The latest HSE financial overrun has, predictably, prompted calls for reductions in expenditure (“HSE records €150 million overrun in two months”, April 3rd). Yet overruns occur when spending exceeds allocated funding, and there is another side to this equation that is consistently overlooked: income not collected.
The HSE holds service-level agreements and memoranda of understanding with health insurers, giving it clear authority to recover costs for services provided. However, for reasons that have never been adequately explained, tens – if not hundreds – of millions of euro in legitimately due payments have gone uncollected in recent years.
At the same time, many patients who would be willing to use their private health insurance for their care are not even asked to do so. This represents a systemic failure to secure available revenue.
No organisation that neglects to collect income for services rendered could remain viable. Yet the health system appears to rely instead on supplementary budgets to compensate for its failures in income generation while gifting millions to insurance companies.
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Although expenditure reduction is important, greater attention should be paid to ensuring that valid income is properly and comprehensively secured. – Yours, etc,
Declan Lyons,
Consultant Physician,
University Hospital Limerick.
