Federal health minister Mark Butler says he is “determined“ to rein in non-GP specialist fees.

Australian taxpayers are increasingly subsidising high specialist fees through the Medicare Safety Net (MSN) as specialist charges rise much faster than rebates, forcing patients into huge out-of-pocket costs, leading to delayed care, a recent Guardian report found.

Established by Tony Abbott in 2010, the cost of the MSN has increased by $522 million since its inception. The government spent $850.4 million in 2024 compared with $324.9 million in 2010.

Experts say the system has two key problems. First, the costs are surging because it’s a badly designed subsidy with money going to fee-charging specialists and the wealthiest patients who can afford to repeatedly see them.

In addition, specialist fees are soaring, pushing more patients over the threshold each year.

Peter Beadon, the health director at the Grattan Institute, says fees have risen by 78 per cent since 2012 on top of inflation.

“Those fees mean a million Australians each year skip specialist care, risking delayed diagnoses, missed treatments and avoidable illness,” he said.

Federal health minister Butler told ABC Melbourne he will focus on the fees charged by non-GP specialists “because they are, frankly – I don’t use these words lightly – in some areas getting out of control”.

Butler has already committed to more transparency on medical fees and has now flagged the government will explore other options, including to “potentially control fees” themselves.