Lisa Evans, who battled breast cancer, has been burdened with ongoing health expenses amounting to around $20,000 in out-of-pocket costs. Her health monitoring expenditures will continue indefinitely, including gap fees for oncologist visits and regular medications, totaling an annual expense of $1,000 for the rest of her life.
In contrast, her brother’s experience with lung cancer treatment has been markedly dissimilar. He has incurred significantly lower costs, prompting Lisa to question the disparity. “I don’t understand why I’m paying. The costs have been debilitating,” she expressed.
This disparity raises inquiries about potential gender bias within the healthcare system, an issue that has come to the forefront through conversations with medical professionals and patients across the nation following a report on rising radiology out-of-pocket expenses.
A 2022 report from the Grattan Institute underscored that women shoulder a greater financial load for out-of-pocket healthcare costs compared to men. Younger women, in particular, bear a heavier burden than men of their age due to factors such as maternity care and a higher prevalence of chronic illnesses.
Gino Pecoraro, President of the National Association of Specialist Obstetricians and Gynaecologists, highlighted gender disparities in pregnancy ultrasounds as a poignant example of the issue. Pecoraro indicated that initial pregnancy ultrasounds, aimed at confirming pregnancy, are priced higher than basic ultrasounds for men.
Differing costs for basic scans are evident:
Scrotum ultrasound fee: $40.75 (85% Medicare benefit) = $6.10 gap fee
Early pregnancy ultrasound fee: $64.70 (85% Medicare benefit) = $9.70 gap fee
Dr. Pecoraro acknowledged that the intricacies of female anatomy contribute to the price difference. However, he emphasized that this discrepancy reflects an overarching underinvestment in women’s health, stretching from pregnancy to the diagnosis of health issues such as heart attacks, where gender-specific symptoms may be overlooked.
Dr. Pecoraro, who practices as an obstetrician in Brisbane and also covers roles in regional New South Wales, noted that the unequal costs persisted throughout pregnancy. He explained that out-of-pocket expenses for later-stage pregnancy scans varied, often contingent on whether women attended specialized pregnancy scanning centers or general radiology clinics.
For specialist morphology ultrasounds, cost discrepancies are evident:
– Specialist clinic cost: $415 – $95 Medicare rebate = $320 gap fee
– Generalist clinic cost: $265 – $95 Medicare rebate = $170 gap fee
Dr. Pecoraro cited disparities in training levels as a determinant of cost, with specialist women’s health centers offering enhanced training leading to higher prices. He highlighted that different levels of expertise could lead to the need for additional scans, causing duplicated Medicare billing.
The potential for gender bias within the Medicare system was addressed by health economist Emily Callander from the University of Technology Sydney. She suggested that while any gender bias is unlikely to be intentional, systemic imbalances could be inadvertent.
According to Callander, the available Medicare data signifies high out-of-pocket costs in obstetrics, with significant increases compared to other healthcare sectors. She emphasized the cumulative financial burden faced by women over the course of their pregnancy journeys.
Medicare data reveals that bulk-billing rates for obstetric items have decreased from 61% to 58% between 2018 and 2023. Additionally, the average out-of-pocket cost for non-hospital items has surged from $250 to $303 during the same period.
Dr. Callander noted that the financial burden also extends to women who haven’t had children, attributing this to factors like a longer life expectancy and a higher susceptibility to chronic health conditions. “Their health is poorer than men and is deteriorating over time,” she observed.
