Madam, - Dr Ruairi Hanley (July 27th) congratulates the Minister for Health and Children on her decision to make 1,000 extra beds available in public hospitals by encouraging the development of new private hospitals and converting existing private hospital beds to public use.
Government policy now appears to be to move towards a US-style system where the private hospital sector is separate from public care. But who will pay?
There has been an extraordinary lack of debate about the Minister's decisions, which will have such far-reaching implications for the future of our people.
In 2003, the United States spent 15.3 per cent of its Gross Domestic Product on healthcare. It is projected that the percentage will reach 18.7 per cent in 10 years. Although nearly 45 million Americans are not insured, the US spends more on healthcare than other industrialised nations, and those countries provide health insurance to all their citizens.
Health insurance cover for an average family costs about €8,400. Commonly, this is paid by employers, who pass on a percentage of the premium to the employee. Large employers typically pay 85 per cent of the cost of the health insurance plan.
Currently 52 per cent of Irish people have private health insurance. It costs between €1,375 and €1,660 to insure a family. One of the main reasons why insurance is relatively cheap in Ireland is that there is subsidy by the public sector. Insurers pay hospitals about one third of the real cost of care.
The new private sector healthcare providers will not subsidise health insurance companies, so we can expect premiums to rise to American levels to cover the real cost of care.
Irish employers do not currently contribute towards health insurance for their staff. How many of them will rush to pay for expensive employee health plans? At present the Government subsidises private health insurance by providing tax relief at the standard rate of 20 per cent.
Will the subsidy be increased to help people pay the extra cost? If so, how will the loss of tax revenues affect public services, including healthcare?
If health insurance premiums rise to American levels, how many people will be forced to give up their private insurance and return to the public health service? Will the end result be a public hospital system still seriously lacking the capacity to meet the needs of the population, and a parallel private health system that is the preserve of the richest people in society?
A recent study by Harvard University researchers found that the average out-of-pocket medical debt for Americans who filed for bankruptcy is $12,000 and that 50 per cent of all bankruptcy filings were partly the result of medical expenses. Every 30 seconds in the United States someone files for bankruptcy in the aftermath of a serious health problem.
Is this the future we want for ourselves and our children? - Yours, etc,
TIM DELANEY,
Gordon Street,
Ringsend, Dublin 4.