This isn’t just a medical specialist cost problem, and is bigger than a few high-priced practitioners. It speaks to outdated funding models, a lack of digital infrastructure, and a lack of transparency. Misaligned economic incentives such as Medicare rebates not keeping up with rising costs of specialist care compounds the situation. Specialist shortages and geographic maldistribution results in longer wait lists (e.g. in dermatology, psychiatry & orthopaedics particularly) that then distorts market power.
Lack of fee transparency means patients are not empowered to make value for money decisions, and the lack of accountability on providers, means the issues persist. If we want universal healthcare to mean something in 2025 and beyond, we need more than good intentions – we need structural reform.
Recent commentary has pointed to 5 critical interventions that deserve serious attention:
- Consider penalising egregious fees – If the fee is excessive (this should be defined i.e. 300% of the MBS) Medicare wouldn’t subsidise it.
- Expand public specialist access – Fund public outpatient clinics, especially in specialties where market failure may be driving prices up.
- Make specialist fees transparent – Enable tech that allows GPs and patients to compare wait times, costs & outcomes across specialists, to empower patients to choose on both quality and cost.
- Expand the workforce – Address specialist bottlenecks through training, enable regional incentives, and smarter workforce planning.
- Re-evaluate the MBS to better reflect the true costs of modern practice, technology, and inflation, to reduce dependency on gap fees.
The imperative for healthcare leaders here, is to unify all stakeholders (healthcare boards, speciality colleges, and regulators) to lead this reform – and not just wait for the government or any one stakeholder to step in to fix it.
Consider penalising egregious fees – If the fee is excessive (this should be defined i.e. 300% of the MBS) Medicare wouldn’t subsidise it.
Expand public specialist access – Fund public outpatient clinics, especially in specialties where market failure may be driving prices up.
Recent commentary has pointed to critical interventions that deserve serious attention
