AMA backs Healthscope in dispute with BUPA
AMA Chairman of Federal Council, Dr Dana Wainwright, today warned that the behaviour of South Australian health fund, Mutual Community (a local arm of British United Provident Association, or BUPA), threatens the quality of care in SA's private hospitals.
Dr Wainwright said the behavior of Mutual Community in its contract arrangements with private hospital operator, Healthscope, shows all the hallmarks of American-style managed care, whereby the health funds dictate the level of and quality of care in the hospital system.
"There is no place for this sort of interventionist activity by health funds in Australia," Dr Wainwright said.
"Health funds cannot expect to pick up large premium increases from patients, based on higher unit costs, and then not pass on those benefits to their contracted hospitals which provide the care for the patients.
"In the current dispute, Mutual Community has offered Healthscope, which runs several large high quality private hospitals in Adelaide, unreasonably low increases over the next three years.
"The impact of this will be a reduction in the quality of care provided at Healthscope private hospitals.
"Healthscope is doing the right thing by their patients by opposing the Mutual Community (BUPA) behaviour and holding out for more reasonable contract arrangements.
"Patients who use Healthscope hospitals while they are in a contract dispute with the Mutual Community should be aware that it is entirely up to Mutual Community what benefit they pay while the hospital is out of contract.
"Mutual Community could fully meet the hospital bills or pay 85% of the bill or any proportion of it to as low as 50% of the bill.
"The AMA believes it should not be a decision of a health fund to decide where a procedure should be done, particularly when they have generated the dispute which leads to a group of hospitals not having a contract, as in this case.
"These decisions should be made by doctors and health providers, not by health funds.
"This is the essence of managed care, which Australians oppose -and rightly so.
"The AMA encourages Mutual Community members who use non contracted Healthscope hospitals on the basis of advice from a GP or specialist medical practitioner to demand a full reimbursement of their hospital bills from Mutual Community.
"If Mutual Community does not agree, we encourage patients to find a health fund which will pay full benefits.
"The danger is that if Mutual Community is successful in this dispute, all the other hospitals will be next in line and mediocrity in health care will be achieved throughout South Australia.
"It's time to draw the line. Say no to managed care," Dr Wainwright said.
CONTACT: John Flannery (02) 6270 5477 / (0419) 494 761
Dr Dana Wainwright (0418) 876747