BUPA says agreement made with doctors as competition in health insurance intensifies

The new health insurer in the Irish market, BUPA Ireland, yesterday announced it had struck a two-year deal with the Irish Medical Organisation, representing almost 4,000 doctors. As competition with its rival - the VHI - intensifies, BUPA claimed it would ensure full cover with no balance billing for its subscribers. BUPA had concluded negotiations with the IMO and the Irish Hospital Consultants Association, which ensures no balance billing for its members, unlike conditions applying to VHI members, a BUPA spokeswoman claimed.

The deal relates to the two-year period up to February 1999 and includes both general practitioners and consultants. The deal would apply to "all consultants working in 75 participating hospitals". It also ensured full cover for more "sub-specialities" than the VHI, such as cancer treatment, the spokeswoman added.

Agreement had been reached with radiotherapists covering both in-patient and out-patient treatment. She added that VHI subscribers who were out-patients, could end up paying more than £1,000 for this service. The VHI has disputed this figure.

The IMO-BUPA deal provides for a 3 per cent increase in the first year and for 3.95 per cent in the second year with further increases if the consumer price index or medical malpractice costs exceed agreed figures.

The increases are the same as those already agreed by the VHI with the IMO and consultants association, but its agreements apply until June 1999. VHI's finance director, Mr John Looney, rejected, however, BUPA's claim that it was in a position to offer full cover. "You can never guarantee full cover for all consultants. In the VHI's case, we have agreement with about 95 per cent of consultants."

He also insisted out-patient cover was the same as BUPA's, subject to excesses applied to claims. The one exception was out-patient services offered by consultant radiotherapists where a deal had yet to reached. The VHI, however, covered consultation fees charged by radiotherapists up to £30 for each out-patient visit under its out-patient scheme. It understood this figure was in the order of what was being charged to patients who had to pay but who could claim it back subject to the application of an excess. In such circumstances, "a small balance bill" could arise.