A NEW model of health insurance cover for all could be introduced in Ireland for the same amount of money that is pumped into “our dysfunctional health system”, it was claimed yesterday.
The Adelaide Hospital Society said current spending on healthcare, if it were diverted to a system of social health insurance for all, would see everyone entitled to a “common basket” of services free of charge, including GP care, medicines, acute hospital care and treatment.
This could be provided for the same proportion of GDP that the State spends on healthcare.
Dr Fergus O’Ferrall, Adelaide lecturer in health policy at Trinity College Dublin, admitted that this may seem remarkable, but it went back to the fact that our system is inefficient and ineffective in delivering care at the point of need.
While other countries have used property tax to help fund universal health insurance cover, he said that he did not believe it would be necessary to have a property tax to fund the “common basket that we are advocating”.
However, a mix of “sin” taxation, such as taxes on tobacco and alcohol, in addition to payroll taxes, could be used to ensure everyone here could have insurance cover at no additional cost to individuals.
However, if payroll taxes alone were used to fund the new model it was likely, with 10 per cent efficiency gains, that individuals wanting more than the “common basket” of services would have to pay 3.1 per cent extra in tax.
For a married couple on a combined income of €70,000 a year, this would result in them paying €1,314 extra per annum, while a single person on €25,000 a year would pay an extra €207 a year.
In a position paper published by the society yesterday, it proposed that Ireland moves in a planned way towards a new social insurance-based system of universal healthcare, which would provide guaranteed access to quality care delivered efficiently and at the lowest cost for all citizens on an equal basis.
The proposed system would bring an end to the two-tier system. While it could take 15 years to get the scheme fully up and running the first step, it says, would be the establishment by the Government of a social insurance health authority with a legislative remit to plan and implement the new approach. It would develop a single social health insurance fund as a not for profit entity, separate from exchequer funds.
It is envisaged that those in employment would contribute to this fund through their taxes and that the Government would subsidise payments for the less well off.
The position paper states that the State is at a crucial turning point in regard to the financing of the health system and that the recession presents an opportunity for reform.
“Increasing expenditure through taxation, facilitating privatisation and creating centralised administration have each been employed in the last decade and have each failed to create the quality of access and care for all citizens which Irish people need and deserve and which are commonplace in our fellow member states of the EU,” it says.
“We must now plan for a radical reform sustained over a period of years . . . continuing to raise funds for health through general taxation and to allocate resources in the current fashion is a recipe for declining health resources, increased rationing and waiting lists, inappropriate care and extensive and continuing waste of resources and poor value for money,” it adds.
Dr O’Ferrall said people were often willing to pay more into a social insurance model of healthcare because they can see the benefits they are getting.
That was in contrast to the system now where people paid tax and were unsure what proportion would go to healthcare. “Social health insurance puts the patient first and money follows the patient,” he said.
Dr Stephen Thomas of TCD said there would be a need to remove some of the capacity “bottlenecks” in the system – such as shortages of GPs and hospital beds – to allow the new system run effectively.
Politicians from all parties will discuss how universal healthcare in Ireland might be funded at a conference in Dublin today.