Sir, – How can we have a rational debate on moving to a new healthcare system when we have no idea how the current system works? Like many others, I have contributed to healthcare costs over many years through PRSI, health levy, universal social charge (USC) and taxation.
If I surrender myself exclusively to the public system then, I can understand the value of my benefits very easily – simply the sum of all costs of my treatment and accommodation.
But if I enter the system via a health insurance policy there is no way of knowing which quantum of the cost of my care is coming from the public fund, to which I have contributed, and which quantum is being met by my insurance provider.
It looks like the general direction is to discount my tax and social contributions over the years and force the insurer to foot the entire cost, leading to catastrophic increases in insurance premiums. Ultimately then, we’ll end up paying for the same services twice?
A starting point in deciding how to react to proposed changes would be to know who pays for what in the current system. Why can’t we see a statement, after any interaction with the healthcare system, which shows how much of the cost was met by the State and how much by the insurer? And also see these same numbers on a national annual basis? Someone must know these numbers – otherwise how could the State negotiate with the insurers? Or am I being naive?
With this information we might be able to understand universal health insurance proposals and assess and debate the issue rationally. Or would that be political madness? – Yours, etc,
JOHN GRIFFIN,
Bloomsbury,
Kells,
Co Meath.
A chara, – I have experience as a patient and as a professional of healthcare delivery systems in Ireland, the UK and the US.
There will inevitably be over-testing and over-diagnosis if the “competition-based model” envisaged for Ireland is implemented. There is no evidence from such systems elsewhere that universal health insurance (UHI) leads to efficiency and equity – rather the opposite!
The costs of administration and assessment are likely to be very high. The model of the NHS system, of medical services at all levels being free at the point of need and use, funded by progressive taxation, would best fit Ireland given its size and demographics.
Wide and honest debate is needed based on the social and economic evidence provided by health-care delivery systems elsewhere. – Is mise,
MARIE COMERFORD,
Broad Street,
Grinnell,
Iowa, US.
Sir, – Minister for Health James Reilly’s latest wheeze is to lobby for a “minimum mandatory health insurance policy”.
It may come as a surprise to the Minister, but, the population already has a minimum mandatory health insurance policy in place. It’s called “the health service”, and is paid for from general taxation. That includes his salary. I’m not sure I want to pay his any more.
Within that system people on low incomes are subsidised by a system called “the medical card”. People who need more than is provided for by the current minimum health insurance policy pay for private health insurance if they can afford it. The rest of us make do.
The real problems with the failures in the health service lie in its organisation, not with the wheeze that an extra mandatory health insurance policy (otherwise known as tax) will solve those organisational problems.
Mr Reilly would be better engaged in sorting out the organisational problems and outdated work-practices which appear to be rife within the health service before deciding to foist even more expense on the residents of Ireland.
If the Minister is not prepared to do that, he should resign.
Fianna Fáil tried to plaster over the problems of the health service with large wads of cash. It didn’t work then. Why would it work now? – Yours, etc,
DAVID DORAN,
Royal Oak Road,
Bagenalstown,
Co Carlow.