HSRAANZ Webinar Series – 27 April 2017 – Bleeding hearts, profiteers or both? Understanding doctors’ fees in an unregulated market


“[The Government] has no authority to control the amount doctors charge for their services as this would amount to civil conscription. Doctors are free to determine their own value of the health service they provide.”    The Australian Department of Health and Ageing, 2009

This presentation focuses on the degree to which doctors use their freedom to set and differentiate their fees to different patients. In the context of the Australian health care system, fees have a direct bearing on the out-of-pocket costs faced by patients.  The first part of this seminar shows that in an unregulated fee-setting environment, general practitioners (GPs) and specialists discriminate their fees on the basis of patients’ income status. The second part focuses on the impact of the 2004 Strengthening Medicare reforms. Whilst these reforms have been widely credited with increasing levels of bulk-billing among GPs, our findings suggest that there is considerable variation in GP responses to the reforms.  As a result, the OOP costs incurred by different population groups have changed substantially, with direct implications on the barriers to access of GP care. Understanding the degree of fee variation among doctors is an important issue in terms of understanding the potential variable impact that a policy change may have.



Associate Professor Kees van Gool is a health economist and has extensive experience in international, national and regional health policy research. He is the Deputy Director of the Centre for Health Economics Research and Evaluation, based at the University of Technology Sydney.  He leads a team of researchers working on the financing and economics of the Australian Health Care system, including a special focus on primary care. Kees was a lead investigator in two independent reviews of the Extended Medicare Safety Net conducted for the Department of Health and has been a chief investigator on a number of competitive grants.  He has worked extensively on cancer care, screening, cystic fibrosis and policy evaluation. In 2011 he completed his PhD at the University of Technology Sydney, looking at the out-of-pocket costs faced by patients under Australia’s Medicare system. Kees has previously worked at the Department of Health, NSW Health and the OECD where he led a project on international policy analysis on cardiovascular disease care and outcomes.


Webinar Instructions

Instructions - After registering, you will receive a confirmation email containing information about joining the webinar – a link and an ID number.


You do not need an account with Zoom to join a meeting.  But please note that some organisations block access to Zoom so you may want to check in advance that you are able to download the software and contact your IT team if you have any problems.   


You can join via the web on your PC, I phone or I Pad or by phone:


Australia: +61 (0) 2 8015 2088; New Zealand:  +64 (0) 9 801 1188.As a delegate you will be able to hear the presenter and view their slides on your computer.  You will not be able to speak but you will be able to use the Q and A (a Q and A button will be visible) to type questions which can be relayed to the speaker.

Call for Speakers for the HSRAANZ Webinar Seminar Series

If you have an idea for a HSRAANZ Webinar please contact Sarah Green or complete the form here.

The series gives an opportunity to scholars and others to share their research results, seek input for developing research, or discuss issues in health services and policy.