The Labour Party promises a glittering future for the health servicesbut is it a viable vision, asks Padraig O'Morain, Health andChildren Correspondent
One day last year a reader wrote to this correspondent to say that if everybody joined Plan B in the VHI the two-tier health system would be abolished: we would all be private patients and treated accordingly.
Yesterday the Labour Party unveiled - not for the first time - its version of our reader's plan.
It promises a glittering future in which we will all be private patients if we go to hospital, if we go to the family doctor it will cost nothing either and we will be treated by a "world-class" health service.
People with incomes below a certain level will have their private health insurance paid for by the State. Other people will get a State subsidy.
Consultants and family doctors will have signed new contracts to allow all this to happen. Other health professionals will be delighted with themselves because an "integrated" personnel and training body will be set up to meet their "needs".
As Caliban exclaimed in The Tempest: Freedom, hey-day! hey-day, freedom!
But perhaps not. The first question that has to be asked is how making everybody a private patient will mean quicker access to treatment for those who are now public patients?
Currently, 20 per cent of beds in public and voluntary hospitals are designated as private, i.e., they are in the control of particular consultants.
Presumably these will have to be de-designated, removed from the control of particular consultants and made available to everybody if the Labour plan is to work.
Proper order, we may say - but how would you, reader, feel about that if you were the consultant?
It is not that it cannot be done - but the negotiation of new contracts with consultants' unions will be contentious and long-drawn out.
And what of the family doctors? How will they feel about a system in which they have no private patients?
What price will they exact for going along with such a system and is it affordable? All observers, it is safe to say, are still agog at the price the Irish Medical Organisation exacted from Micheál Martin for going along with the introduction of medical cards, without a means test, for everybody over 70.
Once again we are looking at very protracted talks indeed and at a price which may well be too high.
The worst of all scenarios would be to get universal health insurance and nothing else.
That could happen if consultants managed to retain control of "fast-track" beds for patients who take out extra insurance at their own expense and if the price sought by general practitioners for universal cover was just too high.
The Labour Party policy is, without doubt, attractive and based on fairness.
What the party has to convince the electorate of is that it is also feasible.