The Australian Medical Association welcomes the government's commitment to increase transparency on consumer out-of-pocket costs for private healthcare, including placing stronger obligations on insurers to reveal data showing how much they contribute to the cost of care and how often patients pay out-of-pocket costs that are not fully covered by their insurance policy.
However, AMA President Dr Danielle McMullen said upgrades to the Medical Costs Finder alone would not fix the systemic issues contributing to increasing costs for the delivery of services.
"Labor's commitment to upgrade the Medical Costs Finder website has the potential to improve transparency for consumers on possible out-of-pocket costs, if the changes include relevant information about all factors that contribute to costs," Dr McMullen said.
This will require close collaboration with the medical profession to ensure the site focuses on key elements of informed financial consent and promoting financial health literacy. The AMA is already in discussions about how to achieve this with Health Minister Mark Butler's office and the Department of Health and Aged Care.
"The AMA has long advocated for greater transparency for patients when it comes to medical costs, which is why we have published a detailed Informed Financial Consent guide — a document that empowers patients to discuss costs with their doctor before undergoing medical procedures," Dr McMullen said.
"The commitment to redevelop the Medical Cost Finder website will require extensive input from the profession, as well as legislative changes. It is essential this time is used to get these changes right, and ensure data is accurate. The AMA will work closely with whichever government is in power after the election to improve transparency on medical costs."
A major challenge to medical practitioner uptake of the Medical Costs Finder website has been the lack of information provided by private health insurers, particularly about the rebates provided for specific procedures. Despite a commitment from the former government to include this, insurers have largely avoided this scrutiny.
"Our private health insurance report card provides a snapshot of the rebates insurers pay for the same service, and this year it highlighted a $510 difference between the highest and lowest rebates for the uncomplicated delivery of a baby. The difference in rebates has a major impact on a doctor's decision to accept the insurer's rebate or charge a gap," Dr McMullen said.
"The rebates patients receive are hidden on individual insurer websites, but we think they should be plainly available to consumers when they visit the Medical Costs Finder website to see which insurer provides the best value for the procedure.
"One change we will push for is to the name of the website, as it's much more than just 'medical costs' that cause out-of-pocket costs for patients."
The lack of transparency on rebates is likely contributing to the poor indexation of rebates from insurers. As the AMA's report card also shows, net profits for insurers have increased by almost 50 per cent in the five years to June 2024, while the patient rebate for medical services has increased by just over 10 per cent in that time.
"The underlying Medicare rebates for specialists were never restored to where they should have been after the Medicare freeze, and there has been no announcements or significant investments to specialist rebates by successive governments. This continues to contribute to out-of-pocket costs for patients, especially for consultations," Dr McMullen said.
Dr McMullen said the AMA would work closely with any government on upgrades the Medical Costs Finder website to ensure all information is available, and the existing technical challenges practitioners have experienced trying to use the website are addressed.
