Bupa – Michmutters
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Business

Bupa dispute with Ramsay Health Care leaves patients in limbo

Sick or injured Australians may have to pay more in up-front costs at hospitals as patients become a bargaining chip in negotiations between two multi-billion-dollar medical firms.

Hospital giant Ramsay Health Care formally ended its long-standing deal with private health insurer Bupa and its 3.9 million members on August 2 when the pair failed to agree on hospital costs for patients.

There is now a 60-day window, which expires on October 2, before Bupa customers have to pay more at Ramsay’s 72 private hospitals across the country.

‘I feel sorry for anyone else’

Bupa customer Liz Havriluk from Coolum on Queensland’s Sunshine Coast said she felt lucky her surgery would still be covered.

She just made the company’s deadline for her nasal surgery next month at Sunshine Coast University Private Hospital.

A sign on a building reads Bupa
Bupa customers will likely pay more if they try to be treated at certain hospitals.(ABC News: Nic MacBean)

Ms Havriluk said she felt for others who would be left with mounting hospital costs.

“Ramsay hospitals are just about all we have up here, so I feel sorry for anyone else,” she said.

Ramsay Health Care has four of the five major private facilities on the Sunshine Coast, including Noosa Hospital, Caloundra Private Clinic, Selangor Private Hospital at Nambour and Sunshine Coast University Private Hospital.

Ms Havriluk has been a member of Bupa health insurance for 22 years and her partner since 1953.

The pair pay $195 a fortnight for their cover.

Hospital with gardens
Ramsay Health owns Sunshine Coast University Private Hospital.(Supplied)

GP says patients sold ‘false promise’

Sunshine Coast Local Medical Association president Roger Faint said he was already having to comfort and advise patients in similar situations to Ms Havriluk, who were feeling lost because of the stalemate between the two giant health companies.

A man standing in a surgical waiting room
Roger Faint says patients face uncertainty in the wake of the dispute.(Supplied: Roger Faint)

Dr Faint said they could need to look further afield.

“It puts them in a difficult financial situation — where there was a certainty there’s now uncertainty,” Dr Faint said.

He said older people would be affected by the fallout.

“These people don’t want to travel to Brisbane, or they can’t travel to Brisbane because transport is difficult and they may or may not have family,” he said.

signage of hospital outside entry with person walking in background
Bupa customers with treatment booked at Ramsay Health Care facilities may have to pay more.(ABC Gold Coast: Steve Keen)

Dr Faint said patients might not realize they were affected until they became sick or injured.

“And they’ve paid their premiums which are thousands of dollars a year, in some cases for a very long time, then they can’t get the service they thought they were paying for,” he said.

“It’s almost been like a false promise as well, isn’t it?”

Hospital spat will ‘ring alarm bells’

Australia Medical Association president Steve Robson said the dispute would make people question why they should bother with private health cover.

“I think people around the country who have private health insurance are looking at this with some trepidation and saying, ‘Why are we in a situation where our health fund and our hospital can’t agree on things,'” Professor Robson said.

A man in blue medical scrubs smiles at the camera.
Steve Robson says customers will be left questioning why they bother with health insurance.(ABC News: Dave Sciasci)

He said hospitals were under pressure with staff shortages and supply issues while insurers spent less because so many surgeries were cancelled.

“I would think there’d be an enormous pressure on Bupa to actually do the right thing by the people who paid them so much money, and for them to have the care that they need,” he said.

“And I think it’s going to ring alarm bells around the country if it’s not resolved quickly.”

In statements, Ramsay Health Care said Bupa’s offer was below inflation and did not cover the increases in its costs.

Bupa said it would not accept a deal that would significantly push up premiums for its members.

Bupa said it would continue to pay some of the costs for care, even at Ramsay, but that the hospital may decide to charge more without a deal in place.

On Friday, Bupa competitor HCF confirmed it had made a five-year deal with Ramsay that “recognizes the increased costs hospitals are facing.”

Ms Havriluk said she was still facing out-of-pocket costs of $2,500 for her September surgery to address her sleep apnea, despite having gold-class membership.

“Bupa only covers only 85 per cent of the very first nasal procedure and then the other side I get 50 per cent, then 25 per cent for a third surgery,” she said.

“When you think about all the money you’ve spent, it’s pretty lousy.”

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Categories
Australia

Bupa patients worried Ramsay Health Care hospital dispute will leave them out-of-pocket

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 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.”

woman walking into entry of John Flynn hospital
There will be a transition period before Bupa patients are charged more at John Flynn Private Hospital.(ABC Gold Coast: Steve Keen)

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.

signage of hospital outside entry with person walking in background
Mark Page says the cost of providing health care has risen significantly.(ABC Gold Coast: Steve Keen)

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’

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