Labor to prioritise ‘out of control’ fees
Health Secretary Mark Butler says Labor’s next challenges after overhauling the NDIS will be reining in “out of control” medical specialist fees and dealing with a severe shortage of care home beds for aging Baby Boomers.
Butler, who campaigned on the cost of seeing a GP in last year’s election, said Labor was now considering all options to follow suit with specialist fees as part of its cost of living agenda in its second term; even if it means pushing the limits of the law.
In an interview with this imprint, Butler said: “Non-GP specialist charges are out of control and they are really putting an end to the problem; I think they are now much higher than bulk billing rates in general practice, which was a focus for many of us in the first period and a huge concern in the community.” Inside Politics podcast.
“This concern has translated into stories of people not going to see a specialist because they can’t afford the out-of-pocket cost, or not having a procedure done because they can’t afford it out-of-pocket, or even if they do get the procedure, they only hear about the out-of-pocket costs the day before.
“From our perspective, every option is on the table. [There have been] Allegations that there are constitutional limitations on our ability to regulate specialty fees. We aim to test the limits of this. “I’m so concerned about this because it’s become a real barrier to accessing care.”
The Grattan Institute said last year the government should remove Medicare rebates from specialists who charge excessive fees, direct the consumer watchdog to review specialists’ costs and allow GPs to seek written advice from specialists to avoid unnecessary referrals.
Specifically, he proposed denying Medicare claims to specialists who charge more than three times the government-funded rebate; This has long been suggested but has been difficult to implement.
Meanwhile, out-of-pocket costs for specialty services have skyrocketed. A La Trobe University study last year found 40 per cent of private hospital patients were struggling with out-of-pocket charges of more than $1,000. Almost a quarter were only informed of all costs while in hospital or after discharge.
Payment data collected from insurers by Private Healthcare Australia has found gap fees for some procedures have increased by up to 300 per cent in the past five years.
Butler said his department was working with major private hospitals and insurance funds to investigate pressures on the system. Part of this involved investigating whether current funding mechanisms were keeping up with the way services are being delivered, particularly as more people receive hospital services at home or stay fewer nights after a procedure.
Another issue was positioning the expert workforce in the right place and employing them in the areas where they were needed. “Frankly, psychiatrists are not doing the level of admission work in private psychiatric hospitals that we would have seen five or eight years ago,” Butler said. “This means private psychiatric hospitals are subject to real survival pressures.
“[That’s] It’s not that there isn’t a demand for mental health support in society. There. However, they cannot have a psychiatrist do this. “We are experiencing some of the same pressures in maternity services, where we are struggling to keep obstetrician-gynecologists working in some segments of society.”
On aged care, Butler acknowledged that the government needed to significantly accelerate the construction of facilities. Labor is considering offering low-interest loans to providers to build care homes as one of a series of measures to encourage construction.
Butler said nearly 17,000 people turned 80 in 2011, the year he was last aged care minister. Nearly 80,000 Australians will turn 80 this year; This will be the first of the Baby Boomer generation born starting in 1946.
“We need to open a new aged care facility every three days; we need to do this for 20 years, not just for a few years,” Butler said. “What we’re entering is the new normal. This is not a spike.”
This means providing 10,600 extra aged care places every year for the next two decades. Data analysis by Bolton Clarke said the net increase in available beds last year was just 800.
Butler said Labor’s $3bn aged care spend announced last week – the funds will be offset by the cancellation of concessional private health insurance discounts for over-65s – will start to be added to construction through targeted capital subsidies.
“We think this will add about 5,000 new beds each year, but we need to go higher than that… We still have a lot more work to do to get to the level of construction we need,” he said.
A review of aged care accommodation funding handed to the government last week recommended the government should help providers with the cost of building homes.
One of his suggestions was for an interest-free loan scheme that would provide $2 billion a year to providers, with financing tied to the proportion of people with lower incomes who would use the facility.
Butler said his findings are currently being evaluated.
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Natassia Chrysanthos is a Federal Political Correspondent. He has previously reported on immigration, health, social issues and the NDIS from Parliament House in Canberra.Connect with: X or email.
Paul Sakkal is the Chief Political Correspondent. He has previously covered Victorian politics and won the Walkley award as well as the 2025 Press Gallery Journalist of the Year award. Contact him securely on Signal @paulsakkal.14.Connect with: X or email.
