Sir, - Even though the unstated purpose of private health insurance in Ireland is to regulate the rationing of health services, it is undeniable that the public wishes our system to continue. The VHI has been an arm of the Department of Health, but has done a good job over the years. All hospitals, many patients and most consultants have benefitted.
I have a declarable interest being in receipt of fee income and medical benefit from the VHI. Without community rating, it is likely that the numbers insure would have fall towards British levels over a short period of time. Such an eventuality would have far reaching consequences, including a major reduction in consultant incomes because private beds in public hospitals would have to be drastically curtained due to a massive increase in public hospital queues. Much more public finance would be required to fund this increased activity, and taxes would have to rise. Increased Angst all round!
The claim by Dr. Garret FitzGerald that BUPA's "essentials services" cover is equivalent to VHI's plan A cannot be wholly accurate. Martin O'Rourke of BUPA states that they provide "full cover in the Mater Private and Blackrock Clinic for heart surgeries available at those hospitals". I presume this means that "cash plans" form no part of the full cover in these two institutions. If these hospitals are not losing money on the BUPA deal, then why cannot VHI clients be billed the same amount for similar services?
BUPA have an ownership interest at Blackrock, but below cost selling is unlawful. The Department of Health should allow VHI to own its own hospitals, as this would allow them direct measures of costs. Private hospitals receive many indirect state subsidies because education and training costs are largely carried by the public system.
The public has a legitimate interest in seeing fair play for the State health insurance board. To avoid importing the administrative quagmire of the US system, private providers must compromise with VHI in their own interests. Community rating must not, be subverted. - Yours, etc.,
Glasnevin Avenue,
Dublin 11.