Consumers puzzled at high cost of healthcare

  • Niall Hunter, Editor

Health consumers are becoming increasingly puzzled as to why, during a time of almost unprecedented deflation and recession, healthcare costs are bucking current economic trends.

The Central Statistics Office's Consumer Price Index has shown consistent rises in healthcare costs over the past year at a time when the prices of most other goods and services have been decreasing.

And, while a small number of health professionals appear to have reduced their private fees, the level of doctors' fees, according to stats from the Central Statistics Office and some recent irishhealth.com surveys, appear to be at best staying the same and even in some cases increasing.

The Consumers' Association of Ireland has said it is baffling as to why most healthcare costs have continued to rise despite the recession.

While most health consumers would be satisfied with the high quality of care provided by consultants and GPs, it certainly comes at a price that many would question in these straitened economic times.

The majority of hospital consultants now charge between €150 and €200 for a private consultation, but just over 10% are charging more than €200, according to a recent irishhealth.com survey.

The Consumers' Association of Ireland (CAI) has queried why doctors' private fees generally have not been reduced in the current economic environment.

However, the Irish Hospital Consultants Association (IHCA) has stressed that consultants still face substantial costs in running their private practices, and this would be reflected in the fees they charge.

We asked our readers what fee a consultant charged them the last time they had an appointment in private consulting rooms.

Forty-four per cent said €150 to €200, while 32% said €100 to €149.

Only 13% said the consultant charged them less than €100 while 11% said their consultant had charged them more than €200 for a consultation.

Over 450 people took part in the survey.

Recent figures from the Central Statistics Office have shown that while the prices of goods and services have been falling generally in recent months, healthcare costs have continued to rise.

Healthcare costs rose by 3.4% from July 2008 to July 2009,  by 2.7% from August 2008 to August of this year, and by 2.5% from September 2008 to September 2009. The latest overall Consumer Price Index, it should be remembered, shows a deflation rate of 6.5%.

The healthcare costs section in the CSO stats do not include the cost of health insurance, which is monitored by the CSO under another heading and which has risen by a massive 21% over the past year.

Indeed, the Government can be held to blame for much of the rate of medical inflation, with its recent increases pushing up the cost of hospital charges and of health insurance. Recent legal recommendations on risk equalisation have also pushed up health insurance costs.

In addition, the cost to health professionals of insuring themselves against negligence claims does not appear to be coming down.

Doctors' fees, the CSO figures show, rose by 2.2% between July 2008 and July 2009, while the year-on-year August figures showed a slight drop of 1.1% and this drop was repeated again in the 12-month figure to September 2009.

Dentists' fees, however, rose by 2% in the 12 month period to both August and September 2009, the CSO figures show. Hospital service charges rose by 9.4% in the 12 months to September.

While the CSO Consumer Price Index indicates some recent stabilisation in doctor's fee rates, recent irishhealth.com polls found that nearly half of the country's GPs charge over €55 for a surgery visit, and that 26% of GPs had increased their surgery fees in recent months, in spite of the worsening recession.

These fees are for private patients. GPs, in their defence,would point out that their fees for treating medical card patients have been reduced substantially by the Government over the past year.

Consultants, on the other hand, have received pay rises of around €30,000 per head in their salaries in return for signing up to a new contract for treating public patients.

Due to the state of the economy, the Government has held back on paying the full increases due to consultants under their new contracts.

CAI Chairman James Doorley told irishhealth.com that while the cost of commodities had reduced substantially
in the current economic downturn , the costs to the consumer of some professional services, including medical services, had not seen any significant reduction, and some had actually increased.

He said while it was clear that consumers wanted high quality healthcare, it was puzzling why health professional fees did not appear to be coming down in the current economic environment.

Mr Doorley said he would have presumed that the costs of running a practice, such as energy and rental costs, would have reduced recently.

He said it was baffling why healthcare costs as a whole, including professional fees, had generally increased over the past year, given that the current state of the economy had led to charges in other areas being cut.

Donal Duffy of the IHCA said the consultants association had no role in recommending private fee rates for consultants. "In fact, due to competition law restrictions, we are precluded from recommending or setting fee rates, good bad or indifferent."

However, Mr Duffy said a number of factors would govern what consultants charge, including cost of premises, staffing, equipment and especially medical negligence insurance, the levels of which vary but can cost consultants up to up to €100,000 per annum for their private work.

He said there have only been relatively small reductions in energy costs. Rental rates would have only recently started to come down significantly and would in any case depend on the terms of leases.

The following are some comments on the current rate of consultants' fees logged as part of our consultant fees survey:

"€200 for an ear nose and throat visit. One would hope that this consultation is accurate and minimises additional expense. Some consideration of a patient's income as a result of the current economic situation should be taken into account."

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"My daughter had an ongoing cough for just over a year. I went to my GP a number of times and was eventually told quite abruptly that it was allergies...I had to strongly insist that I wanted to be referred to a paediatrician, who then charged me €120 x 2 visits on top of all the GP visits!  She's not allergic after all that, and two doctors did very well out of my daughter's ongoing discomfort and my overdraft. Why can I not just go and visit a paediatrician or any other type of "trician" without the rest of them getting their share of my hard earned cash?"

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"Went to my GP with an urinary tract infection. After two visits at €50 euro and three visits at 30 euro and four antibiotics later was referred to a consultant. Was charged €170 for a ten-minute chat, then had an ultrasound at €180. The fact that I am unemployed and the medical profession seem to be taking no pain at all makes me mad."

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"Personally I have been seeing my consultant privately for the last 22 years and he is really excellent. I didn't mind the cost so much when it was only a couple of times a year but as time went by the disease has got worse. For example, so far this year I've had eight visits at €120 each time and the next one is in four weeks time."

You can view the poll results and the results of other polls here


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