Complaints against surgeons triple amid backlash against health cover con

AS doctors blame a few bad apples for mammoth out-of-pocket health care costs, fed-up patients are again wondering why they need private health insurance.

THEY’RE talking tough, but it remains to be seen if the big bills keep rolling in when it comes to medical procedures for those forking out big bucks for private health insurance.

As the Turnbull Government today faced pressure to take action on out-of-pocket medical expenses after a report showed Australians are being ripped off to the tune of thousands of dollars, the Australian Medical Association was decrying the “small number of doctors” making them all look bad.

After a Four Corners report into the issue, the Royal Australian College of Surgeons today fielded twice as many complaint calls in less than 24 hours than it had in the past three years.

Greens leader Richard Di Natale was calling for the fees of individual medical practitioners to be published in a searchable database so patients knew how much they were expected to pay ahead of time and could ‘‘shop” around for treatment.

And many people — sick of being told to get quotes and negotiate the confusing labyrinth of insurance, benefits, gaps, rebates, specialists and costs when they’re at their most vulnerable — were calling for a royal commission and wondering yet again why on earth they needed private health insurance.

Watching Four Corners about the outrageous fees overcharged by specialists..It’s time to name and shame these pariahs, so people can choose a doctor that charges a fair fee #FourCorners

— Geri2018 (@geri20022) May 29, 2018

The problem is you cannot ask your GP to refer you to a No Gap specialist (or even a good one!). And, even if you could, the anaesthetist or asst surgeon can still charge large out of pocket costs. Why use private health insurance? #fourcorners

— Andrew Martin (@andy__man) May 28, 2018

Four Corners’ investigation into the medical bills of more than 700 patients for out-of-pocket costs found patients were being charged hidden fees which medical bodies say are illegal and specialists were charging extortionate fees. The program exposed a “sick system” under which many people don’t find out about the final out-of-pocket costs of surgeons, anaesthetists, pathologists and radiologists until months after their treatment.

Some had ended up thousands — and sometimes tens of thousands — of dollars out of pocket for medical procedures despite having private health cover and believing it, and Medicare, would cover them.

Breast cancer patient Madonna Buiter told Four Corners she was left $16,000 out of pocket and said her private health insurer wasn’t much help when she tried to get an idea of how much her surgery would cost.

A few years ago my specialist got his secretary to call & confirm costs $20k deposit at private - I said I couldn’t afford that - tick tick tick - sigh, well then would have to go public - a short wait and - $0 #FourCorners

— Tracey Henderson (@tandah) May 28, 2018

Can we expect a Royal Commission into the medical industry next? Private Health insurance is one big con. #4Corners

— Kirsty Wilson (@kirsty_wilson) May 28, 2018

Canberra’s John Dunn was left to pay $18,000, after Medicare and private health rebates, for robotic surgery to remove his prostate gland.

Sydney’s Greg Lamont, had been paying for private health cover for 20 years and thought he would only be up for about $3000 for his hip replacement once public and private rebates came back. He was wrong to the tune of $11,000.

Doctors, surgeons and specialist groups were responding to the fallout of revelations some in their ranks are billing patients thousands of dollars in exorbitant charges when they are at their most vulnerable — and the public wasn’t happy.

‘NO-ONE SHOULD HAVE TO RESORT TO MORTGAGING THEIR HOUSE’

Royal Australasian College of Surgeons (RACS) president John Batten told Four Corners the college had received very few complaints — five in three years — because patients tended to blame problems on private health insurers.

That changed on Tuesday. After the report aired 10 more people had contacted RACS outlining their experiences with excessive charges and bill creep, Mr Batten told news.com.au.

All will be contacted to see if they want to lodge formal complaints for investigation.

“We have a few surgeons we feel are extorting the public by raising fees and having booking charges which are illegal,” he said in a statement.

“No one in a health system such as ours should have to contact a financial planner, remortgage their home, touch their superannuation or seek crowd funding to access surgical treatment.

“Urgent, acute or cancer related surgery can be timely and adequately dealt with in the public system and all surgeons have a duty to advise their patients of this.”

Mr Batten went on to say the response was “good”.

“We as a college have been raising this issue for three years. It got to a boiling point last night. And that’s good,” he said.

“We as a professional body need to remediate our members who feel they are entitled to charge fees that are silly. That’s our responsibility. But we have to know about it in order to actually do it.

Breast cancer treatment left Madonna Buiter and her family $16,000 out of pocket. Picture: ABC/Four Corners

“The big thing that would improve this is transparency of fees. That’s what we support and want to see. It would expose those charging ridiculous fees. And give patients the confidence to question it.

“It would expose the small number of surgeons involved. And it is a small percentage 95 per cent of our surgeons charge under AMA rates.”

‘THEY ARE EMOTIONALLY BLACKMAILED’

The AMA took a pre-emptive strike ahead of the Four Corners report, slamming the practice of “cowardly” specialists charging “egregious” out-of-pocket fees at its annual conference last weekend as it debated a draft motion to stop patients being gouged by “booking fees” and “bill splitting”.

As Four Corners aired on Monday night, AMA Media tweeted: “No Australian should need a GoFundMe page to afford their medical care. It may only be a small number of doctors charging egregious fees, but it needs to stop.”

It included a link to a report on the conference, at which ophthalmologist Dr Brad Horsburgh said charging tens of thousands of dollars in out-of-pocket costs was rare and “an embarrassment” that would make the front page of a newspaper, adding splitting bills was far more common and needed to be stamped out, Fairfax reported.

Bill splitting could involve a surgeon and anaesthetist using extended Medicare safety net “workarounds” to find extra item numbers to charge patients up to 45 times the Medicare Benefits Schedule anaesthetics fees and up to 16 times the MBS surgical fees, he said.

“It is cowardly and they should be prepared to stand up and say the fee is ‘X’ and if they don’t like it they can go somewhere else,” Dr Horsburgh said.

Anaesthetist Associate Professor Ross Kerridge said doctors who charged exorbitant fees needed to be denounced, and pointed to crowd-funding sites like GoFundMe which have dozens of pages set up by people trying to raise money to pay surgical fees.

“They are emotionally blackmailed,” Dr Kerridge said. “It’s outrageous.”

AMA delegates voted in favour of the AMA considering the reputational impact bill splitting and booking fees had on medical profession, and a public campaign denouncing the practices.

They also want fees indexed against itemised schedules such as the MBS or AMA fees lists so that patients know higher fees amounted to overcharging.

But the resolutions still have to go to the AMA’s Federal Council for consideration.

— with AAP

Originally published as Complaints against surgeons triple amid backlash against health cover con