News Life and Health06 Apr 2018

Australia:Out of pocket pain becoming common for insured patients

| 06 Apr 2018

Out of pocket medical bills exceeding A$10,000 (US$7.700) have become common place for patients with breast cancer and certain chronic conditions, a national survey conducted by the Consumers Health Forum of Australia has found.

The “Out of Pocket Pain” report released yesterday is based on the survey which drew 1,200 responses, many from people shocked to learn that despite having health insurance they still had to pay thousands of dollars out of their own pockets for critical surgery, other treatment and diagnostic scans.

“The responses to the survey give a disturbing insight into the high costs of medical care and challenge the notion that everyone can access the care they need in Australia,” the CEO of the Consumers Health Forum, Leanne Wells, said.

“We have heard from pensioners and single mothers who have foregone recommended care because of cost, from many people exasperated to find that the insurance they have held for many years will not cover gaps of thousands of dollars, from patients who learn belatedly of unexpected extra costs for junior surgeons, anaesthetists and MRI scans, and from people who have had to call for special access to their superannuation funds to cover the bills.”

“The expense is made the more difficult by the uncertainty and complexity of the relationship between treatment and costs with varying levels of cover, or no cover, provided by health funds and by Medicare, the publicly funded universal health care scheme in Australia.

Among key results of the survey are:

  • More than a quarter of respondents treated for breast cancer incurred out of pocket costs of more than A$10,000
  • More than a third of respondents with chronic conditions like multiple sclerosis reported out of pocket costs of more than A$10,000
  • One in six respondents said that out of pocket costs had a significant impact on their lives
  • A frequently expressed view that using private health insurance would expose people to more costs
  • A third of respondents said the out of pocket costs were not explained to them before treatment.

Ms Wells said that the Consumers Health Forum conducted the survey to provide a strong consumer perspective to the Federal Government’s expert committee chaired by Chief Health Officer Brendan Murphy which is examining out of pocket costs.

“The very high medical costs many Australians now pay to receive the surgery and other treatment they must have is raising profound questions.

“While the survey was largely responded to by people with private insurance, the plight for many uninsured people is likely to mean a choice between high out of pocket costs for private care or significantly longer waits for treatment in public hospitals.”

She said that a key recommendation of the Consumers Health Forum is that transparency be shone on medical costs and on the extent to which subsidised health insurance arrangements are working in the interests of both consumers and the overall health system itself.

“Given the costs involved, consumers require clarity and certainty in ascertaining the fees they face, in total and in detail. This could be provided on an independent, authoritative website containing all doctors’ fees,” she said.



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