We back fee transparency, but not the way this bill does it, say specialists

Just plonking standardised, retrospective numbers on a website won’t lower costs or improve access, says Avant Mutual at a senate inquiry.

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Medical specialist advocacy groups have backed the idea of fee transparency but warned a senate inquiry that the proposed Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026 risks having the opposite effect – increasing costs and reducing access.

The bill would allow the federal government to publish data on what individual specialists charge – using information already collected through Medicare, hospitals and private health insurers – via an upgraded version of the Medical Costs Finder website, which has previously relied on voluntary participation by doctors and has seen limited uptake.

The changes are intended to address long-standing concerns that patients often face significant out-of-pocket costs without knowing fees in advance.

Under the proposal, patients would be able to see not just a specialist’s fee, but also an estimate of their likely out-of-pocket costs after Medicare and private health insurance rebates.

However, the legislation does not place any limits on what specialists can charge, and some stakeholders have raised concerns about how the data will be presented.

Critics warn that publishing average fees could lead to price clustering or even upward pressure on costs, rather than lowering them. The government maintains the changes are about empowering consumers with better information, rather than regulating prices directly.

In today’s opening session of the Senate Standing Committees on Community Affairs hearing, chaired by Labor senator Dorinda Cox, Professor Steve Robson, chief medical officer for doctor-owned medical indemnity insurer Avant Mutual, said the bill in its current form “falls short”.

“For transparency to achieve its aim, it must be accurate, contextualised and meaningful,” said Professor Robson.

“In its current form, while this bill shows promise, it falls short of that standard. It risks presenting information that is incomplete, outdated or lacking necessary context, and therefore is not truly informative.

“I cannot overstate the importance of getting these settings right.

“While the intent of the bill is sound, the detail matters, and without careful design it may lead to unintended consequences.

“The proposed use of a single aggregated fee figure is a clear example. A single number cannot reflect the real-world variability in medical care.”

A central concern is the plan to publish a single “average” fee for each service based on historical Medicare data.

In its submission to the inquiry Avant argued this would oversimplify complex pricing and fail to reflect legitimate variations driven by factors such as patient complexity, procedure type, location and hospital setting. It warned patients might treat the published figure as the expected price, creating a “false benchmark” that doctors then have to explain away.

The use of retrospective data was another major issue raised by Avant.

Because the figures could be 12–18 months old by the time they are published, they risked setting unrealistic expectations in a period of rising healthcare costs. Based on its experience handling fee disputes, the organisation warned that outdated or incomplete information could actually increase complaints rather than reduce them.

Avant also raised concerns about the potential impact on the doctor–patient relationship.

It said patients often arrived at consultations with fixed expectations about costs, and when those differed from the doctor’s actual fee, conversations could shift away from clinical care to fee disputes.

A government-published figure that did not match “real-world pricing” presented by the specialist could entrench the problem and create friction at the point “where trust is most important”.

The organisation was also wary of the bill’s broader scope, warning that provisions allowing the publication of additional information could extend beyond cost into areas such as practitioner “quality indicators”.

Professor Robson told the inquiry that “no such measures exist at an individual practitioner level in any form that is valid, fair and safe to publish”.

“As an insurer, we welcome meaningful, reliable measures of clinical quality,” he said.

“They would be invaluable in understanding and pricing risk. However, the reality, based on both international evidence and our own experience, is that no such measures exist.

“Crude or unadjusted metrics risk fundamentally distorting performance. Doctors who take on more complex, higher risk patients will often have worse raw outcomes, not because they provide lower quality care but because they are treating the patients who need the most care.”

Avant called for stronger safeguards, including a clear and accessible process for doctors to challenge or correct inaccurate data. Its submission said that relying on judicial review alone would be impractical and recommended defined timeframes, temporary removal of disputed data and a transparent review pathway to prevent reputational or financial harm.

It was particularly critical of proposed legal protections that would shield the government from liability if incorrect data was published, arguing that practitioners should have recourse where errors caused harm and that the current immunity provisions were “unacceptable” without stronger correction mechanisms in place.

The submission also highlighted practical issues with how data would be presented, recommending fees be shown by location rather than aggregated across multiple sites where doctors work, to avoid obscuring real cost differences.

Avant also called for greater clarity on whether GP fees would be included and why other health professionals were excluded.

Finally, Avant stressed the need for a comprehensive education campaign before the changes took effect, for both patients and practitioners, saying patients must understand that published figures were only “indicative and based on historical data”, while doctors needed time to prepare and understand their obligations under the new system.