AMA Urges Greater Clarity on Medical Fees

Dr Haikerwal said Australian patients already enjoy one of the world's highest rates - over 80 per cent - of what is known as 'informed financial consent' (IFC), whereby patients are informed in advance of any medical procedure of the expected cost of every step of that procedure.

The AMA campaign - 'Let's Talk About Fees' - is aimed at doctors and patients and will run for twelve months. While doctors will be asked to be open with their patients about fees, patients will be encouraged to ask their doctors about the details of their procedure or treatment and the costs.

Dr Haikerwal said the great majority of doctors are upfront about their fees but there are areas of medical practice where it is just not possible to get IFC before an operation or procedure, and there are occasions where the nature of an operation can change dramatically.

"With emergency medicine it is near impossible to offer IFC, and with disciplines such as pathology, anaesthesia, and surgical assistants it is often difficult to predict the course or duration of many procedures or the need for diagnostic services," Dr Haikerwal said.

"But the AMA will do all it can with this campaign to maximise the practice of letting patients know as much as possible about the costs of their treatment and care."

Dr Haikerwal said that the private health funds have a lot of work to do on IFC to ensure their members are getting what they expect from their private health cover.

"The funds must provide their members with greater quality information about medical gaps, particularly in relation to private inpatient care where gap payments can be substantial," Dr Haikerwal said.

"To know the gap, people need to know the fee and the health fund rebate.

"Doctors can advise the fee but health funds need to get a lot better at advising the rebate that will be paid, and to give that advice in advance of the procedure.

"At the moment, 81 per cent of private hospital admissions either have no gap or, where there is a gap, patients are fully informed.

"This is a vast improvement on the situation five years ago.

"There is now a strong awareness of the issue by doctors and higher expectations by patients.

"This awareness will help us translate that 81 per cent to somewhere closer to 90 per cent over the next 12 months, which in reality is the highest achievable level of IFC.

"Not only do we need the health funds on board for this campaign, we need the Government on board.

"There should be no need for punitive legislation in this area.

"The medical profession has cooperated in implementing a voluntary campaign, and should be given a clear 12 months to work with the full cooperation of the government and the health funds.

"If the health funds don't co-operate, we would be happy to see some form of compulsion imposed on them to provide health insurance rebate information and to offer known gap products in every situation.

"We are hopeful that the Government will direct some resources towards our education campaign to give it an even greater chance of meeting its objectives," Dr Haikerwal said.

The AMA 'Let's Talk About Fees' campaign will feature:

• a dedicated section of the AMA website at ama.com.au
• a clear position statement by the AMA supporting Informed Financial Consent (IFC)
• a letter to all Australian doctors explaining the campaign and the desirability of IFC
• posters
• brochures
• regular articles in Australian Medicine, the flagship member publication of the AMA
• regular articles in AMA newsletters
• liaison with the Medical Colleges and Associations
• liaison with Federal MPs and Senators
• media activity