James Reilly & Brendan Howlin

Why would you want to close down underperforming hospitals? Doesn't that great 'free market competition' that you keep going on about make sure that only the efficient hospitals survive?
I'm talking about closing down underperforming public hospitals. Private hospitals that underperform and cannot attract patients lose money and go out of business, just like ay other business would.
In a competitive environment only those hospitals that can attract sufficient patients will survive. Economic laws of supply and demand and competition are universal, just like gravity is to the physical world. It doesn't change from industry to industry.

Would these barriers to entry have anything to do with little inconveniences like quality, or patient safety?
No, it has to do with restricting the number of licenses that cost millions for no reason. And do you honestly believe that people, who are free to choose what hospital they go to are not able to decide for themselves what level of quality and safety is acceptable? Why would a private hospital, that would go out of business if the public shunned it, not provide the highest level of quality and safety?
And you can hardly argue that our public hospitals are clean or perfectly safe, can you?
 
For the record, I know next to nothing about the German health care system. But the definition of Universal Health Insurance is where every hospital becomes a private hospital, and every citizen gets private health insurance either by paying for it, or by the State providing it for those who can't afford it. That's the universal bit.

So if they have a good working UHI system, then by your definition, the bad hospitals don't get any money and go out of business. Or am I missing something?

No, it has to do with restricting the number of licenses that cost millions for no reason.
So for absolutely no reason then? Would you to give the reason that the German Dept Health give for restricting licences?

And do you honestly believe that people, who are free to choose what hospital they go to are not able to decide for themselves what level of quality and safety is acceptable?
It's not a matter of what I honestly believe or not. It's a matter of fact. The average citizen is in no position to assess the level of quality or safety of a hospital. It's not an amateur sport. Healthcare quality is a fairly tricky area. In Ireland, healthcare is very dependant on key individuals. So the record of any hospital last year may have little relationship to their current delivery.


Why would a private hospital, that would go out of business if the public shunned it, not provide the highest level of quality and safety?
Possibly because the CEO's bonus is based on their profitability this year, not next year.
 
In Ireland, healthcare is very dependant on key individuals. So the record of any hospital last year may have little relationship to their current delivery.
Why do you think that's the case? Quality can only be delivered through a robust and auditable system. If the quality of our healthcare system is really reliant on individuals rather than systems, and I don't believe it is, then we have even bigger problems than I thought.
 
Unfortunately that is not the definition of universal health system. The only thing that is universal is that everyone has private health cover. Hospitals are majority state owned with some completing private hospitals and clinics either run for profit or by charities.
But I would love to see a system of private health insurance where there are only private hospitals where the patient/customer is free to choose where he goes for medical attention.

So for absolutely no reason then? Would you to give the reason that the German Dept Health give for restricting licences?
It's for political reasons due to lobbying from public and private healthcare providers who do not want competition. There is no reason whatsoever to stop a hospital from being built with private funds or to charge millions for a licence.

The average citizen also has no idea how to asses the quality or safety of a computer, but is perfectly capable to research this through consumer or expert reviews. You are painting a picture of a public entirely made of children rather than adults that are perfect capable to do their own research. If the average citizen is so dumb then he can go to a public hospital if he is free to choose. But that should not be a restriction on allowing private hospitals from being built.

Possibly because the CEO's bonus is based on their profitability this year, not next year.
And in an open and competitive environment he can only be profitable this year if his patients choose his organisation's services over those of others. In a truly competitive environment profit is proof of valued service.