ensuring the private health system remains accessible and sustainable to take pressure off the public health system.”
Private Healthcare Australia looks forward to working with the Government to ensure the strengthened Medical Costs Finder becomes a practical, trusted tool for consumers and GPs alike.
About us:
Private Healthcare Australia is the peak representative body for Australia’s private health insurance industry. PHA represents more than 20 Australian health funds and 15 million Australians (55% of the population) who have private health insurance.
Contact details:
Julia Medew 0402 011 438
Andrea Petrie 0412 655 264