Irish Independent

The health insurance ‘twilight zone’ trap

Report slams medical cover here for squeezing out working families

- Eilish O’Regan and Philip Ryan

THOUSANDS of people in Ireland are trapped in a health “twilight zone” because they earn too much to have a medical card but cannot afford private insurance, a damning report has revealed.

Hard-pressed families on middle incomes are at risk of being even worse off than those who qualify for a medical card as a result, according to the internatio­nal report.

The report also reveals the gulf between the health of rich and poor in Ireland is more pronounced when compared with several other western European countries.

It is a further indictment of the failings of successive health ministers to introduce meaningful reform, despite years of promises.

The report, which is published by TASC, the Think-tank for Action on Social Change, and FEPS, the Foundation for European Progressiv­e Studies, will be discussed at a conference in Trinity College today.

It said Ireland remains unique in the EU as the only western European country not to have universal health coverage of primary care.

The level of out-of-pocket expenses people must pay to access health care here is unusual when compared with other countries in Europe.

“We need to introduce universal health insurance as a matter of urgency,” said TASC director Shana Cohen. This is needed as a “targeted and appropriat­e response” to challenges being experience­d by people in the health twilight zone, she said.

Meanwhile, the dire state of the health service dominated the first day of official negotiatio­ns on the confidence and supply agreement.

Department of Health Secretary General Jim Breslin set out serious issues surroundin­g waiting lists, trolleys, mental health services and the renegotiat­ion of the GP contract.

‘Where you are in job market has an impact’

THOUSANDS of people in Ireland are in a health “twilight zone” because they are above the income threshold for a medical card but cannot afford private insurance.

Hard-pressed families on middle incomes are at risk of being even worse off than those who qualify for a medical card as a result.

A new internatio­nal report warns the gulf between the health of rich and poor in Ireland is more pronounced when compared with several other western European countries.

When it comes to how people from different incomes view their well-being, the better-off in Ireland are 21.5pc healthier than lower socio-economic groups.

The report, which is published by TASC, the Think-tank for Action on Social Change, and FEPS, the Foundation for European Progressiv­e Studies, will be discussed at a conference in Trinity College today.

It again highlights the negative impact of Ireland’s twotier health system, with those who can pay having faster access to treatments.

It said Ireland remains unique in the EU as the only western European country not to have universal health coverage of primary care.

“We need to introduce universal health insurance as a matter of urgency,” said director Shana Cohen.

This is needed as a “targeted and appropriat­e response” to the health challenges being experience­d by people “in the health twilight zone”.

The level of out-of-pocket expenses people must pay in this country to access health care is unusual when compared with other countries in Europe.

Universal healthcare – where people are treated according to need rather than ability to pay – was first promised by the last government in 2011.

Seven years on, it also shapes the foundation of Sláintecar­e, the cross-party plan for the future of the health service.

Life expectancy in Ireland at 81.5 years is one of the highest in the EU, while the country’s better-off group has the highest self-reported health across the 28 EU states.

Ms Cohen added: “What this report makes very clear is that people with private health insurance in Ireland have a much better chance of getting the health services they need, and getting them quickly.

“So, where you are in the job market would seem to have a significan­t impact on your well-being and health outcomes.”

Co-author Timon Forster said it was not enough for government­s to just look at the health system in isolation, and they must address the labour market and also fiscal policies if health inequaliti­es are to be reduced.

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