SAM SMYTH
THEY will have to pry the VHI policy from my cold, dead hands for me to give up private healthcare. The ghoulish language of US gun owners may exaggerate how passionate some of us are about adequate healthcare. But it would be unconscionable (or pathologically miserly) for a responsible person with the means not to seek the best possible health outcome for themselves and their loved ones.
If parents cutting back on luxuries can secure an earlier prognosis and resolution of a child’s life-threatening medical condition, they are obliged to buy private health insurance. And for many squeezed families the sacrifices made for private health cover are often replicated to pay school fees in a country that also boasts of universal free education.
The 46% of Irish citizens who buy private health insurance secure a level of healthcare freely available to taxpayers in other EU countries. But it also gives the wealthier a privilege over poorer citizens – a contradiction to the pledge in the 1916 Proclamation of ‘cherishing all the children of the nation equally’.
Providing universal healthcare with free GP coverage and reduced prescription costs as announced at the Sláintecare launch this week is a laudable aspiration to the goals of the Proclamation signatories. But the simultaneous revelation that an estimated one million people are on waiting lists was an antidote to those who dream of it ending the current two-tier health service.
THE Minister for Health has the political cover of the allparty Oireachtas committee that came up with an unrealistic estimated costing last year – €3bn in capital spending and €2.6bn over 10 years. More than 2,500 extra public beds will be needed, and the loss of private patients will reduce hospitals’ annual incomes by an estimated €600m. The Sláintecare plan wants a 29% increase in the number of GPs. Whatever about the availability of doctors, where will the money come from to pay them?
Some experts say that by the end of the 10-year-plan, the State will be spending an extra €5.5bn-a-year more than the current €14.5bn annual health budget.
The most impressive item in the Sláintecare plan of 100 planned actions and the timeline to implement them is Tom Keane, who will chair the advisory council. A decade ago, Dr Keane reorganised cancer services into eight centres of excellence against ugly political opposition. But the road to optimal healthcare is paved with crashlanded old plans that were originally pitched as a panacea – James Reilly’s universal insurance plan and other initiatives that failed.
The Irish State pays €4,706 per head of population, or some 20% of the State’s annual income, to cover health – that’s one third more than the average paid by the 35 member countries of the OECD. All that, and we have a one million people on waiting lists.
The minister did not provide any costing or even estimates when he announced Sláintecare last week.
I suspect the unspoken plan is for those in the squeezed middle who bought private health insurance to pay the equivalent in taxes to cover the ‘free’ health service. Politicians who come up with grand plans are rarely in office to implement them. And then, as costs climb far beyond original estimates, whoever is in government wings it.
From experience, it is more likely that after Sláintecare, healthcare will be disimproved for those with private insurance, with no improvement for those who don’t have it.