Breast cancer patients are frequently incurring more than $10,000 in out-of-pocket medical expenses, a new survey shows, prompting renewed calls for an inquiry into Australia’s private health insurance system.

A survey of 1,200 people, conducted by the Consumers Health Forum of Australia, showed significant out-of-pocket expenses were becoming the norm for many patients, including for those with private health insurance.

Out-of-pocket expenses were more than $10,000 for more than a quarter of breast cancer patients, and more than one-third for those with chronic conditions like multiple sclerosis.

One in six of those surveyed said out-of-pocket medical costs had a “significant impact” on their lives, and one-third of respondents said they were not fully informed of expenses before treatment.

In many cases, the report shows how even those with private health insurance are incurring large and unexpected expenses.



One woman, Nancy, said she was advised to have a double mastectomy after her third diagnosis with breast cancer. Her out-of-pocket costs totalled more than $30,000, despite private health insurance, according to the forum’s Out of Pocket Pain report.

“I opted to have a reconstruction but as I have had radiotherapy on each breast my options were limited and I was advised to have a flap reconstruction, which involved lengthy plastic surgery,” she said.

“While my top-level private health insurance covered my hospital expenses and Medicare made a small payment towards the surgeons and anaesthetist fees, the gap was enormous, and greater than I had been advised.”

The forum’s chief executive, Leanne Wells, backed Labor’s call for a Productivity Commission report on private health insurance while launching the report at Parliament House on Thursday. She said patients were being forced to borrow from family or dip into their superannuation to afford the expenses.

“What we found is that, in a nutshell, being sick in Australia these days is a very expensive business,” she said.

Kathy Hayes spoke of amassing $18,000 in out-of-pocket costs during breast cancer treatment, with her initial surgery costing $8,000 alone. Hayes was told the amount the surgery would cost before treatment but said she was dismayed by what was covered by private health insurance.

“But we were somewhat surprised with the gap that we had to pay as opposed to the private health insurance,” she told reporters in Canberra on Thursday.

The shadow health minister, Catherine King, said the report was further evidence of the need for an inquiry into the private health system. King said Labor would cap private health premiums at 2% for two years, should it win office.

“At the same time as Australians are struggling with medical expenses and being caught out by health insurance gaps Turnbull continues to defend the big insurers and protect their profits,” King said.