“That’ll be $400,” the receptionist said coolly at the gynaecologist’s office. With a dull clack, my card hit the machine. Ouch. After this, rent, and bills, I would be left with about $100 until my next paycheck. This is the reality of healthcare costs in Australia, even after Medicare rebates.
Since my early teens, I have been battling debilitating pain, racking up tens of thousands in “multidisciplinary care” medical bills. Like many with adenomyosis and endometriosis, I am accustomed to a rigmarole of referrals and clinical examinations. Yet, the exorbitant out-of-pocket costs continue to sting.
Challenges of Navigating Public Healthcare
When I moved to Sydney from Queensland this year, I found myself navigating a different public healthcare system. Queensland has a clear referral criterion for its public system, while New South Wales has statewide criteria for general gynaecology “coming in 2026.”
A month before dropping $400 at the gynaecologist, I visited a new GP in Sydney about abnormal bleeding and pain. Despite normal test results, except for polycystic ovarian syndrome (PCOS) indicators, the doctor insisted on a specialist ultrasound and gynaecologist referral. She glanced at my address and said I’d have to be referred privately because my local health district lacked a public option.
As I waited to hear back from my referral to the public gynaecologist, I went for the ultrasound recommended by my GP, which cost $540.95 with a $95.95 Medicare rebate. It left me $445 out of pocket.
The Financial Burden of Chronic Conditions
In 2020, my first gynaecologist in Brisbane told me treatment options for chronic pelvic pain are like an “iceberg,” with no quick fix. She handed me a laundry list of referrals for multidisciplinary care. My monthly expenses included:
- GP long consultation fee: $198; $84.90 Medicare rebate.
- Gynaecologist: $350; $78.05 Medicare rebate.
- Ultrasound: $350; $90.50 Medicare rebate.
- Psychiatrist: $340 for half-hour check-in; $130.85 benefit.
- Dietician: $222.95; plus $100 for supplements.
- Pelvic physio: $95 per session, totaling $190, plus $68 for a pelvic floor exercise product.
- CBD oil: $155 out of pocket, not covered by PBS.
Taking out those measly rebates, my total bill that month came to $1,589.65. This doesn’t include the cost of other pain relief products, medicine, or groceries and supplements suggested to help relieve inflammation.
Systemic Issues and Personal Impact
Back in Sydney, after $445 out of pocket for the pelvic ultrasound, I waited another month to see if I could get on the public gynaecologist waitlist. Worried about my symptoms and with no word from the public system, I returned to my GP for an interim referral to a private gynaecologist. The costs were mounting: $868.75 after Medicare rebate in six weeks.
The public system officially crushed my faith when I received an automated rejection from the hospital: “We are confirming we have received your referral. Unfortunately, our service cannot meet your current need.”
“We assume healthcare is free in Australia, but the system is hard on those with chronic women’s health conditions, as if access to fundamental wellbeing is a luxury product.”
Broader Implications and Calls for Change
Despite National Action Plans to address conditions like endometriosis, which affects at least one in nine girls, women, and AFAB people, I’m still thousands out of pocket. A 2019 national online survey revealed the average medical cost for chronic pelvic pain in Australia can reach $16,970 to $20,898 per woman annually.
The March 2024 #EndGenderBias Survey Summary Report found that women’s health conditions are disproportionately expensive to treat, with much of the management not funded by the public system. Along with paying more, two-thirds of Australian women have experienced gender bias or discrimination when seeking healthcare.
For those with fewer resources for bureaucratic navigation and advocacy, including BIPOC, rural people, and non-native English speakers, the gap is even more cruel. Health reporter Natasha May’s series investigating specialist fees confirmed my experience of falling through Medicare’s “safety net,” showing that shouldering excessive out-of-pocket costs is a widespread national issue.
Why is the onus on us to be perfect patients and expert bureaucratic navigators, all while crying out in pain?
