Madam, – I would suggest that the best and most straightforward way to end the two-tier health system is to copy the method of funding which the British government is going to reintroduce shortly, called “GP fundholding”. Under this system the government allocates the funds spent on patients to a person’s doctor, who in turn purchases all medical services for his or her patients from whichever hospital or out-patients clinic/service they choose.
This system has multiple advantages, not least the absence of any need for any insurance arrangement, as the funds for health care are in the hands of the doctor. Competition enters the medical field, bringing the “efficiencies of the market” to the sector.
Visits to the GP would be free as would all visits to consultants and all procedures, all paid for from the GP’s fund. This effectively provides all citizens with “private” health insurance, yet the cost is borne by the state. GPs would compete for patients and our “fund”. Hospitals could be privatised and even run as co-operatives owned by the employees.
There is no reason why the cost of such a scheme should be prohibitive. The Irish State has traditionally spent 60 per cent more per capita than the UK on health. (This excludes any private insurance taken out by the public, a far higher proportion than in Britain.)
We already spend more than enough money to provide a first-class, free health service. The Irish health system has evolved in a very expensive and inefficient manner over the years. It needs a root and branch reform and I suggest that “GP fundholding” offers a very simple and effective way of providing universal health provision for its citizens, while allowing the government to retreat from the day to day running of the industry. – Yours, etc,