No extra health funds under 2019 plan

No extra funding will be provided for health services under the Government’s plans for universal health insurance cover, over and above that already spent on public and private healthcare at present.

The draft White Paper on universal health insurance says the Government is determined total health spending in Ireland under a single-tier health service should not exceed total spending under the existing two-tier model it will replace.

Suite of measures
The document, seen by The Irish Times, says that over the next few years the Government will introduce a suite of new measures aimed at driving down costs and improving productivity in both the public and private health systems.

The White Paper also hints that the existing provision of tax relief for all on health insurance subscriptions could change under the new system.

Universal health insurance is the key element in the Government’s healthcare reform plans and the draft White Paper sets out that it will be put in place by 2019.

The draft White Paper, which has been drawn up by Minister for Health James Reilly, and is being discussed at present with other Government departments, seeks to set out what universal health insurance would mean for the public and the stepping stones required to put it in place.

Under universal health insurance everyone would be insured for the same comprehensive package of healthcare services, including treatment in primary care and hospitals, but not long-term nursing home care. However, people could buy add-ons.

The draft White Paper says that under the initiative people would purchase this standard package – to be known as the health basket – from one of a number of competing insurers. The Government would either directly pay the full amount charged for this standard basket of services or subsidise the cost.

The draft White Paper provides for a widespread consultation process to determine the elements to be contained in the health basket or standard package. It says the precise composition of the standard package will only be determined when the consultation process is completed.

It also states that the amounts to be provided in exchequer subsidies, which would determine how much individual groups of people would have to pay themselves for the new health cover, would only be decided by the Government in 2019.

“The Government is determined that total spending in Ireland under a single-tier universal health insurance system should not exceed total spending under the two-tier system which it replaces.

'Increase productivity'
"A series of further measures will be introduced over the next few years, prior to the introduction of universal health insurance, to lower costs and increase productivity in both the public and private health systems. In addition the State will maintain specific powers to control costs in the universal health insurance system."

The White Paper says that premium prices in 2019 would ultimately be established in a competitive health insurance market. It says a number of variable factors will influence prices, such as the total cost of healthcare in 2019, taking account of efficiencies introduced in the meantime and the likely demand for services.