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Mother battles health insurer over groundbreaking surgery

A surgical procedure. Photo: AP

A Wollongong mother could go the rest of her life without eating another solid meal because her health insurer has refused to pay for the surgery that could save her.

Fairfax reports mother of three Kerryn Barnett could face bills of more than $30,000 for the insertion of a gastric neurostimulator, a device similar to a cardiac pacemaker, after Bupa declined to cover the cost of the procedure.

Ms Barnett has reportedly not been able to eat a proper meal since Christmas Day after being struck down with a rare condition called gastroparesis which prevents her digesting solid food.

She told Fairfax her only hope of a normal life rested with a new procedure which would implant a gastric pacemaker into her abdomen. Without it she would be forced to undergo a more conventional operation, which would feed liquid nutrients directly into her small intestine.

According to Ms Barnett that would be her last resort as it would mean she could never eat or drink via her mouth again.

“If I don't have this surgery my only other option is to have my stomach removed and a feeding tube inserted surgically into my abdomen for liquid nutrients to be fed directly into my small intestine – surgery that would be covered by health insurance,” Ms Barnett said.

“Bupa has advised me that because they deem the insertion of the gastric neurostimulator to be 'experimental' and because it does not have a Medicare number associated with it, they will only cover the cost of the abdominal surgery, the theatre and my hospital stay.

"I will need to cover the cost of the device itself – which is $25,000 – plus $3800 for each of the leads.”


Bupa has agreed to pay for the cost of abdominal surgery, the theatre and Ms Barnett’s hospital stay, but it will not cover the pacemaker.

A spokeswoman for Bupa told Fairfax the company could not cover the surgery because the gastric pacemaker was not the Department of Health’s approved list of prostheses.

"Cardiac pacemakers and cardiac leads have undergone lengthy clinical trials and safety testing, they have an Australian Register of Therapeutic Goods number issued by the Therapeutic Goods Administration and they're on the department of health prosthesis schedule," the spokeswoman said.

"For safety reasons Bupa only funds procedures and medical devices, which have demonstrated clinical efficacy and comply with clinical safety standards."