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Doctor's outrage over health insurer's policy change: "It's a disaster"

<p>If you’re with Bupa health insurance, you’re about to experience some big changes to your policy, and according to one doctor, they’re not good.</p> <p>Doctor Fred Betros from Toowoomba, Queensland, <a href="https://www.facebook.com/fred.betros/posts/10215284551657455" target="_blank"><strong><span style="text-decoration: underline;">took to Facebook</span></strong></a> recently to warn Bupa customers about the upcoming changes to its Medical Gap Scheme, which could leave them with sky-high hospital bills.</p> <p>“Incredibly, BUPA has now announced that it will not cover patients equally, depending on the hospital they choose to attend,” Dr Betros wrote.</p> <p>“If a doctor wishes to provide private care for a patient under a gap cover scheme (that is avoiding out-of-pocket cost doctors’ bills), after August 1st, they will now only be able to do this for BUPA patients at BUPA contracted hospitals.</p> <p>“If a patient is admitted to a non-contracted hospital (and this includes ALL PUBLIC HOSPITALS!), the patient will have to receive bills from all treating doctors and be highly likely to incur out-of-pocket costs. Many of us who work in the public system are very happy to provide private care to patients in public hospitals via this scheme but BUPA is taking that option away from us.</p> <p>“At present, there is no other insurer in Australia that has taken this step. All other insurers continue to offer practitioners a gap cover scheme to ensure there is an option to avoid unnecessary bills to patients.</p> <p>“We are extremely lucky to have a private health system that allows us to choose our own doctors and hospitals if we wish. With the changes BUPA propose, it means to keep your costs to a minimum, you can only be treated by doctors in a BUPA contracted facility. Therefore if you aren't treated by a doctor under BUPA's preferred terms, you have to pay a potential difference, even if the doctor wants to use a no-gap scheme. This includes patients who become unwell quickly and are taken to public hospital emergency departments.”</p> <p>Dr Betros warned that if customers aren’t careful, they could end up with US-style healthcare, which could leave them with medical bills of tens of thousands of dollars.</p> <p>“It is a disaster over there and they want to bring it here. Trust me we don't need or want that problem in Australia. We have enough problems with our current system thank you very much!</p> <p>“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 1st will have on you. If you do not like what you see, you have the right to change to any other health fund you wish, without having to serve new waiting times for similar benefits and policy inclusions.</p> <p>“I'm a doctor, but at times both me and my family are patients as well. I always want to have a complete choice and I don't want a non-medical person deciding what is best for me. I was a BUPA customer until yesterday.”</p> <p>However, <a href="https://media.bupa.com.au/faq-what-do-changes-to-the-medical-gap-scheme-mean-for-bupa-members/" target="_blank"><strong><span style="text-decoration: underline;">in a statement</span></strong></a> on its website, Bupa claimed the changes will NOT lead to an American-style health care system. “Any claims that Bupa is moving towards a ‘US style system of managed care’ are completely incorrect, and scaremongering by a select group of people whose interests are probably more self-serving than customer centric.”</p> <p>The insurer also implied that Dr Betros and other doctors were only upset about the changes “because it means the out-of-pocket costs they choose to charge their customers will become very obvious”.</p> <p>“It also means if they choose to send you to a non-contracted facility, potentially one they have an interest in, customers will be aware of the additional charges they will be faced with, as a result of the doctor’s decision.”</p> <p>Tell us in the comments below, what do you think about Bupa’s changes? Are you a customer with them? Will you be staying after the August 1 changes?</p>

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This insurance company believes pensioners should pay more

<p>Bupa believes pensioners should pay more for nursing home services, and if the government takes heed it could lead to a nasty shock in this year’s budget. </p> <p>In its <a href="https://consult.treasury.gov.au/budget-policy-division/2018-19-pre-budget-submissions/consultation/download_public_attachment?sqId=question.2017-09-12.3768452384-publishablefilesubquestion&amp;uuId=606116230" target="_blank"><strong><span style="text-decoration: underline;">2018-2019 Pre-Budget Submission</span></strong></a>, Bupa recommends the capped value of people’s home should be increased from $162,087.20, which would theoretically lead to those with valuable homes being asked to pay more for care. </p> <p>The Government covers 70 per cent of aged care costs on balance with seniors picking up the remainder, and the capped value is part of an asset tests that determines how much senior pay for aged care if they don’t sell their home.</p> <p>Bupa contends this is the best way, “to increase consumer contributions to aged care from those who can afford it, while providing a safety net for those who cannot”.</p> <p>“Sustainable funding arrangements are needed to enable the delivery of quality care for residents that is centred on their needs, supporting their independence and allowing them to live their final years in comfort and with dignity and respect,” Bupa states. </p> <p>“It is also required to encourage long term investment in the sector, so that the projected growth in demand for aged care beds and workers can be met. Sustainable funding will help the sector attract, upskill and retain a high quality aged care workforce – from geriatricians, to specialised GPs, nurses, care workers and other support staff.”</p> <p>Figures from the Australian Bureau of Statistics suggest the number of Australians aged 85 and over will balloon to 1.8 million by 2050, and Bupa contends this will stretch demand and the amount of spending on nursing care for seniors.</p> <p>But some people are sceptical about the insurance company’s suggestion.</p> <p>Jillian Slade of Oasis Aged Care Solutions, told <em><a href="https://www.yourlifechoices.com.au/" target="_blank"><strong><span style="text-decoration: underline;">YourLifeChoices</span></strong></a></em> that it’s important to remember that the assets means tests is complicated, and everyone’s case is different. </p> <p>“There is no formula, no one rule. Every case is different and it is very difficult for people to understand how much it will cost them to move into aged care when they need to,” Ms Slade said.</p> <p>“Often, when I meet a client I begin to find out that what they thought would be a clear cut case is not. All sorts of issues complicate their circumstances, such as whether they hold their property under a tenants in common agreement or if there is a surviving partner who continues to live in the family home, and so on.”</p> <p>What are your thoughts? Do you agree with Bupa’s suggestion? Or are there other factors that should be considered? Let us know in the comments section below. </p>

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The facts about dementia you need to read

<p>Thanks to advances in medicine we’re living longer than ever. Thus, it’s now more important to be aware of the signs of dementia. We sat down with Margaret Ryan, Head of Dementia Services for Bupa, to sort fact from fiction when it comes to dementia.</p><p><strong>Why do you need to know?</strong></p><p>The risk of dementia increases the older you get – about 1 in 10 people over 65 have dementia, and about 1 in 3 people over the age of 85. But – and it’s an important distinction – dementia isn’t a disease of ageing or a normal part of the ageing process. Not all older people get dementia. As our risk develops with age it’s important that all over-60s be aware of the early warning signs, which are often subtle, vague and not immediately apparent.</p><p><strong>What is dementia?</strong></p><p>Most people immediately think of Alzheimer’s disease when talking about dementia – indeed the terms are often used interchangeably – but dementia actually describes a collection of symptoms caused by disorders affecting the brain.</p><p>“Dementia in itself isn’t a disease,” says Margaret Ryan, Head of Dementia Services for Bupa, “it’s an umbrella term, covering a whole range of diseases and conditions that affect the brain that are progressive and irreversible.</p><p>“A good analogy is the term cancer. We use the word cancer to cover a whole range of cancers that can be quite different.”</p><p>There are hundreds of different types of dementia but <a href="http://theblueroom.bupa.com.au/caring/dementia/what-are-the-different-types-of-dementia" target="_blank"><strong>Alzheimer’s disease is the most common type, followed by vascular dementia.</strong></a></p><p><strong>What are the early signs of dementia?</strong></p><p>The following list mainly refers to an Alzheimer’s-type dementia where the progression is slow and predictable. While these are signs that are experienced by most people living with dementia, the nature and severity of any symptom can vary considerably between individuals.</p><p><strong>1. Progressive and frequent memory loss</strong></p><p>We’re all forgetful occasionally but there’s a difference between forgetfulness because you’re tired or stressed, and memory loss that could signify dementia.</p><p>“The difference is when you have dementia you forget that you’ve forgotten,” Ms Ryan explains, “If you still have an awareness that you’ve forgotten something, it’s usually just forgetfulness. For example, there’s a difference between forgetting where you parked your car and forgetting you have a car.”</p><p><strong>2. Confusion, disorientation and getting lost easily</strong></p><p>People who have dementia can sometimes seem to be suspicious and paranoid. “It’s not in a psychiatric sense,” explains Ms Ryan, “it’s that they haven’t been able to remember things or are wondering why they can’t remember, so in trying to make sense of what is going on they can appear to be suspicious or paranoid.”</p><p><strong>3. Changes in mood or behaviour</strong></p><p>We can all be moody from time-to-time and it’s no different when you live with dementia. What might be different is your ability to express what you are feeling and why. This can mean a person may act or react in ways that seem strange, but this can sometimes just be the person trying to communicate their needs.</p><p><strong>4. Difficulty with language &nbsp;</strong></p><p>People with dementia can still communicate fairly well, Ms Ryan says, but might have trouble naming simple words. “They might be trying to say pass me the TV remote but forget the word for remote.” &nbsp;</p><p><strong>Why is early diagnosis so important?</strong></p><p>Family and friends often notice the warning signs of dementia before the person experiencing it. If you notice a loved one displaying some of these symptoms, you should start a conversation with them and encourage them to see a healthcare professional for tests.</p><p><a href="http://theblueroom.bupa.com.au/caring/dementia/testing-for-dementia-and-alzheimers" target="_blank"><strong>Related link: How dementia and Alzheimer’s are tested</strong></a></p><p>Ms Ryan is quick to emphasise that even if you or a loved one are showing some of these signs, you shouldn’t immediately jump to the conclusion that it is dementia.</p><p>“A lot of people can inordinately worry about it, but there are other things that can mimic signs of dementia,” Ms Ryan explains.</p><p>“People living with depression can often have the same sort of difficulties with memories and concentration. The other thing that it could be, which is very common in older people, is called a delirium. The person may be presenting memory loss, confusion, not acting ways that are normal for them.”</p><p>Ms Ryan believes the stigma surrounding a diagnosis of dementia means that people often don’t get tested, believing signs will simply go away or are part of ageing. But early diagnosis is important and while there is no cure, there are drugs that can be taken to slow the progression of the condition and strategies that can support independence.</p><p>“If you’re in your 70s and 80s, any slowing down of the disease can still give you a fairly good quality of life and perhaps let you make some decisions about your care, which could otherwise be a lot of pressure and stress for the family to make the big decisions,” Ms Ryan says.</p><p>“Even if you’re living with dementia, with support and care, you can still live well,” she reminds us all.</p><p><em><strong>How do you know if a loved one has dementia?</strong><span style="text-decoration: underline;"><strong> <a href="http://theblueroom.bupa.com.au/caring/dementia/testing-for-dementia-and-alzheimers?_sm_au_=iZVmqWMmj7N7Qr7s" target="_blank">Click here for some useful information.</a>&nbsp;</strong></span></em></p>

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