A 64-year-old man has been quoted a gobsmacking $18,000 for prostate cancer surgery in Sydney.
And the eye-watering cost for his robotic radical prostatectomy didn’t cover additional fees the man had to pay for pathology tests, hospital stays, assistant surgeon fees, the anaesthetist or the operating theatre. When these factors were taken into consideration, it meant the man would actually be $22,000 out of pocket, the newspaper said in its exclusive report.
And despite some of the nation’s leading doctors and health groups, including the Australian Medical Association (AMA) and the Urological Society of Australia and New Zealand (USANZ), speaking out against doctors overcharging patients for live-changing surgery, the unnamed doctor responsible for the quote allegedly quoted both organisations in explaining the size of the bill.
“This fee is derived from the Australian and New Zealand Association of Urological Surgeons and the AMA and the particular difficulty or expertise required for the operation,” the quotation letter, which was published by the Sydney Morning Herald, read. The newspaper did not identify the patient or the surgeon involved.
USANZ released a statement in which it said that it did not condone surgical fees that cause financial hardships for patients and that it strongly condemned price-gouging.
“It is extremely disappointing that a small group of individual specialists behaving in an egregious way harm the reputation of the specialty as a whole and by association, that of their colleagues,” the statement read. “There is no evidence suggesting higher fees equate to better results.”
The organisation noted, however, that it could not legally control fees charged by its members. USANZ added that although a small number of individuals charged excessive fees, the remaining 90 to 95 per cent of urologists conducted themselves appropriately.
Meanwhile, AMA President Dr Tony Bartone told Sydney Morning Herald the fee wasn’t in line with the AMA’s guidelines and that it was actually “several orders of magnitude about what we recommend for that procedure”. Dr Bartone told the publication that the AMA was investigating the matter. The AMA confirmed to Starts at 60 that these comments reflected the organisation’s stance on the matter.
Increasing surgeon fees are said to be one of the many reasons consumers are turning away from private health cover, with investment bank Credit Suisse predicting Aussies with health insurance could be forking out more than 50 per cent of fees charged by surgeons within five years.
As reported by The Australian, the bank’s private healthcare analysts believe the gap between what is covered by insurers and what patients must cover will increase to as much as 52 per cent by 2023, with patients being charged not only the private health insurance excess and the gap between coverage and the surgeon’s bill, but also costs associated with anaesthetic, diagnostic procedures or hospital stays.
As part of the government’s remodelling of the private health sector, healthcare products will soon be categorised as gold, silver, bronze or basic, depending on the level of coverage they offer. The changes are expected to be rolled out by April next year, although a spokesperson for Health Minister Greg Hunt recently told Starts at 60 nothing had yet been finalised.
“The details of minimum cover required under the gold, silver, bronze and basic reforms are continuing to be finalised by the private health ministerial advisory committee,” the spokesperson said. “Final decisions have not been made.”
It’s not the first time huge medical quotes or bills have made headlines in Australia. A recent episode of Four Corners found many patients were being hit with hidden fees and that specialists were charging higher costs for procedures.
It’s also proving to be a problem at general medical practices across the nation, with the Daily Telegraph recently reporting some GPs were providing customers with shorter consultations and refusing to deal with more than one health issue per visit, resulting in patients being forced to pay for numerous visits.
The Sydney Morning Herald reported that the man seeking prostate cancer surgery did not end up accepting the $18,000 surgical quote and instead was able to have the operation at a public hospital.