As more and more people abandon private health insurance, a new report by the Grattan Institute has blamed what it calls "inefficient private hospitals" for the exodus.
The report's co-author, Stephen Duckett, says one of the biggest issues lies with some doctors charging exorbitant fees.
The report found seven percent of specialist doctors are billing their patients at more than double the Medicare benefit schedule fee.
These bills account for nearly 90 per cent of all out-of-pocket costs for private hospital patients, and many of those patients aren't given a quote in advance.
Mr Duckett says the hospitals, and the insurers, need to take more responsibility.
"When a patient goes along to see a specialist, they have to trust the specialist, and there's a very significant power imbalance here, and so patients are not really in a position to bargain with their doctor. And what we're saying is, maybe it's the hospital that should bargain with the doctor."
To hear the full report, click on the audio link above.
