The Oireachtas Committee on Health is expected to hold public hearings into what should be covered as part of the standard package of universal health insurance which everyone will have to have in future under proposals drawn up by the Minister for Health James Reilly.
The Irish Times understands that following a meeting of the Cabinet today a number of further amendments to Dr Reilly's draft white paper on universal health insurance are to be made.
The draft white paper will be brought back to Cabinet next week.
It is understood that original plans to establish a citizens’ health assembly to consider the composition of the standard package or “basket” of universal health insurance have been shelved.
This role in the widespread consultation process envisaged on universal health insurance will be taken up by the Oireachtas committee on health.
It is still envisaged that separately a commission will be established to engage intensively with the public and health service stakeholders in relation to the composition of the future basket of universal health insurance.
It is understood that on foot of the Cabinet discussions the white paper is no longer expected to suggest two separate potential policy approaches for the introduction of universal health insurance - a “basic” standard package and a more comprehensive “preferred” standard model or basket.
The draft had indicated that the “basic” model would include universal GP care, acute hospital care, acute mental health care and rehabilitative care.
The draft white paper suggested that the “preferred” basket would include all the elements in the “basis” package in addition to chronic disease and case management and step-down care.
It is understood that the intention now is that the white paper would be silent on what could be contained in the standard package or basket of universal health insurance and that it would be up to the various consultation processes to come up with their own proposals.
Ultimately the final decision on the composition of the standard basket of universal health insurance, which under Dr Reilly’s plans everyone in the country would have to have, will be taken by the Government on foot of recommendations arising from the various consultation processes.
The Irish Times reported today that the Government will not make any decision on implementing Dr Reilly plans for universal health insurance for at least a year until a "major costing exercise" is completed.
A draft memorandum circulated to Ministers yesterday indicated that the plan will not be given the go-ahead until the Cabinet is given an estimate of the “average premium costs to be paid by individuals”, among other issues.
The draft memorandum circulated ahead of the weekly Cabinet meeting says the cost review will focus on the policy proposals within the UHI scheme. “No decision will be taken to advance implementation of UHI before the completion of this exercise,” the memo says. The costing review will also decide issues such as the “detail and cost of health packages to be provided”.
According to the draft memorandum circulated to Ministers the aspects of the cost assessment exercise of universal health insurance which will have to be completed before the Government makes final decisions on implementing the initiative are:
- Decide and cost the package of health services to be provided under universal health insurance
- Decide and cost the services to be provided in the overall health basket
- Estimate future demand for health services in a universal health insurance environment
- Decide on the proportions of the population to receive full/partial subsidy
- Estimate average premium costs to be paid by individuals
- Estimate the potential administrative and regulatory costs involved in delivering universal health insurance
- Devise a formula for the “efficient market rate” and estimate the liability of the State for the provision of subsidies
