Where your health insurance premiums go: more than $1.1bn spent on the top 10 procedures at Bupa
Australia is becoming a nation reliant on spare parts and tune ups for our bodies with health insurer Bupa revealing knee and hip replacements were the most expensive claim items in 2018.
Eye, back and cardiac procedures were also prominent in the list of the 10 most expensive claim items, for which Bupa paid out more than $1.1bn. While many of those items were directly related to the ageing population, the other end of the spectrum also made the list with caesarean births slotting in at number four with a claim cost of almost $126m.
Dr Dwayne Crombie, Managing Director of Bupa Health Insurance, said that by looking at where the biggest expenditures came from, the health system can work together to deliver a sustainable system.
This data tells an interesting story. It shows in real terms the impact the ageing population and impact of obesity is having on the cost of healthcare.
“These are all very good and very useful procedures. They are helping us live longer lives and have better quality of life. But many of these operations are symptomatic of people getting older and more of the population being overweight or obese.
“Greater access to more sophisticated technology to improve health outcomes should be celebrated, but we need to understand that these advances come with increased costs.
Specialty | Category | Total benefit paid by Bupa in 2018 |
Orthopaedics | Knee replacement | $223,280,361.92 |
Orthopaedics | Hip replacement | $197,328,352.20 |
Ophthalmology | Lens Procedures | $154,293,710.93 |
Obstetrics | Caesarean Delivery | $125,728,500.33 |
Orthopaedics | Spinal Fusion | $92,230,311.70 |
General Surgery | Major Procedures for Obesity | $75,691,096.00 |
Cardiology | Interventional Coronary Procedures W/Stent | $74,239,887.76 |
Cardiothoracic | Cardiac valve procedure without invasive investigation | $71,886,993.48 |
Cardiology | Cardiac Pacemaker Implantation | $58,262,539.73 |
General Surgery | Major Small & Large Bowel Procedures | $58,188,678.33 |
“It also tells us that if we want to be able to put downward pressure on health insurance premiums, we need to be able to trial different ways of delivering healthcare which don’t affect quality of care but may reduce cost or give patients more choice.
“This includes continuing to look at why prosthetics for hips and knees cost significantly more in Australia than other parts of the world. It means changing the mindset that a person must stay in hospital for rehabilitation after a knee or hip replacement where all the evidence says the outcome is the same or better if done in their home.
“And it also means understanding that surgery for many of these conditions could be avoided if appropriate preventative health measures, including weight management, are appropriately promoted and funded.
“We’re keen to have these discussions, to work with clinicians to see people getting the right care, in the right place, at the right time and for the right price,” Dr Crombie said.
Read more about factors affecting the cost of private health insurance.
