Sir, – We get a bad deal from our health system. Compared to people in other countries of similar wealth to ours, we pay more and get less. Specifically, we do not have universal healthcare, and operate a two-tier system that is unfair and highly unusual.
Your front-page story on Thursday (“Hikes in health insurance loom in months ahead”, News, May 25th) outlines how health insurance premiums are likely to continue to rise. For the 50 per cent or so of Irish people with private cover, this raises distressing choices. In other words, half of Irish people are paying for the same thing twice: through tax, which funds the public system, and through expensive insurance premiums, which funds our overlapping private system. This is inefficient and ultimately unnecessary.
Those who do not have private cover, meanwhile, face longer waits for many vital forms of care, from children’s disability assessments to prostate surgery. This is deeply wrong, and also unnecessary.
In addition to tax and insurance costs, we bear the third burden of out-of-pocket charges, to a greater extent than elsewhere. For example, most citizens pay out of pocket, in full, to see a GP; this occurs nowhere else in Europe. Also, if you have private insurance, you still have to pay for many elements of your care, from seeing a consultant to buying medications.
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Universal healthcare systems guarantee high-quality and timely care to all who need it, based on clinical need and not on ability to pay. It is based on a conception of healthcare as a human right of all people. It is not a radical idea: every other country in western Europe has universal healthcare, not to mention most of the countries to which our healthcare workers are emigrating, like New Zealand, Australia and Canada. Everybody pays in, and everybody gets a fair deal.
Countries achieve universal healthcare by one of two main routes: tax or insurance. The universal insurance route – like Germany’s – was floated under Dr James Reilly. It was shelved for several reasons, particularly the concern that it would inflate costs without necessarily improving care.
The other main route is through tax – as in Scandinavia, Canada, and of course the NHS. I think this is the best fit for Ireland. Sláintecare is based on this model. We must invest in our public system so that it meets the needs of our people, who will not feel the need to recourse to additional private cover. It requires major investment, political leadership, and buy-in from healthcare workers.
Rather than pouring money endlessly into a leaky bucket, we need to have the maturity as a society to look around us and to realise that there is a better way. As it stands, Sláintecare is that way forward. It can deliver a fairer system and a better deal for all of us. Let’s do it. – Yours, etc,
Dr DOMHNALL McGLACKEN-BYRNE,
Bray,
Co Wicklow.