09 March 2017

Letter to the editor

The West Australian

Re: ‘WA’s Specialist Fees Verge on greed’ article by Cathy O’Leary Medical Editor 

Dear Editor

I write following your article ‘WA’s Specialist Fees Verge on greed’ by Cathy O’Leary Medical Editor (West Australian 8 March, 2017). It is disappointing that this article confuses increasing medical costs and an ongoing eight-year freeze on Medicare and Health Insurance benefits with greed. The report in the MJA highlights that although the costs associated with running medical practices continue to be subject to inflation, income from Medicare has been continually cut by successive governments and is now in the middle of an eight-year freeze. Yet during this time secretarial wages and nursing wages have increased, rents have gone up, as have electricity costs. Doctors must meet the cost of running a practice to ensure they provide the highest quality service to their patients. There is no desire to disadvantage their patients, but without the support of their staff and the ability to cover the costs of doing business there would be no service at all.

The author then discussed the case of their relative who had a ‘bit of a toothache’. If this were the case then a simple visit to the dentist should have solved the problem. Clearly the need to go to a surgeon and have general anaesthesia indicated something far from trivial. From the information in the article it would appear that the health insurer did not provide a full level of benefit cover for this patient. Unfortunately, many health funds have a myriad of technical rules that allow them to reduce the level of benefit paid to their policy holders. This is often not clear to them. It appears likely the insurer’s arbitrary fee was inadequate, and in this case of was well under half of the AMA fee.

As the freeze on Medicare rebates continues your readers should know that 76% of services for anaesthesia attract no out of pocket expenses at all. Of those services that do have out of pocket cost the average is about $85 per service.

Specialist doctors and General Practitioners will continue to charge patients for the work they do. Costs will continue to rise. If the Medicare freeze and lack of indexation of health insurance benefits continues then it will be the patient who pays more out of their own pocket. It is important that our patients are aware of this. It is also important that doctors should ensure that our patients are not surprised by these costs and that their ability to pay be considered when setting fees that will result in out of pocket payments.

Kind Regards

Associate Professor David M Scott


Australian Society of Anaesthetists