The Reilly File – Hospital Charges

Well what do you all make of the charge to be levied on all “private”
patients in public hospital beds?

Background

“Mr Reilly said €143m is hoped to be raised next year through the
combination of increased charges to private patients, improved
collection of income and changes to legislation to allow for charging
of all private patients irrespective if they are occupying a
designated private bed or not or only if they are choosing to go
private to the consultant.”

“The move will generate more income for public hospitals, but the VHI
has estimated that the change could cost it an extra €320m a year, a
cost that may have to be passed on to customers.” RTE webpage

VHI claims that there will be a 50% rise in premium charges as a result.
2009 VHI increased premiums by 23%
2010 + 15 -45%
November 2011 + 2%

Aviva – 2010 + €40
Aviva March 2011 + 14%

Quinn + 10% in JANUARY 2010,
+7.9% IN January 2011 and +6% in April 2011.
+12% on January 1st 2012.

About 75,000 cancelled premiums in 2011-12-08

Take out you binoculars and look at the horses.

Now Dr Reilly let’s examine your budget proposals. How many patients
are elective admissions into private beds in public hospitals? Then
is there not a single tier queue for beds in public hospitals? Do the
overwhelming majority of patients get into the public hospitals via
A&E?
Then they are public unless they opt otherwise.

How are you going to enforce the consultant contract when the numbers
of private patients exceed 20% for new category B contracts? Will
those consultants have money taken off them as per contract and be
subjected to admonition from the HSE or the hospital management? Will
their names be bandied about in the press? For old stagers like me 30%
is the maximum limit on private patients. What happens of the doctors
tell the hospital that the next 10 patients are public even when they
want to go private because the doctors have exceeded their quota? The
hospitals can hardly bill the VHI for people who opt for public care
or is that the intention?

Will the insurers pay a maximum per case and employ an excess system?

What are the perverse incentives in the system? Will there be a
financial incentive to avoid the public hospitals and go to the
smaller private hospitals when have sprung up like tumbleweed? Will
HIQA inspect all private facilities and will the units get hospital
accreditation?
Every citizen has a right to a bed in a public hospital?

What will happen when hospitals have category A clinicians who are not
entitled to admit private patients and are not disallowed by contract
from practicing elsewhere?

Surely, this is the time for universal insurance and an abandonment of
the 2008 Harney contract!
Can you imagine what you would be doing and saying if the bold
MEEEHAWL was the Minister for Health and you were the opposition
spokesman? I think you might be leaving his head on the gibbet by now.

The Comptroller and Auditor General said that about 50% of patients
going through A&E are private patients and should be charged for their
stay but are not because 20% of beds are designated private. However
the obvious question arises – are these patients charged private fees
by the doctors? If not how can the VHI/Aviva/Quinn be levied?

Has the detail here been thought out Sir James?

The craic is only starting Sir James!

Anyway, I suggest you try to get a few guys to help you find the exit.
Your heart is in the right place but Oh! Sir James?