Reducing bill shock – a work in progress

There’s no denying that the experience of cancer is an expensive one. At BCNA, we regularly hear from members about overwhelming and unexpected out-of-pocket expenses; an additional burden for people already coping with a breast cancer diagnosis.

Back in 2018, we spoke with thousands of Australians affected by breast cancer whose experiences formed the basis of the State of the Nation report. The report identified eight priorities for urgent action, many of which relate to out-of-pocket costs for breast cancer treatment and care.

Since then, reducing out-of-pocket costs and increasing transparency around those costs – so you know what you are up for before you have a test or treatment – has become BCNA’s top priority to drive change.

Over the last 18 months, we have worked to raise attention to the ‘bill shock’ caused by unexpected out-of-pocket costs, and called for greater transparency around fees and charges.

Standard for Informed Financial Consent

BCNA along with Cancer Council Australia, Prostate Cancer Foundation Australia and Canteen have developed a Standard for Informed Financial Consent; aiming to ensure that Australians receive comprehensive, upfront information about the out-of-pocket costs of treatment and what options may be available to them to help reduce or meet these costs.

The standard, which you can read here will be officially launched this year.

Specialist medical services fees website

Prior to the last federal election, Health Minister Greg Hunt announced a working group tasked with developing a website listing fees charged by individual specialists and other related out-of-pocket costs.

From a consumer perspective, this would mean the ability to compare fees on the website, and either choose a specialist accordingly or use the information to negotiate lower fees with their preferred specialist. BCNA CEO Kirsten Pilatti was appointed to the working group.

Despite the best intentions of the Health Minister, Kirsten and other patient advocates, specialists have been slow to come on board. While our friends at Breast Surgeons of Australia and New Zealand volunteered to be the first group to provide details of their fees, this information is not yet publicly available.

The  Australian Department of Health has launched an online Medical Costs Finder (which you can view here) but rather than allowing people to search and compare individual specialists’ fees, it only provides general information on what people in a local area can expect to pay out-of-pocket for a particular procedure. There are no specialists listed on the website, and there is no information that provides a reliable quote on what a particular individual will have to pay.

What can we do?

There are some things we can all do now to help improve our understanding of the potential out-of-pocket costs of tests and treatments. BCNA is asking doctors to provide full financial disclosure at every point in an individual’s treatment pathway and to talk to patients about options for treatment in the public health system as well as the private setting.

As individuals, we can explore our insurances – remembering that some superannuation funds include insurance – and ask for referrals to other health services we might need, such as counselling.

BCNA continues to work on your behalf, advocating for improvements to the health system, such as better Patient Assistance Transport Scheme, Medicare rebates, and private health ‘no gap’ programs.

Reducing your out-of-pocket costs

BCNA’s My Journey online tool provides information to help you reduce out-of-pocket costs. Tips include:

  • Consider having some or all of your treatment in the public health system, even if you have private health insurance.
  • If going private
    • ask for a written quote from your specialist/s so you know what your out-of-pocket costs will be – shop around if you’re not happy
    • talk to your private health fund before booking any surgery – they can tell you which surgeons participate in their no gap or known gap schemes.
  • Ask if you can have tests and scans bulk-billed.
  • Radiotherapy treatment is not covered by private health insurance – think about going public where you will be bulk-billed.

Your hospital or cancer centre may have a social worker who can talk to you about services that can help you and give you some advice on ways to manage out-of-pocket costs. Don’t be afraid to ask for an appointment.

More information

Issue 86
Autumn 2020