The mirage of a free health service dances before our eyes, as it has done in every country in Europe, writes Kevin Myers. And so we dutifully follow the well-worn path taken by others towards an earthly paradise which doesn't exist, and has never existed anywhere, and never ever will, as a few minutes examining the experiences elsewhere could show us.
The depressing thing is that even the Irish Medical Organisation, which should know better, nearly voted for a motion which didn't know what it was talking about: "That this IMO a.g.m. calls on the incoming Government to introduce a national whole population GP service, Exchequer or insurance based and seamless in its delivery of primary care to the poor and the rich." Listen, docs, do you know the purpose of that single conjunction "or"? So, what's it to be, a privately funded insurance scheme, such as already exists with VHI and BUPA, except it would be mandatory? Or a government-based one, i.e., paid for by taxes? You see, docs, that word or not merely conjoins two concepts, but also rules one of them out.
Casualty ward
So, we are left with much of the IMO saying that the entire population should be legally obliged to take out health insurance, which is probably a good idea - but try selling that one in Donegal, where over 90 per cent of the population is on health cards. Or - that word again - it is to be paid for by the taxpayer.
Nice idea, and gentle reader, if you want to see what a tax-subsidised, free-at-the-point-of-supply medical service is like, why, I suggest you pop into any casualty ward at around midnight, any Friday, where the voluntarily unwell brawl and vomit and bleed, and very possibly have A&E patient reunions: Didn't I meet you here last month? You had a broken nose then, but wow, that black eye you've got this time is really something else.
Now it's just about possible that with a disciplined and cohesive society, where everyone is blond and has their hair in plaits or neatly parted, you can run a free health service. In such Scandi-paradises, they plan their economies decades ahead, pay 120 pert cent tax, work 55-hour weeks, eat wood-shavings for breakfast and have perfectly formed bowel movements that bound out like seals, barking with joy.
But even Sweden, full of responsible, sober citizens, has found that it cannot cope with the demands placed upon it by the expectation that a totally free service is possible. And anyone wandering down any of our cities in the early hours of the morning who thinks that what they see is just like downtown Malmo, so peaceful and orderly and sober, is in urgent need of hospital treatment themselves.
Never mind that our hospital doctors can't cope with the impact of a cost-free medical service, which nightly produces a re-run of the Vietnam war, live, in a State-run institution near you. Never mind that hospital work is so dreadful that fewer and fewer Irish doctors are prepared to undertake it. Never mind that the experience of elsewhere shows that free medical care sooner or later means a flight into private medical care. Never mind what your senses and your intellect tell you. Embrace folly. Why? Because it makes you feel good.
A good thing
It's not that free medical care is a bad thing. It's a good thing - in a perfect world; and of course, in a perfect world, there'd be no illness anyway. The truth is nothing that is worth having is free. Anything which is free is sooner or later abused. That's human nature for you, even where people are called Sven and Inge and touch their toes in front of open windows every morning.
But here in Ireland, what does the future hold with free medical care for every patient at every GP's surgery? It means that doctors will be besieged by the neurotic, the frivolous, the lonely, and who don't even have the hurdle of paying a euro between them, encumbering an enormously expensive state service with their complaints: I woke up twice last night, doctor, can I have something for it please? And somewhere in the press of malingerers and mad, there are the genuinely ill, who, unless they are spotted in the crowd, will not get the treatment they deserve.
Long-term ill
We don't even have to look into the future for this. They're not getting it already in the pioneering experiment into free medical treatment currently being conducted in our hospitals. There, beds booked ahead for the long-term ill are regularly and routinely being captured and held by the voluntarily unwell being transferred from casualty. When doctors try to protect such beds for their genuinely ill patients, they are accused of self-serving manipulation; and of course, being doctors, they seem incapable of defending themselves.
A free health service will see a flight of bright young students to other professions, which don't offer free anything - and good morning to you all in the Four Courts, and forgive me for scaring you half to death by mentioning the word "free" in your hearing. So, our free national health service - it won't be a "health" service, of course - will be run by people who might, or might not, speak English, and whose home village in the Bengal Delta hasn't even got a nurse, never mind a doctor, and it will inhale money like a firestorm sucks in air.
No matter. Having one will make us feel better about ourselves as a people: and isn't that what health services are for?