Australia's peak GP group has defended a secret list that recommends specialists charge more than the Medicare fee, saying successive governments and insurers "must take their share of the blame".
The Australian Medical Association's List of Services and Fees is provided to members at a cost and is also available to others who purchase the book every year, president Michael Gannon said on Sunday.
The charges - some up to 10 times more than Medicare recommends - cover everything from births to replacement hip and knee surgeries, as well as cancer treatments.
Dr Gannon said successive governments and insurers must "take their share of the blame" after failing to index their schedules according to inflation.
"They dropped the football a long time ago," he told reporters in Perth.
"The (AMA) list of fees is indexed every year according to various measures of inflation and in many ways reflects the true cost of delivering health care.
"The vast majority of doctors deliver services well below the AMA fees, but certainly the AMA list is closer to a list of truth than the Medicare schedule, which lost pace with the true cost of health care 10, 15 , 20 years ago."
Dr Gannon said the AMA list provided recommended fees but doctors still set their own.
"The reality is that most doctors use the insurer's no gap schemes, recognising that substantial out of pocket costs are harmful to patients," he said.
"Although the AMA stands behind its list of fees, well over 90 per cent of AMA members charge well below the list of fees at the insurer's schedule using no gap schemes to minimise the hurt to patients."
Dr Gannon said 88 per cent of operations were provided under no gap schemes and fees paid to doctors were typically between one-half and two-thirds of the AMA list of fees.
