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From: Elroy Jetson	3/27/2006 3:47:45 PM
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Push for doctors to reveal charges The Australian -- Patricia Karvelas -- March 28, 2006 theaustralian.news.com.au Doctors will be forced to tell patients how much their treatment would cost or risk not being paid, under a proposal favoured by federal Health Minister Tony Abbott. In a hardening of his position, Mr Abbott told The Australian yesterday he preferred a mandatory system, to force specialists to tell patients how much their treatment would cost. Mr Abbott's tough approach sets him on a collision course with doctors who want a voluntary system to prevail. Health funds have been pushing for gap payments charged in private hospitals to be wiped from accounts unless doctors receive agreement from patients. The gap is the difference between what the health fund and Medicare will agree to cover and what the doctor actually charges. Mr Abbott said he wanted a mandatory system, despite calls from the powerful Australian Medical Association to keep it voluntary. "My instinct is to make informed financial consent mandatory," Mr Abbott said. "I welcome the AMA's toughening of their position on this. Now that the AMA has declared that in almost every circumstance the opportunity for informed financial consent should be given I find it hard to see how there could be any substantial objection to making it mandatory except in unusual circumstances." The average gap payment is about $700 but some patients face much higher out-of-pocket payments. AMA federal president Mukesh Haikerwal said about 80 per cent of consultations now had informed consent on gap fees. "There is still a problem with the remaining 20 per cent," he said. "We think it is an unnecessary move to bring in legislation in an area where there is a problem which is only 20 per cent, and reducing." But Australian Health Insurance Association chief executive Michael Armitage said yesterday a mandatory system would protect patients against specialists who did not disclose their fees voluntarily. "It's almost impossible to believe that the same medical specialist who may not provide informed financial consent would not get a quote if they were going to have their house painted from the painter," he said. "When a person is in an emotionally fraught state because they've got an illness they are less likely to ask the questions: What am I up for? What gap am I going to get? "Unless there is a mandatory form of sanctions, there will always be people who will get really quite nasty surprises and we just think that's not reasonable." Mr Abbott's $500 "gap" payment for his kidney stone operation at a private hospital early last year prompted his call for an overhaul of the system. He said that after being dosed up on morphine, he woke in a "cold sweat" wondering whether his health fund had a "no-gap" deal with the hospital so he would not be charged an extra fee. .

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