Varadkar review casts further doubt on future of universal health insurance

Minister for Health Leo Varadkar orders a cost review  of the controversial policy. Photograph: Dara Mac Dónaill

Minister for Health Leo Varadkar orders a cost review of the controversial policy. Photograph: Dara Mac Dónaill


Minister for Health Leo Varadkar has cast further doubt on the Government’s plan to introduce universal health insurance (UHI) by ordering a major review of the cost of the controversial policy.

Days after he in effect deferred the policy by saying his predecessor James Reilly’s intention to introduce UHI by 2019 was “too ambitious”, Mr Varadkar has commissioned a detailed study of the system.

The move could signal the final nail in the coffin of UHI if it confirms the findings of external studies, which have suggested a standard package of insurance could add €5 billion to healthcare costs.

Dr Reilly resolutely refused to say how much UHI would cost the State or individual subscribers during the three years he championed the plan as minister for health, even when he published a White Paper on the subject this year. No one would pay more than they were currently paying, he insisted.

Detailed costings

Now Mr Varadkar has asked the Economic and Social Research Institute and the Health Insurance Authority to draw up detailed costings of UHI, including an analysis of how it could be paid for.

He has said UHI remains “the vision” of the Government, with the ultimate plan to set up a universal one-tier health service with access based on need, rather than on ability to pay.

Ministers claim this is the biggest undertaking in social provision since Donogh O’Malley announced free second-level education or Noel Browne planned the Mother and Child Scheme.

“Because it is such a huge undertaking, we are proceeding on a phased basis, preparing for each stage in advance, making sure there is capacity in the service to deal with increased activity, ensuring that the State and taxpayers can afford it, and aiming to bring the public and staff with us,” a Government source said.

Mr Varadkar has said he plans to focus on universal GP care first, in particular the planned introduction of free GP care for under-sixes and over-70s by the end of this year. This has been costed at more than €50 million a year.

Financial impact

“But before we extend the system further at a later date to include hospitals, we need to know how much that stage will cost, how it will be paid for and any financial impact it would have on the exchequer,” the source said.

The cost of UHI was the subject of a major row earlier this year between Dr Reilly and Minister for Public Expenditure Brendan Howlin.