Outrage over health insurer's 'disaster' policy change

Kristine Tarbert

Health insurance company Bupa has been called out online for changes to its Medical Gap Scheme, which a doctor has branded a ‘disaster’ like the US system.

Toowoomba Doctor Fred Betros took to Facebook this week, urging people to check their policies after Bupa announced the changes to the scheme would come into effect on August 1.

“Incredibly, Bupa has now announced that it will not cover patients equally, depending on the hospital they choose to attend,” he wrote in a lengthy post.

Fred claims the scheme – which currently sees patients avoid out-of-pocket expenses – will now only apply to Bupa patients at Bupa contracted hospitals, leaving those at public hospitals in the lurch.

A doctor has called out Bupa on Facebook. Photo: Facebook

“At present, there is no other insurer in Australia that has taken this step,” his post continues.

“All other insurers continue to offer practitioners a gap cover scheme to ensure there is an option to avoid unnecessary bills to patients.

“We are extremely lucky to have a private health system that allows us to choose our own doctors and hospitals if we wish.

“This is nothing short of managed health care a-la-USA style. It is a disaster over there and they want to bring it here.

“If you are with Bupa, I would encourage you to make sure you completely understand the impact of what staying with their policy after August 1 will have on you.”

He claims patients will be left to pay huge medical bills. Photo: Getty

The post has been shared nearly 9,000 times and attracted a lot of attention from confused and worried Bupa customers.

“Maybe we need to do some research,” one person commented.

“Not a good sign,” said another.

“In time it will reflect the American system and that's not a good thing,” another wrote.

Bupa however has since responded to the claims on Twitter, sharing a link to their website where they attempt to clarify the impact the change will have on its customers.

“There have been a lot of questions raised about changes #Bupa has made to the Medical Gap Scheme, as a result of misinformation shared on social media,” the company tweeted.

The health insurer has said these changes do not mean that health insurance in Australia will become a managed care system like the US.

“The statements some are making about Australia becoming a ‘managed care’ system like the US, are simply incorrect," the website reads.

In a statement to Be, Dr Dwayne Crombie, Managing Director Health Insurance of Bupa Australia, said the company wants to do the very best to protect its customers from unnecessary costs.

“The big thing for us is honesty and transparency. We’re trying to help patients not face out-of-pocket payments, from doctors or facilities when they don't need to," he told Be.

"Every Australian citizen or permanent resident can avail themselves of emergency care and public hospital. It's a basic tenet of Medicare.

"Our private health insurance in a public hospital is absolutely available to be used. The only thing is, if the public hospital doctor wants to charge a gap then were saying ‘no you can't do that'."

Bupa states the change is to encourage transparency among doctors. Photo: Getty

Bupa's website also explained the change will not impact the majority of customers or services and applies to doctors in public hospitals and the small number of beds that are currently not contracted to the provider in the private system.

“At the end of the day, some doctors are reacting to our changes because it means the out-of-pocket costs they choose to charge their customers will become very obvious,” the provider wrote.

“By pushing to reduce gaps for our customers, it means doctors will have to be transparent about how much extra they’re charging patients as a result of their private cover.”

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