A funding dispute between one of Australia’s largest private hospital operators and a major insurer could result in millions of people being out of pocket if they need treatment.
- A contract between Ramsay Health and Bupa has been terminated
- The Private Health Insurance Ombudsman has offered to mediate
- More than 3.5 million Australians have private health insurance with Bupa
A contract between insurance giant Bupa and Ramsay Health Care, which operates 72 hospitals and day surgeries across Australia, expired on Tuesday after months of negotiations failed to secure an agreement.
The Private Health Insurance Ombudsman has offered to mediate between the parties.
It has left Bupa customers, including Sue Burrin from the NSW far north coast, angry and confused.
“It has really thrown me,” she said.
“You would think in this day and age you could come up with an agreement and it obviously hasn’t happened.”
The Banora Point resident recently had surgery for breast cancer and was receiving follow up radiation treatment across the Queensland border at Ramsay Health Care’s John Flynn Hospital on the Gold Coast.
“If I need a follow up with my doctor or at John Flynn, I’m in a quandary as I can’t use that hospital,” Ms Burrin said.
“I have to go public at Tweed Hospital and that’s booked up to the never ever.”
Ms Burrin said she was working out whether or not she could transfer to another health insurance fund.
She said it was an added complication to being part-way through treatment of a major disease.
“I have to go through the process of saying to them ‘I have actually got breast cancer’,” she said.
She was concerned about paying more money and having to go through another waiting period.
“It’s not a good situation to be in,” she said.
Hospital boss says costs rising
John Flynn Private Hospital chief executive Adam Stevenson said there would be a two month transition period before Bupa patients were charged more.
He said Bupa members would begin charged out of pocket at Ramsay hospitals if no agreement was reached before the end of 60 days.”There will be no impact for 60 days on patients, but after that if there is no agreement, after that patients will begin to be charged out of pocket if they are Bupa members and needing care at our hospitals.”
Pindara Private Hospital chief executive Mark Page, whose facility is also owned by Ramsay, said the costs of masks, protective equipment and nurses’ wages were increasing.
“Costs have gone up significantly for hospitals over the last two-and-a-half years and now everyone is feeling and seeing the inflation impacts on all of us,” he said.
Mr Page said Ramsay Health Care had about 130,000 people admitted across its six hospitals from Southport to Ballina in the year to June 30.
He said 40,000 of them went to emergency departments at Pindara and John Flynn hospitals.
He said he hoped to see a resolution with Bupa quickly.
“All this is doing by not being able to reach an agreement … it just creates worry and distress for patients,” he said.
Patients ‘worried about their future’
Gold Coast obstetrician Andrew Cary said more people were seeking private health care during the pandemic.
“It has been very busy,” Dr Cary said.
“A lot of the routine and elective work that hasn’t been able to be done in the public hospitals has come across into the private health sector.
“A number of my patients are worried and are looking forward… a year ahead or nine months ahead, so they’re… worried about the future.”
Bupa Health Insurance managing director Chris Carroll said in a statement he hoped an agreement would be reached soon.
“We want to move beyond this impasse,” the statement reads.
“We want our members to know that our first priority in our negotiations with Ramsay has been to keep health care costs affordable especially when cost of living pressures continue to impact families.”