The deliberate constraint of specialist doctors by medical colleges is driving up the cost of healthcare and contributing to a perverse system where taxpayers who foot the bill for their training can’t even afford to see them, the Health Services Union said today.
In its submission to the Standing Committee on Health, Aged Care and Disability on the Inquiry into access to and affordability of medical specialists in Australia, the union argues Australia’s specialist medical colleges deliberately engage in ‘scarcity as a business model’ and restrict the pipeline of available specialists while demand continues to grow.
The HSU is calling on Government to break the monopoly they have over the supply of new specialists and consider similar approaches to overseas jurisdictions where training and regulatory powers are separate.
HSU National Secretary Dustin Halse said for too long, warnings about the ability of specialist medical colleges’ to control supply had gone unheeded.
“As far back as 2005 the Australian Competition and Consumer Commission (ACCC) warned us about the sketchy processes of specialist medical colleges, saying they lack transparency and lessen competition – all of which directly contribute to the cost of accessing specialist care,” Mr Halse said.
“Much of the colleges’ power is historical rather than evidence-based and there is little proof that their business practices improve the quality of the medical workforce than models used in comparable overseas jurisdictions. By 2048 there will be an oversupply of almost 11,000 doctors waiting to enter specialist training and a shortage of almost 13,000 specialists. It’s time for a new approach.”
Mr Halse said competition for access to specialist care is driving health costs beyond the reach of ordinary Australians.
“More than 80 per cent of specialist training occurs in the public system yet just 37 per cent of specialists go on to work in it. Taxpayers fund the pipeline, public hospitals carry the training burden, and then the majority of specialists charge whatever the market will bear. The deliberate shortage of specialists means that in a wealthy country like Australia that amount is significant,” Mr Halse said.
“Average out-of-pocket costs have risen 43 per cent in a decade to $316 per patient while spending on out-of-pocket costs for non-hospital healthcare has doubled from $1.1 billion in 2014-15 to $2.2 billion last year.
“Sixty one percent of HSU members are delaying or going without necessary specialist care due to cost. Our members say they have cut medication and missed critical appointments – in some cases even accessing their superannuation and sacrificing their future financial security – so they can pay for climbing medical bills.
“There is very little transparency around these soaring prices and we know specialists working across multiple locations charge different fees for the same service which don’t reflect clinical complexity, the cost of treatment or patient outcomes. Instead, it is the wild west where data shows prices are shaped only by what patients can afford to pay. Those with the least money and often the greatest health needs are left with the fewest choices. We must do better.”
The submission also recommends setting fair market rates for procedures and consultations to protect patients from excessive out-of-pocket costs, as well as enforcing open referrals so patients know they have a choice over where they receive care, and increasing investment in preventative health to 5 per cent of total health expenditure, among other findings.
MEDIA: Eliot Barham 0423 921 200