Health cover and market forces

Andrea Booth and Martin McKenzie-Murray were right to start their exposé of Bupa by emphasising its global reach (“Done for cover”, March 17–23). Bupa is not the first to try introducing US-style managed (or rationed) care systems here. Kaiser Permanente tried in the 1990s. While doctors are not perfect, they do at least start from a patient-centred position. Bupa’s decision to disallow cover for hip and knee replacement surgery, while also stopping no-gap cover, tells us exactly where it starts from. The argument about rising costs hides a coercive trend to provide less cover for more premium while limiting choice to “accredited” hospitals. The government has no “Gordian knot” to unravel as suggested; rather it needs to decide if its interests lie in community welfare or corporate welfare.

– Gil Anaf, Norwood, SA