Australians are paying ‘extreme’ specialist fees. Here’s how the government can rein in costs

Specialist medical fees in Australia have been skyrocketing, according to a new analysis by the Grattan Institute. Between 2010 and 2025, these fees increased by 73% in real terms, outpacing the growth of GPs or other Medicare services. Last year alone, specialist fees grew 4% faster than inflation. Some specialties, such as psychiatry and dermatology, have experienced particularly steep rises, with median out-of-pocket fees reaching up to A$351 and A$217, respectively, in the past two years.

The most expensive specialists charge extreme fees that are often more than triple the standard Medicare Benefits Schedule (MBS) rate, and these fees have been rising faster than inflation. Despite the growing concern, the government's attempts to address the issue have been limited. The parliamentary inquiry and consultations have sparked reform discussions, but these efforts only target the easy and inexpensive steps, such as publishing specialists' fees and expanding public clinics.

The fundamental issue lies in the lack of effective market controls, as there are often limited alternatives for patients outside major cities, and many GPs do not even have access to the specialist's fee structure until after the appointment. The government's recommendations, such as setting training targets for specialists and investing in public clinics, are necessary but insufficient measures to curb the rising costs.

To effectively tackle the problem, the government should implement a clear rule: if a specialist's fees exceed triple the MBS rate for a full year, they should repay the Medicare rebates for their services that year. This approach would hold specialists accountable while protecting patients from the immediate financial burden.