"He did not give me an option; he didn't say these are your options – public or private. "If only I had known that it would cost me $10,000 I would have gone public, definitely, because I would have been seen immediately as it was life threatening and it would not have cost me as much." Unfortunately the surgeon was unable to remove all of the tumour and Balhatchet is supposed to have an MRI (magnetic resonance imaging) every six months to check on whether her tumour is growing. Even though she has maintained her top-level cover, she is out-of-pocket to the tune of $600 each time she has an MRI, so Balhatchet is having it only every 12 months. It seems there are plenty of people who will avoid seeing a medical specialist because of the cost, a survey of 2000 people by comparison site Finder suggests.

Two out of five respondents say they have avoided seeing a medical specialist due to the costs. The survey also found that women (47 per cent) are much more likely than men (35 per cent) to have dodged a specialist visit because it was too expensive. The costs of seeing private specialists are putting off many people, says Bessie Hassan, the money expert at Finder. Specialist doctors are often the ones who diagnose more serious conditions. "I doubt this is a decision made lightly but it seems people really do put a price-tag on their health, " Hassan says. "A referral should be taken seriously. If you are worried about affording the secondary appointment or resulting surgery, ask about what government services are available."

A report by the University of Melbourne, published in the Medical Journal of Australia in March, which analysed Medicare claims for an initial consultation in 11 non-surgical specialties, found out-of-pocket costs for patients could vary up to 400 per cent within each specialty. The research found that neurologists, endocrinologists, rheumatologists and allergy and immunology specialists are charging some of the highest prices for private consultations outside the public health system. "Private health cover gives patients the option to choose their own specialist, seek treatment in a private hospital, and greater flexibility in terms of when they would like to be treated," Hassan says. "However, there can still be a gap fee so it's best to ask your doctor for a cost estimate and then check with your health insurer to find out how much your rebate will be for that treatment, and whether it's included in your policy." Peter Sivey, an associate professor at RMIT University, wrote last year that it is difficult to find out exactly what the costs are going to be for specialists.

"Outside of public hospitals, most clinical health services are essentially private markets," he says. While the government, through Medicare, provides subsidies to reduce the cost burden on patients, the government does not regulate prices. "Doctors can charge what they like – or what the market will bear," he says. The fees of local GPs are easily ascertained but specialist prices are more obscure, he says. "Patients often rely on their GP to make the choice of specialist for them through the referral process, with little or no discussion of prices," he says.