Kevin Myres on working class mindsets.


At the moment those people with private health insurance are funding the majority of their healthcare costs through their insurance companies. If there was no private healthcare the state would have to shoulder the full cost. Giving limited tax breaks to people to fund something themselves which would otherwise be funded by the state is eminently sensible and offers a huge net saving to the state. Only those who are ideologically blinkered would thing otherwise.
There are huge problems with the public health system. Moth of the problems are caused by management and healthcare workers themselves. The solution proposed by the socialists is to make everyone suffer the same. This is simple begrudgery. The real solution is to fix the public healthcare system, not abolish the private one. Again, a national health insurance scheme would level the playing field and force hospitals to compete or close.
 
Again, a national health insurance scheme would level the playing field and force hospitals to compete or close.

I've just read a bit about the Swiss model and it looks good for urban areas. How would it work though in rural areas, where there is no incentive for private investors to spend hundreds of millions building a new hospital to compete with a small, rural hospital? Surely, in such a model, the rural, public hopsital could charge what they like?
 

Small rural hospitals are now, and always will be, socond rate. It doesn't matter what funding model is used the best staff will want to work in large teaching hospitals. In general if you go and see a consultant in Portiuncula Hospital that there is a very good chance that they are working there because they weren't good enough to get a job in a major hospital. In an island this small there is no need for small rural hospitals.
 

Whether they are second rate or whether there is any justification for them is irrelevant...under the Swiss model they can surely charge what they like as there won't be any competition? Or else the will close themselves due to lack of business - surely not fair for people living in remote areas?
 

The model used in Belgium (the country with the best healthcare in Europe) is a reimbursement system where insurance companies agree a set fee per procedure/ overnight stay etc. The hospital has to find a way to cover its costs within that charge. Obviously there are cases where this does not happen but there are also cases where a profit is made. The function of the state is then to audit and police quality levels. A simple ISO 9000 based quality system would suffice as a framework here.
Therefore small rural hospitals can only charge what the insurance companies are willing to pay. the state will, obviously, have some part to play here as a community rated system would be necessary. There would be no reason for the state to insure anyone, just pay the premiums for those that can't afford to pay their own.
 

This sounds a lot better.

And as it's the best thing for the people of this country I'm sure the unions will be all for it.
 
Have read up about the Swiss system quite a bit, and friend of mine has been living there for a while and thinks it's great. As long as the national health insurance scheme, i.e. the insurance part is run by private enterprises and not government I'm all in favour of it. I've posted before about how the private Swiss system costs less than the Irish public system and provides far more.

Hospitals can only charge as much as the insurance company is willing to pay. There is also nothing to say that a small private clinic would not be set up as soon as a public one started charging huge prices. The higher the profit margin the more attractive the area becomes to competition.
 
There is also nothing to say that a small private clinic would not be set up as soon as a public one started charging huge prices. The higher the profit margin the more attractive the area becomes to competition.

The publicly-owned hospital (with government reserves/backing) is the incumbant here where there is a very high barrier to entry (building costs). Nothing stopping the publicly-owned hospital from operating at a loss for a few years to force the closure of a newly opened (highly indebted) private clinic.
 

Absolutely true, my point was in regard to small public hospitals overcharging. But running at a loss through taxpayer funds is a serious problem in all government services. And the common solution to a nonfunctioning public service to to throw more money at it.
 

The government should not allow it's hospitals to run at a loss. Their only source of revenue should be from the insurance companies.
If they want money for capital development they can just borrow it like any other business.
 
The government should not allow it's hospitals to run at a loss. Their only source of revenue should be from the insurance companies.
If they want money for capital development they can just borrow it like any other business.

There are very few publically owned hospitals in Ireland. The majority are privately owned by religious organisations. If we were moving to the Swiss model, these hospitals would no longer receive lump sums from the Government (as currently happens) and would operate as normal private hospitals.
 

Exactly. While the hospitals are owned by some group of nuns or other in practice they are state owned as the state foots all the bills.
 
The government should not allow it's hospitals to run at a loss. Their only source of revenue should be from the insurance companies.
If they want money for capital development they can just borrow it like any other business.

Sounds good to me.
 
A lot of the working class thing is snobbery.

eg. address, schools, colleges, place of work.

Who isn't working class?

But take a guy wearing a tracksuit with a tight hair cut - why is it persumed that he is working class?
 
A lot of the working class thing is snobbery.

eg. address, schools, colleges, place of work.

Who isn't working class?

But take a guy wearing a tracksuit with a tight hair cut - why is it persumed that he is working class?

Because 9 out of 10 scumbags wear tracksuits and have tight hair cuts.