Specialist fees skyrocket as Aussie patients ditch care — A health system in the red
One million Australians are skipping or delaying specialist appointments due to out-of-pocket costs, with psychiatry fees soaring to an average of $671. Experts say urgent reforms are needed.
Aussie health care feeling like a sneaky extra billycart on the bill — a report from the Grattan Institute has revealed nearly 1 million Aussies are delaying or skipping specialist appointments due to soaring out-of-pocket costs.
Over the past 15 years, outpatient fees have ballooned. Specialists are pocketing up to 3× Medicare’s scheduled fee, with psychiatrists leading the charge at an average of $671 for an initial consult in 2023. For context, that’s a hefty chunk when you’re already paying school fees and petrol!
Public hospitals are copping the overflows — untreated issues delayed for financial reasons now end up costing the system far more.
Specialist Fee Breakdown – 2023 (out-of-pocket for extreme-fee specialists)
| Specialty | Avg Cost (AUD) |
|---|---|
| Psychiatry | $671 |
| Endocrinology | $372 |
| Cardiology | $369 |
| Paediatrics | $363 |
| Immunology | $358 |
| Neurology | $356 |
| Perinatal medicine | $312 |
| General medicine | $292 |
| Cardio‑thoracic surgery | $233 |
| Oral & maxillofacial surg. | $230 |
| Obstetrics/Gynaecology | $228 |
Source: Grattan Institute 2024 data.
Key Insights
- Cost conundrum: One in 10 Aussies are coughing up nearly $600/year just for regular specialist check‑ups.
- Income gap: For low‑income households (under $500/week), the average out-of-pocket bills hit nearly $500 annually.
- Postcode lottery: Results vary significantly depending on where you live – some regions get ⅓ fewer specialist visits compared to others.
- System strain: Delayed care leads to hospital overload and more severe health crises down the line.
- Lack of transparency: Patients often walk into appointments blind on fees — there’s little way to compare or even know costs upfront..
Proposed Fixes (Grattan’s 5‑Point Plan)
- Strip Medicare rebates from specialists charging “extreme” fees, and publicly name them.
- Expand public specialist clinics in under-served areas — add ~1 million extra services/year.
- Mandate fee transparency, upgrading tools like the Medical Costs Finder.
- Boost specialist training funding — especially psychiatry, rural/general fields, with $160m over time.
- Enable GP-specialist consults, aiming to eliminate ~70,000 unnecessary referrals and save $4m.
Federal Health Minister Mark Butler backed calls for more cost transparency, pledging to overhaul the Medical Costs Finder tool.
Final Take
Let’s call it — seeing a specialist lately feels less like healthcare and more like a surprise entry fee at Luna Park. With 1 in 10 households forgoing vital care over cost, it’s no wonder GP waiting rooms and public hospitals are jam-packed.
Takeaway: Unless we’re serious about tackling out-of-pocket specialist fees, we’ll keep short-changing real health and funding future pain — literally and financially. Time to implement some of Grattan’s suggestions before a full-blown postcode healthcare crisis goes off the rails.
