Health Insurance and tired health care in Ireland

Rebuilding Ireland – It’s time to press for real change
Saturday, January 29, 2011
HOW appropriate it is, how illustrative, that as Taoiseach Brian Cowen prepares to dissolve the 30th Dáil that a row impossible in a country with an egalitarian health service has broken out.

Earlier this month health insurer VHI announced staggering price increases of up to 45%. Yesterday the semi-state company was criticised for reducing cover without properly informing its customers. Aviva has just announced a 14% premium increase weeks after chief executive Jim Dowdall assured us all the company had no plans to increase fees, an assurance that must have appealed to very many of the 30,000 people — Mr Dowdall’s figure — who joined Aviva in recent weeks.These increases will put health insurance beyond the reach of very many people who will have to fall back on public services putting even more pressure on a stretched but contracting system. None of this would matter if we had a universal health service funded through taxation, a service that treated everyone the same. Some of us already pay the money except insurance companies rather than health providers get it.

This idea, so at variance with the market-orientated, co-location philosophy advanced by this Government, would of course make the VHI, Aviva and all the private clinics held by consultants and other medical professionals redundant. It would also mean that the costs involved could be refocused on health provision rather than on the health business. It would reassert that an efficient and reliable health service is the right of every citizen, not an opportunity to buttress private balance sheets.

This would not of course preclude those who would still want to take out private health insurance from doing so. It should just mean that their options would be confined to private hospitals and personnel who have no connection with public medicine or public funding.

That we are still arguing about this system, which has been shown to work splendidly right across Europe, is another indication of the deference, indifference and conservatism that has forced us to settle for second best.

Though Fine Gael and Labour have promised systems that might be described as first cousins of a universal health system none of the parties seem prepared to fight vested interests for a system that treats everyone properly and equally irrespective of their means.

We all know our health system does not work as it should or could despite the great efforts of the majority of those working in it and the huge resources dedicated to it. Making it as efficient as any health system in Europe would be a great achievement which would have an positive impact well outside the system.

Though, as the man who founded the HSE Micheál Martin tries to convince anyone who will listen that this is year zero and that the format of a television debate is a pressing issue, and as Bertie Ahern announces that his greatest regret after a decade as Taoiseach is that he did not get to build a football pitch, it is depressingly easy to see why things are the way they are. They will remain so unless we demand real change. Now would be a good time to do so.

This appeared in the printed version of the Irish Examiner Saturday, January 29, 2011

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