A recent report by the Grattan Institute reveals that nearly 1.9 million Australians are delaying or skipping critical medical care due to high specialist medical costs.

In the 2023/24 period, approximately 40% of Australians consulted a specialist, with about two-thirds of these appointments being private, where patients incur additional gap fees after receiving Medicare rebates.

The report highlights that some private specialists charge two to three times more than Medicare rates, which significantly contributes to the delays in accessing care.

Patients of one specialist were paying an average of $300 annually in 2023, reflecting a staggering 73% increase since 2010.

These high costs create barriers to essential healthcare, particularly impacting lower-income Australians who may wait months or even years for urgent appointments, leading to missed diagnoses and increased strain on hospitals.

Peter Breadon, director of Grattan's Health Program, emphasized that the healthcare system is fundamentally flawed and requires comprehensive reform in planning, funding, and integration of care.

Federal Health Minister Mark Butler stated that private health insurers and specialists must take more responsibility to protect patients from high costs and announced plans to enhance the Medical Costs Finder for better cost transparency.

The Grattan Institute's recommendations include eliminating Medicare subsidies for specialists with excessive fees, publicly naming them, and increasing the number of specialist appointment services by one million annually in underserved areas.

In 2023, the average out-of-pocket expenses for high-fee specialists reached $671 for psychiatry services and over $350 for specialties like endocrinology and cardiology.

Additionally, the report suggests modernizing public specialist clinics and investing $160 million to improve training in undersupplied specialties and rural areas.

Danielle McMullen, President of the Australian Medical Association, stressed that underinvestment in public hospitals and inadequate Medicare rebates exacerbate access issues, potentially worsening health outcomes due to delayed care.

While McMullen supports Grattan's recommendations, she argues that removing Medicare funding from high-fee specialists is impractical.