Madam, - I would like to add my voice to Dr Tom Hogan's criticism (January 7th) of Dr Ruairi Hanley's attack (January 4th) on Ms Harney's stance on risk equalization .
As a long-time (mostly satisfied) customer of the VHI, a Swiss national, and not much of a fan, generally, of the PDs, might I advise anyone who believes, like Dr Hanley, that this important social issue can easily be solved by market forces, to examine the mess that Switzerland has got itself into by "opening up" health insurance to "free" market competition.
In Switzerland health insurance has now become the national obsession and topic of conversation. There is indeed competition between quite a number of insurers, but prices are so "competitive" that more and more people, even on quite good salaries, are finding they simply can no longer afford to be insured and are therefore opting out of health cover altogether.
This is bad not only for their own health but for the health of the public finances, from which the cost of looking after "indigent" ailing citizens will have to be met. And there is no community rating, which means that from one day to the next all the over-65 customers, say, of a company can find themselves without cover, when that company decides, as has happened, that such customers are too expensive a risk and so simply dumps them.
In my family we were fortunate enough that my ailing mother could afford health insurance and had excellent cover, but that meant paying as a monthly premium for a single person more or less what I was paying at the time as a yearly premium for a family of three.
If Ireland does not manage to maintain risk equalisation, that is the scenario we are all facing, sooner rather than later. On the other hand if Ireland does succeed, it will once again, and deservedly so, be the envy of and a model for the rest of the world. - Yours etc,
ERIC HAYWOOD,
Maretimo Gardens East,
Blackrock,
Co Dublin.
Madam, - Dr Ruairí Hanley (January 4th) knows nothing about health insurance if he thinks that anyone, other than his friends in the medical profession, will gain from the insurance free-for-all he proposes.
In the 1980s I held medical insurance in the UK, provided by my employer. This was under a medical insurance system which excluded "risk-equalisation". All my pre-existing medical conditions were specifically excluded from the terms of my cover. This is what happens in a free-for-all medical insurance market - insurance companies cherry pick who they will insure, and who they will load, to maximise their profits.
Most people die from pre-existing medical conditions; many Americans are impoverished by them. If you allow insurance companies to decide who they will insure, you create a system in which penalises the sick.
Rick equalisation is the sine qua non of a civilised medical insurance system. Even a PD must realise that the law of the jungle is no basis for civilised behaviour towards our fellow citizens. - Yours, etc,
SIMON McGUINNESS,
St Joseph's Cottages,
Ashtown,
Dublin 7.