If you stick with the public system, you can face long waiting lists. If you go for the private system, you can face high out-of-pocket costs.

The extent of the difficulty depends on the nature of the illness being faced.

Cancer is undoubtedly among the most difficult. Not only do patients face big mental and physical challenges, they can also face big financial challenges.

University of Newcastle Professor Christine Paul's research has made some striking findings in this area.

Unexpected costs for cancer treatment can range from a few hundred dollars to $70,000 and beyond in some cases.

In the public sector, a range of cancer treatments are covered by Medicare. But the public system has its limits.

And case studies of cancer patients show that getting help through Centrelink can be a dehumanising experience. Surely this is something that has to change.

The research shows that many cancer patients face a depleted income not only because of medical expenses but because they have to take time off work. Some struggle to return to work at all, particularly those over 50.

Those with private health insurance face double the out-of-pocket expenses as those without it. But even those in the public sector are not immune from costs. Opting for drugs not covered by the PBS can be a hard hit to the finances.

The system itself also has some inherent problems and conflicts. Sometimes patients aren't informed that a treatment in the private system can be given in the public system for free.

Also, specialists have been known to hold financial interests in private hospitals. In order for a private hospital to make a profit, it needs patients.

Some specialists may direct people for particular private treatments when other, less expensive options are available. This might not be done intentionally, but it can happen. Furthermore, the expensive options aren't always better.

People are generally told to seek a second opinion on such matters and compare the cost of doctors and treatments. But this can be difficult for patients. A doctor may cost double the price, but how does a patient know they're getting double the value? It's an unknown. A lot of trust is involved.

Another factor is specialist medical colleges can limit the number of doctors with specialist qualifications. This can cause demand to rise and effectively mean that such specialists can set their own price.

The Cancer Council has been working towards more transparency and accountability in the sector. And consumer advocacy group Cancer Voice is pushing for fees and charges to be in the public domain.

That's a good start, but society can clearly do a lot better in this important area.

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