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With the election behind us, the final ironic legacy of a previous government lies before us
With the election behind us, the final ironic legacy of a previous government lies before us

The Advertiser

time4 days ago

  • Health
  • The Advertiser

With the election behind us, the final ironic legacy of a previous government lies before us

On March 2 this year, I wrote on these pages: "Bulk-billing GPs have borne the brunt of the Coalition's stealth attack on Medicare." "They should have a very substantial catch-up, and in a way that makes bulk-billing pretty much universal," I said. "It would happen more quickly if the government did not just give more to bulk-billing GPs but also reduced the payment to those who do not. "And with specialists, too, there needs to be much bigger incentives to those who bulk-bill and reduced payments to those who do not. "Maybe Medicare payments should cut out altogether when specialists' gap fees rise too much - certainly if they are more than the scheduled fee itself." Last week the independent think-tank Grattan Institute came out with a similar proposal. It suggested that Medicare benefits should not be available to the patients of specialists who charge more than double the Medicare scheduled fee. I do not mention this to give myself a pat on the back, or, indeed, to give the Grattan Institute a pat on the pack. To the contrary, it shows that what I had proposed was hardly original. Indeed, it was the bleeding obvious. A lot of what you might read in this column each week is the bleeding obvious. The dispiriting thing is that government behaviour in Australia is often so bad that the bleeding obvious has to be pointed out again, and again, and again. Capital gains concessions, cash franking credits, negative gearing, tax-avoided trust incomes, superannuation tax concessions for the uber-wealthy, profit-shifting to tax havens; tax rebates on private-health premiums, GST exemptions for health and education enjoyed mostly by the well-off, over-funding of private hospitals and private schools, gambling advertising, food labelling, the sugar tax, exploitation of workers in the gig economy, massive immigration increases, fossil-fuel subsidies, idiotic and ineffectual housing subsidies that fuel the fire, massive investment in inefficient private transport, and the list goes on and on. Solid think tanks, like the Grattan Institute and the Australia Institute, and oodles of my journalistic colleagues, point out the merit of reform in all these areas and more, again and again and again. Yet nothing happens. Why? MORE CRIPSIN: Like most unfairness in Australia, this super problem can be traced back to one government It bespeaks the slow erosion of the way government is done in Australia. And now should be the time to do something about it. This is because nearly all of the items in the list above are legacies from the Howard government and all of them have made access to quality health, education, and housing much less equal and more unfair. Now with the election results declared, the final ironic legacy of the Howard government lies before us. Howard began the systematic process of removing nearly all the moderate people and moderate policies from the Liberal Party, which resulted in the party being unelectable and the country without an effective or constructive opposition. The pews to the left of the nave in Howard's "broad church" have been emptied. With that narrowing to the right, membership of the party aged and shrank, so it had to turn elsewhere for the resources (human and monetary) to underwrite election campaigns in the form of large corporate donations and shadowy organisations like the Exclusive Brethren handing out how-to-vote cards. The price was social and economic policies moving even further to the unacceptable right. To a lesser degree, it happened to Labor as well. To that extent, Prime Minister Anthony Albanese's address to the National Press Club was disappointing. Not because he said that he was reformist, not revolutionary, but because of the suggestion that the winding back any of those Howard agenda items would be "revolutionary" when in fact they would hardly be even reformist - just a return to the centre. The message Labor should get from the election is that, at the very least, the electorate wants an end to the unfair policies and the putting into effect very obvious evidence-based policies to protect people against harm - gambling and sugar, are good examples - all underpinned by more democratic processes. Labor's superannuation changes are an example of how not to do it - just tinkering at the edges while the rorts are left largely intact. Of course, the obvious cause for the policy inertia is the control of the major parties by sectional interests: big employers, big agriculture, fossil fuels, mining, property, big pharma, and the list goes on. It is fine for a major political party to have as its aim the gaining and retaining of power. The trouble now is the way that is done and for what purpose. These days it is not by appealing to what the mass of voters want or arguing a case before the voters so they support it. Rather is done by getting enough donations to run an election campaign, even if that means compromising the public good in favour of sectional interests to as great an extent as they can get away with. In that context it becomes the pursuit of power for its own sake, necessitating the duping of many voters as to what they are doing. The Trumpists, the Brexiters, and the Coalition used distraction and blame to exploit the resentment of those who had lost out in the free-trade, economic-rationalist revolution by saying it was the fault of the Washington swamp, the Brussels bureaucracy, and the Canberra bubble - elite conspirators against older, white, male, Christian workers. But people working in government or academia are much more likely to be on the side of the broad public interest than the real swamp and bubble dwellers - industry lobbyists who slink around the corridors of power promoting the selfish, sectional interests of their masters invariably in a way inimical to the public interest and the environment. Policy should be developed in a more open way, with the public, the Parliament, and the party rooms, and diverse inputs, not hatched in the Prime Minister's office and imposed from the top down. Whether Albanese calls it revolutionary or just reform does not matter. Getting rid of that way of politics would go a long way to making Labor the natural party of government if the Liberal Party continues to go down an unelectable sinkhole with the National Party. Otherwise, voters - who are slowly realising how they have been dudded and by whom - will continue to turn to the independents. On March 2 this year, I wrote on these pages: "Bulk-billing GPs have borne the brunt of the Coalition's stealth attack on Medicare." "They should have a very substantial catch-up, and in a way that makes bulk-billing pretty much universal," I said. "It would happen more quickly if the government did not just give more to bulk-billing GPs but also reduced the payment to those who do not. "And with specialists, too, there needs to be much bigger incentives to those who bulk-bill and reduced payments to those who do not. "Maybe Medicare payments should cut out altogether when specialists' gap fees rise too much - certainly if they are more than the scheduled fee itself." Last week the independent think-tank Grattan Institute came out with a similar proposal. It suggested that Medicare benefits should not be available to the patients of specialists who charge more than double the Medicare scheduled fee. I do not mention this to give myself a pat on the back, or, indeed, to give the Grattan Institute a pat on the pack. To the contrary, it shows that what I had proposed was hardly original. Indeed, it was the bleeding obvious. A lot of what you might read in this column each week is the bleeding obvious. The dispiriting thing is that government behaviour in Australia is often so bad that the bleeding obvious has to be pointed out again, and again, and again. Capital gains concessions, cash franking credits, negative gearing, tax-avoided trust incomes, superannuation tax concessions for the uber-wealthy, profit-shifting to tax havens; tax rebates on private-health premiums, GST exemptions for health and education enjoyed mostly by the well-off, over-funding of private hospitals and private schools, gambling advertising, food labelling, the sugar tax, exploitation of workers in the gig economy, massive immigration increases, fossil-fuel subsidies, idiotic and ineffectual housing subsidies that fuel the fire, massive investment in inefficient private transport, and the list goes on and on. Solid think tanks, like the Grattan Institute and the Australia Institute, and oodles of my journalistic colleagues, point out the merit of reform in all these areas and more, again and again and again. Yet nothing happens. Why? MORE CRIPSIN: Like most unfairness in Australia, this super problem can be traced back to one government It bespeaks the slow erosion of the way government is done in Australia. And now should be the time to do something about it. This is because nearly all of the items in the list above are legacies from the Howard government and all of them have made access to quality health, education, and housing much less equal and more unfair. Now with the election results declared, the final ironic legacy of the Howard government lies before us. Howard began the systematic process of removing nearly all the moderate people and moderate policies from the Liberal Party, which resulted in the party being unelectable and the country without an effective or constructive opposition. The pews to the left of the nave in Howard's "broad church" have been emptied. With that narrowing to the right, membership of the party aged and shrank, so it had to turn elsewhere for the resources (human and monetary) to underwrite election campaigns in the form of large corporate donations and shadowy organisations like the Exclusive Brethren handing out how-to-vote cards. The price was social and economic policies moving even further to the unacceptable right. To a lesser degree, it happened to Labor as well. To that extent, Prime Minister Anthony Albanese's address to the National Press Club was disappointing. Not because he said that he was reformist, not revolutionary, but because of the suggestion that the winding back any of those Howard agenda items would be "revolutionary" when in fact they would hardly be even reformist - just a return to the centre. The message Labor should get from the election is that, at the very least, the electorate wants an end to the unfair policies and the putting into effect very obvious evidence-based policies to protect people against harm - gambling and sugar, are good examples - all underpinned by more democratic processes. Labor's superannuation changes are an example of how not to do it - just tinkering at the edges while the rorts are left largely intact. Of course, the obvious cause for the policy inertia is the control of the major parties by sectional interests: big employers, big agriculture, fossil fuels, mining, property, big pharma, and the list goes on. It is fine for a major political party to have as its aim the gaining and retaining of power. The trouble now is the way that is done and for what purpose. These days it is not by appealing to what the mass of voters want or arguing a case before the voters so they support it. Rather is done by getting enough donations to run an election campaign, even if that means compromising the public good in favour of sectional interests to as great an extent as they can get away with. In that context it becomes the pursuit of power for its own sake, necessitating the duping of many voters as to what they are doing. The Trumpists, the Brexiters, and the Coalition used distraction and blame to exploit the resentment of those who had lost out in the free-trade, economic-rationalist revolution by saying it was the fault of the Washington swamp, the Brussels bureaucracy, and the Canberra bubble - elite conspirators against older, white, male, Christian workers. But people working in government or academia are much more likely to be on the side of the broad public interest than the real swamp and bubble dwellers - industry lobbyists who slink around the corridors of power promoting the selfish, sectional interests of their masters invariably in a way inimical to the public interest and the environment. Policy should be developed in a more open way, with the public, the Parliament, and the party rooms, and diverse inputs, not hatched in the Prime Minister's office and imposed from the top down. Whether Albanese calls it revolutionary or just reform does not matter. Getting rid of that way of politics would go a long way to making Labor the natural party of government if the Liberal Party continues to go down an unelectable sinkhole with the National Party. Otherwise, voters - who are slowly realising how they have been dudded and by whom - will continue to turn to the independents. On March 2 this year, I wrote on these pages: "Bulk-billing GPs have borne the brunt of the Coalition's stealth attack on Medicare." "They should have a very substantial catch-up, and in a way that makes bulk-billing pretty much universal," I said. "It would happen more quickly if the government did not just give more to bulk-billing GPs but also reduced the payment to those who do not. "And with specialists, too, there needs to be much bigger incentives to those who bulk-bill and reduced payments to those who do not. "Maybe Medicare payments should cut out altogether when specialists' gap fees rise too much - certainly if they are more than the scheduled fee itself." Last week the independent think-tank Grattan Institute came out with a similar proposal. It suggested that Medicare benefits should not be available to the patients of specialists who charge more than double the Medicare scheduled fee. I do not mention this to give myself a pat on the back, or, indeed, to give the Grattan Institute a pat on the pack. To the contrary, it shows that what I had proposed was hardly original. Indeed, it was the bleeding obvious. A lot of what you might read in this column each week is the bleeding obvious. The dispiriting thing is that government behaviour in Australia is often so bad that the bleeding obvious has to be pointed out again, and again, and again. Capital gains concessions, cash franking credits, negative gearing, tax-avoided trust incomes, superannuation tax concessions for the uber-wealthy, profit-shifting to tax havens; tax rebates on private-health premiums, GST exemptions for health and education enjoyed mostly by the well-off, over-funding of private hospitals and private schools, gambling advertising, food labelling, the sugar tax, exploitation of workers in the gig economy, massive immigration increases, fossil-fuel subsidies, idiotic and ineffectual housing subsidies that fuel the fire, massive investment in inefficient private transport, and the list goes on and on. Solid think tanks, like the Grattan Institute and the Australia Institute, and oodles of my journalistic colleagues, point out the merit of reform in all these areas and more, again and again and again. Yet nothing happens. Why? MORE CRIPSIN: Like most unfairness in Australia, this super problem can be traced back to one government It bespeaks the slow erosion of the way government is done in Australia. And now should be the time to do something about it. This is because nearly all of the items in the list above are legacies from the Howard government and all of them have made access to quality health, education, and housing much less equal and more unfair. Now with the election results declared, the final ironic legacy of the Howard government lies before us. Howard began the systematic process of removing nearly all the moderate people and moderate policies from the Liberal Party, which resulted in the party being unelectable and the country without an effective or constructive opposition. The pews to the left of the nave in Howard's "broad church" have been emptied. With that narrowing to the right, membership of the party aged and shrank, so it had to turn elsewhere for the resources (human and monetary) to underwrite election campaigns in the form of large corporate donations and shadowy organisations like the Exclusive Brethren handing out how-to-vote cards. The price was social and economic policies moving even further to the unacceptable right. To a lesser degree, it happened to Labor as well. To that extent, Prime Minister Anthony Albanese's address to the National Press Club was disappointing. Not because he said that he was reformist, not revolutionary, but because of the suggestion that the winding back any of those Howard agenda items would be "revolutionary" when in fact they would hardly be even reformist - just a return to the centre. The message Labor should get from the election is that, at the very least, the electorate wants an end to the unfair policies and the putting into effect very obvious evidence-based policies to protect people against harm - gambling and sugar, are good examples - all underpinned by more democratic processes. Labor's superannuation changes are an example of how not to do it - just tinkering at the edges while the rorts are left largely intact. Of course, the obvious cause for the policy inertia is the control of the major parties by sectional interests: big employers, big agriculture, fossil fuels, mining, property, big pharma, and the list goes on. It is fine for a major political party to have as its aim the gaining and retaining of power. The trouble now is the way that is done and for what purpose. These days it is not by appealing to what the mass of voters want or arguing a case before the voters so they support it. Rather is done by getting enough donations to run an election campaign, even if that means compromising the public good in favour of sectional interests to as great an extent as they can get away with. In that context it becomes the pursuit of power for its own sake, necessitating the duping of many voters as to what they are doing. The Trumpists, the Brexiters, and the Coalition used distraction and blame to exploit the resentment of those who had lost out in the free-trade, economic-rationalist revolution by saying it was the fault of the Washington swamp, the Brussels bureaucracy, and the Canberra bubble - elite conspirators against older, white, male, Christian workers. But people working in government or academia are much more likely to be on the side of the broad public interest than the real swamp and bubble dwellers - industry lobbyists who slink around the corridors of power promoting the selfish, sectional interests of their masters invariably in a way inimical to the public interest and the environment. Policy should be developed in a more open way, with the public, the Parliament, and the party rooms, and diverse inputs, not hatched in the Prime Minister's office and imposed from the top down. Whether Albanese calls it revolutionary or just reform does not matter. Getting rid of that way of politics would go a long way to making Labor the natural party of government if the Liberal Party continues to go down an unelectable sinkhole with the National Party. Otherwise, voters - who are slowly realising how they have been dudded and by whom - will continue to turn to the independents. On March 2 this year, I wrote on these pages: "Bulk-billing GPs have borne the brunt of the Coalition's stealth attack on Medicare." "They should have a very substantial catch-up, and in a way that makes bulk-billing pretty much universal," I said. "It would happen more quickly if the government did not just give more to bulk-billing GPs but also reduced the payment to those who do not. "And with specialists, too, there needs to be much bigger incentives to those who bulk-bill and reduced payments to those who do not. "Maybe Medicare payments should cut out altogether when specialists' gap fees rise too much - certainly if they are more than the scheduled fee itself." Last week the independent think-tank Grattan Institute came out with a similar proposal. It suggested that Medicare benefits should not be available to the patients of specialists who charge more than double the Medicare scheduled fee. I do not mention this to give myself a pat on the back, or, indeed, to give the Grattan Institute a pat on the pack. To the contrary, it shows that what I had proposed was hardly original. Indeed, it was the bleeding obvious. A lot of what you might read in this column each week is the bleeding obvious. The dispiriting thing is that government behaviour in Australia is often so bad that the bleeding obvious has to be pointed out again, and again, and again. Capital gains concessions, cash franking credits, negative gearing, tax-avoided trust incomes, superannuation tax concessions for the uber-wealthy, profit-shifting to tax havens; tax rebates on private-health premiums, GST exemptions for health and education enjoyed mostly by the well-off, over-funding of private hospitals and private schools, gambling advertising, food labelling, the sugar tax, exploitation of workers in the gig economy, massive immigration increases, fossil-fuel subsidies, idiotic and ineffectual housing subsidies that fuel the fire, massive investment in inefficient private transport, and the list goes on and on. Solid think tanks, like the Grattan Institute and the Australia Institute, and oodles of my journalistic colleagues, point out the merit of reform in all these areas and more, again and again and again. Yet nothing happens. Why? MORE CRIPSIN: Like most unfairness in Australia, this super problem can be traced back to one government It bespeaks the slow erosion of the way government is done in Australia. And now should be the time to do something about it. This is because nearly all of the items in the list above are legacies from the Howard government and all of them have made access to quality health, education, and housing much less equal and more unfair. Now with the election results declared, the final ironic legacy of the Howard government lies before us. Howard began the systematic process of removing nearly all the moderate people and moderate policies from the Liberal Party, which resulted in the party being unelectable and the country without an effective or constructive opposition. The pews to the left of the nave in Howard's "broad church" have been emptied. With that narrowing to the right, membership of the party aged and shrank, so it had to turn elsewhere for the resources (human and monetary) to underwrite election campaigns in the form of large corporate donations and shadowy organisations like the Exclusive Brethren handing out how-to-vote cards. The price was social and economic policies moving even further to the unacceptable right. To a lesser degree, it happened to Labor as well. To that extent, Prime Minister Anthony Albanese's address to the National Press Club was disappointing. Not because he said that he was reformist, not revolutionary, but because of the suggestion that the winding back any of those Howard agenda items would be "revolutionary" when in fact they would hardly be even reformist - just a return to the centre. The message Labor should get from the election is that, at the very least, the electorate wants an end to the unfair policies and the putting into effect very obvious evidence-based policies to protect people against harm - gambling and sugar, are good examples - all underpinned by more democratic processes. Labor's superannuation changes are an example of how not to do it - just tinkering at the edges while the rorts are left largely intact. Of course, the obvious cause for the policy inertia is the control of the major parties by sectional interests: big employers, big agriculture, fossil fuels, mining, property, big pharma, and the list goes on. It is fine for a major political party to have as its aim the gaining and retaining of power. The trouble now is the way that is done and for what purpose. These days it is not by appealing to what the mass of voters want or arguing a case before the voters so they support it. Rather is done by getting enough donations to run an election campaign, even if that means compromising the public good in favour of sectional interests to as great an extent as they can get away with. In that context it becomes the pursuit of power for its own sake, necessitating the duping of many voters as to what they are doing. The Trumpists, the Brexiters, and the Coalition used distraction and blame to exploit the resentment of those who had lost out in the free-trade, economic-rationalist revolution by saying it was the fault of the Washington swamp, the Brussels bureaucracy, and the Canberra bubble - elite conspirators against older, white, male, Christian workers. But people working in government or academia are much more likely to be on the side of the broad public interest than the real swamp and bubble dwellers - industry lobbyists who slink around the corridors of power promoting the selfish, sectional interests of their masters invariably in a way inimical to the public interest and the environment. Policy should be developed in a more open way, with the public, the Parliament, and the party rooms, and diverse inputs, not hatched in the Prime Minister's office and imposed from the top down. Whether Albanese calls it revolutionary or just reform does not matter. Getting rid of that way of politics would go a long way to making Labor the natural party of government if the Liberal Party continues to go down an unelectable sinkhole with the National Party. Otherwise, voters - who are slowly realising how they have been dudded and by whom - will continue to turn to the independents.

Report finds excessive medical fees prohibit patients accessing specialist care
Report finds excessive medical fees prohibit patients accessing specialist care

SBS Australia

time4 days ago

  • Health
  • SBS Australia

Report finds excessive medical fees prohibit patients accessing specialist care

Report finds excessive medical fees prohibit patients accessing specialist care Published 16 June 2025, 8:21 am Cost barriers are preventing millions of Australians from receiving specialist care. That is based on a Grattan institute report shining a light-on the extreme fees being charged. While the public system provides the majority of care in some specialties, it accounts for only a fraction in others.

Soaring doctor fees are a pain, but medics have another problem
Soaring doctor fees are a pain, but medics have another problem

The Age

time4 days ago

  • Health
  • The Age

Soaring doctor fees are a pain, but medics have another problem

If you have a history of medical mayhem in your family, specialists are part of your life from early on. Sure, you might feel fine. But my darling GPs have a different vibe. Feeling fine means nothing to them. So it is, with still a good six months to go in 2025, that I've nearly reached my safety net. Probably by this weekend, I'll be there. The Medicare safety nets come in when you incur a certain amount of out-of-pocket costs for out-of-pocket medical services. There's a scheduled fee. Then there is what we're really charged. This week, the Grattan Institute released a report which revealed, kind of, the true cost of visiting a specialist in this country. It says 40 per cent of Australians saw a specialist in 2023-2024, and, with government, we spent nearly $9 billion in 2021-2022. More than one in five Australians who saw a specialist in 2023 was charged an extreme fee at least once. Grattan tells us one in 10 Australians who saw a psychiatrist ended up paying $400 in out-of-pocket costs for their initial consultation alone. Grattan has a bunch of excellent recommendations. My favourite would be to strip Medicare rebates from specialists charging excessive fees. And then set the competition watchdog on specialist costs. Perfect. But money is not the only problem. It's the emotional cost, the cognitive load. Decades back, we spent time concentrating on the way doctors dealt with patients. Universities started to interview students based on their interpersonal skills – and choosing them on that basis, as well as stuff they could study for. The Australian Health Practitioner Regulation Agency received more than 11,000 complaints about medical practitioners last year – well up from the year before. About one in six of those complaints is about communication. Whatever universities and specialist colleges are teaching their students about communication, it is not enough. Five out of six in the list of top earners from the Australian Taxation Office are doctors of one kind or another. I'm sure they're happy. I wouldn't mind paying their gaps if I also thought I was getting good service. Clear, open communication. Warm hearts, warm hands. Medical receptionists who are not so overloaded they can't do their jobs properly. (A special shout-out to Anna. You are a gem and so is your boss.) A quick but seriously anecdotal and eavesdroppy survey of the people who shared a waiting room with me last week – people going to the medical receptionist every 20 minutes or so to ask how much longer they would have to wait. My own experience at this practice? Five hours of delay. 'Sorry, the doctor is very busy.' So are the rest of us.

Soaring doctor fees are a pain, but medics have another problem
Soaring doctor fees are a pain, but medics have another problem

Sydney Morning Herald

time4 days ago

  • Health
  • Sydney Morning Herald

Soaring doctor fees are a pain, but medics have another problem

If you have a history of medical mayhem in your family, specialists are part of your life from early on. Sure, you might feel fine. But my darling GPs have a different vibe. Feeling fine means nothing to them. So it is, with still a good six months to go in 2025, that I've nearly reached my safety net. Probably by this weekend, I'll be there. The Medicare safety nets come in when you incur a certain amount of out-of-pocket costs for out-of-pocket medical services. There's a scheduled fee. Then there is what we're really charged. This week, the Grattan Institute released a report which revealed, kind of, the true cost of visiting a specialist in this country. It says 40 per cent of Australians saw a specialist in 2023-2024, and, with government, we spent nearly $9 billion in 2021-2022. More than one in five Australians who saw a specialist in 2023 was charged an extreme fee at least once. Grattan tells us one in 10 Australians who saw a psychiatrist ended up paying $400 in out-of-pocket costs for their initial consultation alone. Grattan has a bunch of excellent recommendations. My favourite would be to strip Medicare rebates from specialists charging excessive fees. And then set the competition watchdog on specialist costs. Perfect. But money is not the only problem. It's the emotional cost, the cognitive load. Decades back, we spent time concentrating on the way doctors dealt with patients. Universities started to interview students based on their interpersonal skills – and choosing them on that basis, as well as stuff they could study for. The Australian Health Practitioner Regulation Agency received more than 11,000 complaints about medical practitioners last year – well up from the year before. About one in six of those complaints is about communication. Whatever universities and specialist colleges are teaching their students about communication, it is not enough. Five out of six in the list of top earners from the Australian Taxation Office are doctors of one kind or another. I'm sure they're happy. I wouldn't mind paying their gaps if I also thought I was getting good service. Clear, open communication. Warm hearts, warm hands. Medical receptionists who are not so overloaded they can't do their jobs properly. (A special shout-out to Anna. You are a gem and so is your boss.) A quick but seriously anecdotal and eavesdroppy survey of the people who shared a waiting room with me last week – people going to the medical receptionist every 20 minutes or so to ask how much longer they would have to wait. My own experience at this practice? Five hours of delay. 'Sorry, the doctor is very busy.' So are the rest of us.

Mental health hit hardest amid exorbitant doctor fees
Mental health hit hardest amid exorbitant doctor fees

The Advertiser

time5 days ago

  • Health
  • The Advertiser

Mental health hit hardest amid exorbitant doctor fees

Psychiatry has topped the list of extreme fee-charging medical specialties, with those seeking vital mental health care among the hardest hit. A report from a public policy think tank has found about 1.9 million Australians are delaying or skipping critical medical care due to exorbitant fees for specialist doctors. The Grattan Institute report also highlights access to specialist care in Australia is a "postcode lottery", with people living in well-served areas receiving about a third more services than disadvantaged communities. Average out-of-pocket costs for extreme-fee-charging specialists in 2023 reached $671 for psychiatry services and more than $350 for endocrinology, cardiology, paediatrics, immunology and neurology services. The fees are resulting in "too many people are missing out on specialist mental health care", according to the Royal Australian and New Zealand College of Psychiatrists. "Access to psychiatric care is a major issue ... along with workforce shortages, high out-of-pocket costs and maldistribution of psychiatrists in rural and remote parts of the country," the spokesperson said. About 28.7 per cent of people who needed to see a psychiatrist either delayed or did not see one due to costs in 2023/24, according to the Australian Bureau of Statistics. In March, concerns over access deepened when it was revealed that more than 140 of 433 psychiatrist positions were vacant in NSW, following a stand-off over pay in the public health system. Grattan's Health Program director Peter Breadon told AAP the system was broken from start to end. The report outlines recommendations to address these growing issues, including scrapping Medicare subsidies for specialists who charge excessive fees and publicly naming those practitioners to increase accountability. It also urges governments to fund additional specialist appointments annually in under-serviced areas, and invest $160 million to expand training in undersupplied specialties and rural regions. The RANZCP spokesperson told AAP it supported several of the recommendations, including the need for structural changes to improve the affordability of psychiatric care in private outpatient clinics and consulting rooms. "Medicare is meant to be the backbone of our health system, and yet mental health services are chronically underfunded," they said. Australian Medical Association president Danielle McMullen supports most of Grattan's recommendations, but said removing Medicare funding from specialists who charged excessive fees was not practical. She urged leaders to sort out longer-term funding for public hospitals and develop a health workforce data tracker to show where investment was needed. Federal Health Minister Mark Butler said private health insurers and specialists needed to do more to protect patients from exorbitant bills. Psychiatry has topped the list of extreme fee-charging medical specialties, with those seeking vital mental health care among the hardest hit. A report from a public policy think tank has found about 1.9 million Australians are delaying or skipping critical medical care due to exorbitant fees for specialist doctors. The Grattan Institute report also highlights access to specialist care in Australia is a "postcode lottery", with people living in well-served areas receiving about a third more services than disadvantaged communities. Average out-of-pocket costs for extreme-fee-charging specialists in 2023 reached $671 for psychiatry services and more than $350 for endocrinology, cardiology, paediatrics, immunology and neurology services. The fees are resulting in "too many people are missing out on specialist mental health care", according to the Royal Australian and New Zealand College of Psychiatrists. "Access to psychiatric care is a major issue ... along with workforce shortages, high out-of-pocket costs and maldistribution of psychiatrists in rural and remote parts of the country," the spokesperson said. About 28.7 per cent of people who needed to see a psychiatrist either delayed or did not see one due to costs in 2023/24, according to the Australian Bureau of Statistics. In March, concerns over access deepened when it was revealed that more than 140 of 433 psychiatrist positions were vacant in NSW, following a stand-off over pay in the public health system. Grattan's Health Program director Peter Breadon told AAP the system was broken from start to end. The report outlines recommendations to address these growing issues, including scrapping Medicare subsidies for specialists who charge excessive fees and publicly naming those practitioners to increase accountability. It also urges governments to fund additional specialist appointments annually in under-serviced areas, and invest $160 million to expand training in undersupplied specialties and rural regions. The RANZCP spokesperson told AAP it supported several of the recommendations, including the need for structural changes to improve the affordability of psychiatric care in private outpatient clinics and consulting rooms. "Medicare is meant to be the backbone of our health system, and yet mental health services are chronically underfunded," they said. Australian Medical Association president Danielle McMullen supports most of Grattan's recommendations, but said removing Medicare funding from specialists who charged excessive fees was not practical. She urged leaders to sort out longer-term funding for public hospitals and develop a health workforce data tracker to show where investment was needed. Federal Health Minister Mark Butler said private health insurers and specialists needed to do more to protect patients from exorbitant bills. Psychiatry has topped the list of extreme fee-charging medical specialties, with those seeking vital mental health care among the hardest hit. A report from a public policy think tank has found about 1.9 million Australians are delaying or skipping critical medical care due to exorbitant fees for specialist doctors. The Grattan Institute report also highlights access to specialist care in Australia is a "postcode lottery", with people living in well-served areas receiving about a third more services than disadvantaged communities. Average out-of-pocket costs for extreme-fee-charging specialists in 2023 reached $671 for psychiatry services and more than $350 for endocrinology, cardiology, paediatrics, immunology and neurology services. The fees are resulting in "too many people are missing out on specialist mental health care", according to the Royal Australian and New Zealand College of Psychiatrists. "Access to psychiatric care is a major issue ... along with workforce shortages, high out-of-pocket costs and maldistribution of psychiatrists in rural and remote parts of the country," the spokesperson said. About 28.7 per cent of people who needed to see a psychiatrist either delayed or did not see one due to costs in 2023/24, according to the Australian Bureau of Statistics. In March, concerns over access deepened when it was revealed that more than 140 of 433 psychiatrist positions were vacant in NSW, following a stand-off over pay in the public health system. Grattan's Health Program director Peter Breadon told AAP the system was broken from start to end. The report outlines recommendations to address these growing issues, including scrapping Medicare subsidies for specialists who charge excessive fees and publicly naming those practitioners to increase accountability. It also urges governments to fund additional specialist appointments annually in under-serviced areas, and invest $160 million to expand training in undersupplied specialties and rural regions. The RANZCP spokesperson told AAP it supported several of the recommendations, including the need for structural changes to improve the affordability of psychiatric care in private outpatient clinics and consulting rooms. "Medicare is meant to be the backbone of our health system, and yet mental health services are chronically underfunded," they said. Australian Medical Association president Danielle McMullen supports most of Grattan's recommendations, but said removing Medicare funding from specialists who charged excessive fees was not practical. She urged leaders to sort out longer-term funding for public hospitals and develop a health workforce data tracker to show where investment was needed. Federal Health Minister Mark Butler said private health insurers and specialists needed to do more to protect patients from exorbitant bills. Psychiatry has topped the list of extreme fee-charging medical specialties, with those seeking vital mental health care among the hardest hit. A report from a public policy think tank has found about 1.9 million Australians are delaying or skipping critical medical care due to exorbitant fees for specialist doctors. The Grattan Institute report also highlights access to specialist care in Australia is a "postcode lottery", with people living in well-served areas receiving about a third more services than disadvantaged communities. Average out-of-pocket costs for extreme-fee-charging specialists in 2023 reached $671 for psychiatry services and more than $350 for endocrinology, cardiology, paediatrics, immunology and neurology services. The fees are resulting in "too many people are missing out on specialist mental health care", according to the Royal Australian and New Zealand College of Psychiatrists. "Access to psychiatric care is a major issue ... along with workforce shortages, high out-of-pocket costs and maldistribution of psychiatrists in rural and remote parts of the country," the spokesperson said. About 28.7 per cent of people who needed to see a psychiatrist either delayed or did not see one due to costs in 2023/24, according to the Australian Bureau of Statistics. In March, concerns over access deepened when it was revealed that more than 140 of 433 psychiatrist positions were vacant in NSW, following a stand-off over pay in the public health system. Grattan's Health Program director Peter Breadon told AAP the system was broken from start to end. The report outlines recommendations to address these growing issues, including scrapping Medicare subsidies for specialists who charge excessive fees and publicly naming those practitioners to increase accountability. It also urges governments to fund additional specialist appointments annually in under-serviced areas, and invest $160 million to expand training in undersupplied specialties and rural regions. The RANZCP spokesperson told AAP it supported several of the recommendations, including the need for structural changes to improve the affordability of psychiatric care in private outpatient clinics and consulting rooms. "Medicare is meant to be the backbone of our health system, and yet mental health services are chronically underfunded," they said. Australian Medical Association president Danielle McMullen supports most of Grattan's recommendations, but said removing Medicare funding from specialists who charged excessive fees was not practical. She urged leaders to sort out longer-term funding for public hospitals and develop a health workforce data tracker to show where investment was needed. Federal Health Minister Mark Butler said private health insurers and specialists needed to do more to protect patients from exorbitant bills.

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