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Variation in the fees of medical specialists: problems, causes, solutions

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Greater transparency in setting charges may be the most efficient way to rein in excessive fees

Articles in this issue of the MJA1,2 and elsewhere35 have reported significant variation in the fees charged by specialist physicians and surgeons. These variations raise questions about excessive health care costs, as well as about barriers to access for patients.2,4,5

That costs are barriers to medical care in Australia has been reported by 8% of people who needed to see a medical specialist and by 19% of those needing to see a general practitioner.5 International studies have also found that cost is a barrier for those needing medical specialist or general practice care; Australian prices generally fall in the middle range of the countries surveyed, but are among the highest for patients with certain chronic conditions.6 Financial barriers are more significant for poorer, sicker people, and for those in remote areas,7 and in the long run may lead to poorer health and greater costs.