Sir, Reading of the current unseemly tussle between the Voluntary Health Insurance Board and the hospital consultants makes one wonder whether the former organisation is not possessed of a corporate death wish in the face of real and probably increasing competition in the health insurance field.
The present confrontation, the latest of a series of conflicts between the VHI and the medical profession, appears to have been provoked by a proposal to reduce existing fees to consultants in respect of some procedures, which in the view of the omniscient gurus who run the Board have become similar in the context of developing technology. Whilst the medical profession is correctly regarded as one of the better upholstered occupational groups, the present VHI rates of payment of £10 and £30 respectively to general practitioners and medical specialists already bear little relationship to reality, average charges in each respect being of the order of £20 to £50 in my own experience. Neither of these can be considered outrageous and, presumably, the rates payable by the VHI for other medical and surgical procedures are equally derisory.
That 94 per cent of hospital consultants accept the existing rates says much about their professional dedication that some of the remaining six per cent charge as much as 250 per cent of the VHI rates makes an interesting point. To suggest reductions in already inadequate rates of payment to highly skilled professionals betrays an ostrich like divorce from reality on the part of those responsible for the decision, which is alas all too typical of the semi state sector.
Over the years, the degree of cover provided by the VHI seems to have declined in direct inverse ratio to the spiralling increase of its premium rates. This has not been helped by the extraction of interest free loans by the Government from a body already almost bankrupt as a result of years of mismanagement, nor by the progressive erosion of the tax relief allowed in respect of subscriptions and the imposition of a "temporary" Health Levy on gross incomes sometime back in the mists of geological time and which remains with us to this day.
In an election year it might well be remembered that, although compulsory, Pay Related Social Insurance contributions from all tax payers carry with them an entitlement to a bed in a public ward of a general hospital. Barry Desmond, as Minister for Health, decided that those who were prudent enough to insure themselves against ill health were anti social elements and should therefore be deprived of the equivalent value of such accommodation, which was theirs as of right to offset against the cost of a private or semi private room. I am not sure which great humanitarian amongst his successors decided that such bourgeois reactionaries should also be penalised by a further £20 daily levy should they use the public bed to which their PRSI contributions already entitled them.
This year, given a choice, for the first time ever, of alternative elective health cover, I decided to remain with the VHI. I took this decision after an assessment of the alternatives available and on the basis of the available restricted benefits. It, as seems likely, consultants react to the totally unreasonable reduction of the already inadequate rates paid to them for some procedures, as threatened, and I am faced with additional balance billing for my medical costs, I shall hold the VHI in breach of contract and seek suitable legal remedies. ram sure that I am not alone in this resolve. - Yours, etc.
Kilcolman Court,
Glenageary,
Co Dublin.