Massive medical bills can knock out even the sturdiest of bank accounts. And the question as to why this is remains unanswered.

An investigation conducted by current affairs programme, Four Corners, is seeking to reveal the details. The answer it uncovered revealed that the person to blame for this might be closer than you expected.

It’s likely those expenses are increasing due to specialists, the surgeon holding the knife, and a wide range of furtive fees being levied when you book in to see one of them.

A research done into 700 medical bills forwarded to the programme bared that patients being charged mysterious fees which medical organisations say are illegal, specialists charging exorbitant fees, and a “sick system” under which many people know out about the final out-of-pocket expenditures of surgeons, anaesthetists, pathologists and radiologists until months after their treatment.

Bill creep — under which a patient is recommended to undergo numerous tests and consultations for the same medical ailment — was also deemed to be a problem, according to physician and ABC journalist Dr. Norman Swan.

Many of those who shared their bills had ended up thousands — and in some cases, tens of thousands — of dollars out of pocket for medical procedures, despite having private health cover.

The problem lies in that a lot of the bills are charged are for procedures which occur outside the hospital — such as MRIs and specialist visits — where, by law, health funds can’t operate. It’s a space where specialists can charge what they want to.

As it happens, patients should be getting a second opinion on more than a course of treatment. We should also be getting it on any medical bill before we pay it, and any test before we undergo it.

However, that’s clearly easier said than done, especially when you are in the middle of a medical crisis. In the case of Madonna Buiter, out-of-pocket costs for breast cancer treatment reached nearly $16,000 after almost 40 procedures and tests.

“We were saving for a house deposit … now we don’t have that house deposit anymore,” she was quoted as saying in the programme.

The deposit evaporated as the family buckled from the news that she had breast cancer, the gap payments rising and rising as she got treatment, a double mastectomy and breast reconstruction.

And yes, they actually had private health insurance but later found out that her company did not offer much in the way of assistance.

“When I was first received the diagnosis that it had been confirmed as breast cancer I rang my private health insurance and the two people I spoke to at the time said: ‘Well have you got item numbers?’ ‘No, I don’t have item numbers, I’ve just been diagnosed with breast cancer, I need to have surgery. I just want to be comfortable that I’m covered,’ she shared.

“Oh, without item numbers I can’t tell you,” was the reply.

She divulged that she felt “almost guilty” she had the reconstruction part of the surgery where most of the costs came from.

“We could have saved a lot of money if I’d just had the mastectomy and left it at that.

“Even in private health they say, ‘Oh well, you should shop around and find a cheaper surgeon.’

“Well, that sounds great in theory, but on this side of my journey I can say now, when you’re given that diagnosis, you have breast cancer, you need surgery. I don’t know that that’s realistic or reasonable at that time.”

She cited an identical scenario for a lot of people, with her private health insurer not helping much when she tried to get a clearer picture of how much the cost of her breast cancer surgery would reach.

“Running around from surgeon to surgeon … until I was booked for surgery they couldn’t tell me even which anaesthetist I was seeing, so I couldn’t even find out the charges there,” she said.

The programme also opened the lid on some shady mathematics, with several people levied an “administration” or “booking” fee of up to $6000, just to see a specialist.

According to Royal Australasian College of Surgeons president, John Batten, the fees are as unethical as they are unlawful.

“Booking fees or other fees beyond the surgical fee are in fact illegal and should not exist and that is unethical to be charging,” he said.

Private Healthcare Australia chief executive officer Rachel David said anyone charged such a fee should ask their doctor what it’s for, how it applies to their care, and if the answer isn’t clear, refuse to pay it and discuss it with their health fund.

Swan says patients can be savvier by asking questions until they have answers to better navigate the system.

“Seek second opinions, they are your right,” he said ahead of the broadcast of his investigation.

“You’ve got to sort a lot of this out before you get referred,” Swan said.

“Because it’s very hard to back out once you’re in front of the surgeon.

With the astronomical costs of medical care, your finances might not be enough for emergencies of that nature. However, one of the best ways to make sure that you have some when you need it is to take on some extra work. Here are your best options at getting some extra work and some extra cash in your pockets.

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