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One small change: An accountant on how to make Ireland’s health system better

Here’s an easy way the four health insurers could radically simplify what’s on offer

As our health system begins to return to normal activity levels following the Covid-19 pandemic, we would like to hear from doctors, nurses, paramedics, medical secretaries, hospital porters, canteen staff and others about one change they would like to see in our health system.

It can be something simple that annoys you, day in, day out, that is easily fixed, or it can be a small change in practice or attitude that would make life easier for everyone. Email: with your suggestion.

Dara Hogan


As a retired accountant, I find it unusually difficult to make meaningful like-for-like comparisons between the 321 different health-insurance plans offered by the four insurers in the Irish market. Most families must find it nigh impossible to make such decisions when selecting a health insurance plan. This is because the various policies offer a huge variety of benefits, conditions and restrictions. It's almost as though the insurers don't want families to be able to compare the different policies. The Health Insurance Authority (HIA) website helps in the task of comparing plans but, even with that tool, it is still an exceedingly complex task.


Standard plans

The one small change I would like to see is for all four health insurers to be required to offer, say, four standard health insurance plans (in addition to their current wide range of policies).

These four standard plans could be positioned at the bottom, lower-middle, upper-middle and top of the market. Typically they would provide benefits approximately categorised as (1) public ward plus basic benefits (2) semi-private room plus low-cost benefits (3) semi-private room plus more expensive benefits and (4) private room plus top-level benefits.

The Department of Health and/or the HIA would be tasked with specifying the four standard plans with input from the insurers. Insured families would be permitted to select one of the standard plans and, if required, to add on a limited number of particular non-standard benefits of their choice, eg maternity benefit. Hospitals would be required to price their services in alignment with some or all of the four standard plans where relevant, eg some public hospitals may not offer private rooms.

This approach would radically simplify the task of comparing health insurance policies and it would enable families to make genuine, like-for-like comparisons when renewing their cover.