There’s little value for 2.2 million paying for their health cover
THOSE of you reading this who are paying for private health insurance – and there is a good chance that you are one of those given that 2.2million people in the country do – are getting little or no value for your hefty payments at present.
The various health insurers are making a big deal of refunds of about half the monthly contributions, but the services they’re providing are so limited as to be worth a fraction of what you are paying for them. This is as bad as flyers being offered vouchers instead of refunds by airlines, but there isn’t half the fuss: people are almost embarrassed to admit publicly they pay private health insurance for fear of being shamed for looking to get value for that expenditure.
The insurance is worthless because the private hospitals have been requisitioned by the State to fight Covid-19. Fair enough at a time of crisis, although it should be noted that the Department of Health and HSE engaged in an opportunistic asset grab, to cover for their failure to have enough hospital and ICU beds ready for the emergency when it faced us.
The owners of the hospitals were also paid royally: €115million per month on a basis that has been explained inadequately but which is of no use to the patients who used to receive services from doctors there but now can’t.
Temporary
The only justification for subscribers putting up with this treatment is an expectation that this situation is just temporary and that private healthcare will return to normal in the future. In some respects, the payments made now are a different type of insurance, not for healthcare but to ensure that the provider will be there in the future to give the usual service. The problem is that this may not happen.
Department of Health secretary general Jimmy Breslin reminded people yesterday that the arrangement between the department and the 19 private hospitals ‘is in place for three months, and the HSE has the option to expand that for a fourth month and by agreement with the private hospitals for a fifth month’. Further comments suggested he was interested in taking up the option because the capacity is still needed by a public sector which was woefully illprepared to face the initial potential Covid-19 impact, and still would be if there was to be a second surge without it having access to the private hospitals. What’s to stop that happening next year too?
It is disputed whether a majority of private consultants have signed up for the public system as claimed by the HSE – and also whether some of them felt coerced into signing the contract offered – but many of those who stayed private have effectively found themselves locked out of their premises and unable to provide essential services, up to and including surgery. And herein lies a major problem.
It is totally understandable that the public system had to be prepared for a massive Covid-19 influx. Fortunately the doctors and nurses were not overwhelmed and there were enough beds in which to provide treatment. But in doing that, urgent procedures that would have been carried out in the private sector were cancelled, and worse, the people who need them have been told to go to the back of the HSE queue. People who were willing to pay for treatment they now can’t get are being denied access to a hospital of choice, and cannot see a specialist who may have been treating them on a long-term basis and best knows their needs. All this is doing is making the public queues longer. Major health problems are being created, particularly with cancer care.
It is easy to argue that we need a much better public health system, with sufficient bed capacity, theatre space, more doctors and nurses, and improved equipment run on a cost-effective basis. It is harder to deliver it. The easy option, which the department is now apparently considering, is simply to nationalise some of the private hospitals. You wouldn’t be too hopeful about deals being done at a fair price – although it might be cheaper than the State building new public hospitals – but the real need is for extra capacity, not moving beds from private to public. Nationalisation does not create new beds.
Until we get the perfect public sector health system – which is most unlikely – we need an effective private sector to pick up the slack, to fill in the gaps. But that private system is in the process of being broken down, and when those who pay for private health insurance – from their after-tax income – realise that, then the rows will become very loud.