$354 charge that broke Perth woman Imogen Blow

Imogen Blow, a content creator, took to TikTok last week to reveal she had been to see her GP because she kept losing her voice, which she needs for work.

Her doctor referred her to a specialist who spent exactly 13 minutes examining her, leaving her more than $350 out of pocket.

“What the heck is wrong with our world right now,” Imogen tearfully asked while sat in her car immediately after the specialist appointment.

“I paid $80 for my GP, and she’s amazing she gave me six different specialists. I called the up to ask the prices to see which one was the cheapest,” she said.

“I found one that was the cheapest — but only by about $20.”

Imogen said she was in the waiting room longer than the 13 minutes she was in the doctor’s office.

“She charged me – and it’s not her fault, it’s just what it is – $354.90,” Imogen said.

“But it gets worse. I know I’m not even the worst case. My income and expenses are not as terrible as they could be I know there’s people out there who have life-threatening surgeries and they can’t pay it.

“But the worst thing about my situation is this doctor put this little light and camera down my throat to see my vocal cords. She was there for about eight seconds and that got added to the bill.”

Imogen was told she had vocal nodes but the specialist wasn’t able to address the issue and said she would refer the young Australian to another specialist. That was another $354.90 for Imogen to pay.

She was also told the second specialist worked with a speech pathologist who could give Imogen some tips surround her medical predicament, and Imogen could see them at the same time.

“I was like how the heck, how much is that gonna cost,” Imogen asked.

“I get some money back with Medicare. I get $81 back – maybe $114. I’m not the worst one out there. There are people who have it way worse. Like they have kids and it’s so stressful.

“I get it. This is messed up. I need to go live in Scandanavia or somewhere.”

Many social media users could relate to Imogen’s plight.

“I feel you girl. I had a specialist appointment today, consultation $150 for four mins, discussed the X-rays, sent for a CAT scan because ‘could be a shadow on the X-ray’. It cost $354 and no Medicare rebate,” one revealed.

One said: “Waited over six months for an appointment with a psychiatrist to get an ADHD assessment. The appointment was $550. Then after the assessment I had to make another appointment to see about medication.”

“I have a referral for an ultrasound on my leg that’s about six months old because I can’t afford $300 to see if it’s a blood clot, tumour or cyst,” another revealed.

One added: “I feel your pain totally. My tooth is now infected because I couldn’t afford to go to dentist because daughter need dermatology specialist etc.”

A small number of people disagreed, saying we should be thankful Medicare allows Aussies to see medical professionals at all.

“Millions in the world. A plumber, mechanic charges more than specialists do in this country but we don’t complain,” one social media post said.

Imogen said she read the responses to her video and felt a mixture of validation and anger.

“I was angry, especially reading about people with kids, I don’t have kids myself, but hearing people are going without because their kids come first,” she said.

“That’s so scary to me. It made me think ‘do I want kids?’.”

Imogen said she had never posted a video that raw and emotional before but, after reflecting, she said it was also sad people only listened because she was in such an emotional state.

“Because it’s sad. People who don’t get upset and usually talk about matters like this and don’t [look physically] upset wouldn’t get as much attention,” she said.

Imogen’s tearful plea comes after a survey published in March 2023 found out-of-pocket costs were causing more than half of Aussies to visit the GP less often, with one in 10 saying they had changed doctor or clinic as a result.

And a growing number of patients report delaying care due to the cost, Australian Bureau of Statistics (ABS) data shows, with that figure highest among the 15-24 age group.

The latest annual Medicare statistics from the Department of Health released in August last year showed bulk billing rates plummeted to their lowest point in more than a decade.

After peaking at 88.8 per cent in 2020-21, national bulk billing rates for GP services dropped to 80.2 per cent in the last financial year, according to Medicare Benefits Schedule (MBS) data.

Meanwhile, out-of-pocket costs for patients who are charged a fee have generally continued to rise at about 4-5 per cent per year, outpacing inflation, according to Monash Business School health economist Professor Anthony Scott.

The fee of a standard GP consultation rose to $102 in November, after the Australian Medical Association (AMA) recommended doctors lift their prices to battle rising practice costs.

The latest inflation figures from the ABS showed medical and hospital services rose 6.3 per cent in the 12 months to September.

Dr Nicole Higgins, president of the Royal Australian College of General Practitioners (RACGP), said at the time that governments have valued or funded GP visits over the last decade.

From 2014 to 2018 the federal government froze increases to the Medicare rebate, meaning doctors were taking a real pay cut.

When it was unfrozen it was “poorly indexed at less than half of CPI”, Dr Higgins said.

“The [level of the] rebate now means GPs are taking more than a 50 per cent discount on the cost of providing care when they bulk bill,” she said.

Medicare is the Commonwealth-funded universal health insurance, which includes rebates for privately rendered services on the Medicare Benefits Schedule (MBS). The MBS includes 5800 services including pathology and diagnostic imaging.

Currently, the rebates stand at 100 per cent for GP visits, 75 per cent for hospitals as a private patient and 85 per cent for all other services.

“MBS fees are generally determined in consultation with the profession or medical experts, and they consider the relative complexity and technical difficulty of the procedure as well as the average time involved. Indexation is applied to MBS Fees on 1 July each year, including specialist and GP services,” a spokesperson from the Department of Health told news.com.au.

“While the Government is responsible for setting Medicare benefits to assist patients to access services, it has no direct power to set the fees charged by doctors, nor can the Government require doctors to charge only the MBS fee for a medical service or bulk bill.

“Medical practitioners are free to set their own value on their services, and the actual fee charged is a matter for doctor and patient. Doctors may consider the personal circumstances of their patients when determining the fees they charge, and many do so.”

The Australian Government also helps patients with out-of-pocket costs through Medicare safety nets such as the Extended Medicare Safety Net (EMSN).

“The EMSN provides an increase in Medicare benefits of up to 80 per cent of out-of-pocket costs for out-of-hospital services once the relevant annual threshold has been reached, with a lower threshold applying to concessional patients. Everyone who is enrolled in Medicare is entitled to safety-net payments once they reach the relevant threshold,” the spokesperson said.