Private vs. public healthcare

[television]

Re: The Lisbon vote

What is driving demand for me is the fact that the public health service is so underfunded people like me have no option but to get VHI etc. this does not mean that a far more equitable system should not be put in place. It creates a two tier system where those who can afforf to pay do and those who cant get left behind. this is wrong. And a publically funded not for profit system is the only equitable way forward.

 

[television]

Re: The Lisbon vote

Yet you continue to pay for said services despite your stated aversion to private health care. Why worry about Europe foistering private health care on the Irish public when you yourself are already driving the demand?

You believe that health care should only be provided by the public sector. No choice for the consumer. Yet when faced with the choice between public and private sector health care you find the public sector wanting and opt for the private sector intead. I am not condemning you for this in any way. If I had dependent children I'd probably purchase private health insurance as well. However, I do find it galling that you desire to deny others the same choice.

Anyway, I'm dragging this thread off-topic. There is discussion here concerning public/private healthcare which is probably more suited to a continuation of this discussion.

And youtalk about consumars of health care like health care was the same as purchesasing a TV. This is what is wrong with privitisation of health care provision. People become consumars and doctors become health care providors. And a patient is called a "client". Using the languege of business will do nothing good for health care. Mark my words.

 

[room305]

Re: The Lisbon vote

What is driving demand for me is the fact that the public health service is so underfunded people like me have no option but to get VHI etc. this does not mean that a far more equitable system should not be put in place. It creates a two tier system where those who can afforf to pay do and those who cant get left behind. this is wrong. And a publically funded not for profit system is the only equitable way forward.

Under-funded? We pay more per-capita for our public health system than France. The problems are not money but general public sector incompetence and malaise exacerbated by a union strong hold.

It's hard to imagine how dismantling the private sector (the most successful part of the health system) will improve things. Would you be happy if the government announced tomorrow that private health care was evil and from now on everyone would have to rely solely on public health care.

 

[television]

Re: The Lisbon vote

Under-funded? We pay more per-capita for our public health system than France. The problems are not money but general public sector incompetence and malaise exacerbated by a union strong hold.

It's hard to imagine how dismantling the private sector (the most successful part of the health system) will improve things. Would you be happy if the government announced tomorrow that private health care was evil and from now on everyone would have to rely solely on public health care.

where doyou get you figures from. Iam not saying dismantle the private sector. I am saying that if private sector health care is the only option then poor people who cannot afford it will suffer.

 

[S.L.F]

Re: The Lisbon vote

Our health service was seriously underfunded for 20 or so years.

Any money being put into it now is only helping to play catch up.

Playing catch up always costs more because you are not only upgrading but you also have running costs to deal with too.

 

[Complainer]

Re: The Lisbon vote

That's hilarious. You voted no to the Lisbon Treaty in case it resulted in further privatisation of Irish health services but you actually pay for private health care for yourself.

It is refreshing to see someone whose beliefs run so deep.

It's not funny at all. Many, many Irish people (including myself) who have deep reservations about the creation of a 2-tier health service have no choice but to take out private health insurance to protect their families given the atrocious state of the public system.

The thousands of children born using IVF technology would not exist without the private healthcare system, given that the Dept of Health don't provide IVF services to public patients.

 

[television]

Re: The Lisbon vote

Would you be happy if the government announced tomorrow that private health care was evil and from now on everyone would have to rely solely on public health care.

Yes if i meant a good quality service that has equality of access to all regardless of ability to pay.

 

[Brianne]

I think there are people arguing here who are throwing out huge statements about our health system which aren't necessarily accurate.

Everyone living in Ireland and certain visitors to Ireland are entitled to free maintenance and treatment in public beds in Health Service Executive (HSE) hospitals and voluntary hospitals. Some people may have to pay some hospital charges. Holders of [broken link removed] and certain other groups do not have to pay charges.
There are daily in-patient charges, an out-patient charge and some long-term stay charges.


The charge for in-patient/day services is €66 euro per day up to a maximum of €660 euro in a year (1 January 2008). The charge does not apply to the following groups:

• Medical card holders
• People receiving treatment for prescribed infectious diseases
• People who are subject to "long stay" charges
• Children up to six weeks of age, children suffering from prescribed diseases and disabilities and children referred for treatment from child health clinics and school board examinations
• People who are entitled to hospital services because of EU Regulations
• Women receiving maternity services

So basically everyone has the above. What would happen if all those in VHI etc. decided to drop their private insurance and use the system?
Well the system would collapse and maybe then people would realise that this health care system out of which FF government in the 1980's took three thousand beds, is not adequate . Yes we had that many more beds in 1980's Ireland when the population was up to half a million less , when people were not living as long and when many of the procedures which we now take for granted such as CAT Scans and MRI were either not around or in their infancy.
Then, if there was a revolution and the Irish people wanted an NHS situation would we, the electorate put in a government who said they'd increase taxes? The system was stripped , the private system developed and some would say took pressure off the public system but now hard decisions have to be made.
Will we allow any government to make them?
Will we allow our local hospitals to be downgraded and go further for certain treatments?
Health care is an endless demand curve and all this talk about the private system being efficient is just that.........talk.
The private system doesn't deal with major accidents, old people with dementia and multi disease who are waiting on suitable nursing homes. The private system doesn't have the orthopaedic lists f.......d up for the next two days because joy riders or drunken drivers or plain road traffic victims need urgent operations and automatically jump the list.The private system can pick and choose, the public system can't.
They operate on you in the private system but if things go really wrong, where do you end up.......back in casualty at 3 am being looked after by the public system.
Futhermore we had clean hospitals, I remember them:we also had domestic staff,,,,,,yes the dreaded public servant who cleaned them. Now the cleaning is done by private companies employing people on low wages.We didn't value some of the most important people in the system.....yes the cleaners.......
I think people should be entitled to use private health care, I also think they have paid for the public system and should avail of both if it suits and there is no reason why if efficiencies in administration and management with extra funding were agreed on by the taxpayer , we couldn't have a good public system as well.
Incidentally the midwife who was not able to work the epidural machine could have been reported to the Chief Nursing Officer and also to An Bord Altranais; we have a highly regulated nursing profession and surely a reprimand with further training or conditions attached to her/his registration would be a better result.

 

[television]

I think there are people arguing here who are throwing out huge statements about our health system which aren't necessarily accurate.

Everyone living in Ireland and certain visitors to Ireland are entitled to free maintenance and treatment in public beds in Health Service Executive (HSE) hospitals and voluntary hospitals. Some people may have to pay some hospital charges. Holders of [broken link removed] and certain other groups do not have to pay charges.
There are daily in-patient charges, an out-patient charge and some long-term stay charges.


The charge for in-patient/day services is €66 euro per day up to a maximum of €660 euro in a year (1 January 2008). The charge does not apply to the following groups:

• Medical card holders
• People receiving treatment for prescribed infectious diseases
• People who are subject to "long stay" charges
• Children up to six weeks of age, children suffering from prescribed diseases and disabilities and children referred for treatment from child health clinics and school board examinations
• People who are entitled to hospital services because of EU Regulations
• Women receiving maternity services

So basically everyone has the above. What would happen if all those in VHI etc. decided to drop their private insurance and use the system?
Well the system would collapse and maybe then people would realise that this health care system out of which FF government in the 1980's took three thousand beds, is not adequate . Yes we had that many more beds in 1980's Ireland when the population was up to half a million less , when people were not living as long and when many of the procedures which we now take for granted such as CAT Scans and MRI were either not around or in their infancy.
Then, if there was a revolution and the Irish people wanted an NHS situation would we, the electorate put in a government who said they'd increase taxes? The system was stripped , the private system developed and some would say took pressure off the public system but now hard decisions have to be made.
Will we allow any government to make them?
Will we allow our local hospitals to be downgraded and go further for certain treatments?
Health care is an endless demand curve and all this talk about the private system being efficient is just that.........talk.
The private system doesn't deal with major accidents, old people with dementia and multi disease who are waiting on suitable nursing homes. The private system doesn't have the orthopaedic lists f.......d up for the next two days because joy riders or drunken drivers or plain road traffic victims need urgent operations and automatically jump the list.The private system can pick and choose, the public system can't.
They operate on you in the private system but if things go really wrong, where do you end up.......back in casualty at 3 am being looked after by the public system.
Futhermore we had clean hospitals, I remember them:we also had domestic staff,,,,,,yes the dreaded public servant who cleaned them. Now the cleaning is done by private companies employing people on low wages.We didn't value some of the most important people in the system.....yes the cleaners.......
I think people should be entitled to use private health care, I also think they have paid for the public system and should avail of both if it suits and there is no reason why if efficiencies in administration and management with extra funding were agreed on by the taxpayer , we couldn't have a good public system as well.
Incidentally the midwife who was not able to work the epidural machine could have been reported to the Chief Nursing Officer and also to An Bord Altranais; we have a highly regulated nursing profession and surely a reprimand with further training or conditions attached to her/his registration would be a better result.

Brilliant post. Well informed. Well done.

 

[csirl]

A for profit health system creates a divide between those who can pay and those who cant. that is unfair and immoral.

As a previous poster said, you are confusing 2 issues here - (1) whether or not there should be universally available public healthcare at taxpayers expense & (2) whether or not public healthcare should be provided by the private or public sector.

It is possible to have universally available public healthcare at taxpayers expense which is provided entirely by the private sector on a for profit basis.

Is your issue with the provision of healthcare by private companies or is your issue having equal level of healthcare for all citizens regardless of whether or not they can afford to pay extra for better service?

 

[television]

It is possible to have universally available public healthcare at taxpayers expense which is provided entirely by the private sector on a for profit basis.

Ok then given me one example in the world today where this is actually the case.

I dont believe it is possible because heath care sometimes costs more than is economically viable. Health is not about profit and trying to convince yourself that the free market economic eutopia will cure all ills (excuse the pun) does not take into account that sometimes proceedures that save lives may not balance the balance sheet. In a purely for profit system there is presures put on to do just that at the expence of patient care. And if you think that would not/does not happen your deluding yourself.

The untimate aim of universal health care provision should always be about patient care and never profit

 

[csirl]

I dont believe it is possible because heath care sometimes costs more than is economically viable. Health is not about profit and trying to convince yourself that the free market economic eutopia will cure all ills (excuse the pun) does not take into account that sometimes proceedures that save lives may not balance the balance sheet.

Not true. If a hospital is getting paid solely on a usage basis, then the opposite is actually the truth - they are more likely to do procedures as they get paid for doing so. Doing the procedures is necessary to make a profit. You dont do procedures, you dont get paid.

Again you are confusing unrelated issues - in this case you are confusing the method of delivery of services (i.e. doing procedures) with how those procedures should be paid for (public purse, insurance etc.) and who should ultimately pay the cost.

 

[Purple]

Not true. If a hospital is getting paid solely on a usage basis, then the opposite is actually the truth - they are more likely to do procedures as they get paid for doing so. Doing the procedures is necessary to make a profit. You dont do procedures, you dont get paid.

Again you are confusing unrelated issues - in this case you are confusing the method of delivery of services (i.e. doing procedures) with how those procedures should be paid for (public purse, insurance etc.) and who should ultimately pay the cost.

You are right but you are banging your head against an ideological brick wall.

 

[redstar]

If a publicly-funded, efficient, clean health-care system was provided in Ireland then there would be no debate about public V private care.

But because our health-care system is publicly-funded AND grossly inefficient/mismanaged, and dirty, people will pay extra to get private care.

People will search and pay for what they perceive as the 'best' way to get health-care. i.e shop around, just like a consumer.

 

[csirl]

If a publicly-funded, efficient, clean health-care system was provided in Ireland then there would be no debate about public V private care.

The only way this can possibly be achieved is by giving people a choice of hospitals in which to receive treatment with competition between the hospitals.

The other 2 publically funded models have failed miserably in Ireland.

In some parts of the country, you have publically owned hospitals providing the service without competition and its clearly not up to scratch.

In other parts e.g. Dublin, you have a "Railtrack UK" style nightmare - the worst possible situation from a level of service, cost and customer friendly point of view - the private sector monopoly i.e. privately owned hospitals, who never even tendered for the business, having a monopoly on public health provision.

Look at newspapers reports in recent weeks and you'll see plenty of stories about hospitals saying that they will be closing wards, units, services etc. unless they get more money from the Government. This shows us how messed up this monopoly is. Could you imagine any other part of the private sector taking advance payment for a service and then refusing to provide it or asking for more money to provide it? They'd lose customers very quickly or get sued out of existance.

 

[bullbars]

deleted

 

[bullbars]

Look at newspapers reports in recent weeks and you'll see plenty of stories about hospitals saying that they will be closing wards, units, services etc. unless they get more money from the Government. This shows us how messed up this monopoly is. Could you imagine any other part of the private sector taking advance payment for a service and then refusing to provide it or asking for more money to provide it? They'd lose customers very quickly or get sued out of existance.

Emotional bribery at its best. They know it will twig the response from the public that they need. The blame is shifted to the government.

 

[bullbars]

Health is not about profit and trying to convince yourself that the free market economic eutopia will cure all ills (excuse the pun) does not take into account that sometimes proceedures that save lives may not balance the balance sheet. In a purely for profit system there is presures put on to do just that at the expence of patient care. And if you think that would not/does not happen your deluding yourself.

The untimate aim of universal health care provision should always be about patient care and never profit

I agree. Health care and profit should never be linked. However Health care and efficient use of public money is the issue.

 

[Purple]

Well the system would collapse and maybe then people would realise that this health care system out of which FF government in the 1980's took three thousand beds, is not adequate .

And why did they do that? Do you not know what a state the country was in at the time?

Yes we had that many more beds in 1980's Ireland when the population was up to half a million less , when people were not living as long and when many of the procedures which we now take for granted such as CAT Scans and MRI were either not around or in their infancy.

... and a vast array of procedures that required 3-5 days in hospital are not done as elective day surgery. Many others that required weeks in hospital now require days. There was no such thing as keyhole surgery, stents and balloon catheters were crude and used for only a tiny number of the applications for which they are now. Don't tell half the story when you have read the whole book.

Then, if there was a revolution and the Irish people wanted an NHS situation would we, the electorate put in a government who said they'd increase taxes? The system was stripped , the private system developed and some would say took pressure off the public system but now hard decisions have to be made.
Will we allow any government to make them?

No, the first people to down tools when the government tries to sort out the health service are the nurses. This has been seen over and over again. The solution is good management that is allowed to manage. At the moment we have neither.

Health care is an endless demand curve and all this talk about the private system being efficient is just that.........talk.
The private system doesn't deal with major accidents, old people with dementia and multi disease who are waiting on suitable nursing homes. The private system doesn't have the orthopaedic lists f.......d up for the next two days because joy riders or drunken drivers or plain road traffic victims need urgent operations and automatically jump the list.The private system can pick and choose, the public system can't.
They operate on you in the private system but if things go really wrong, where do you end up.......back in casualty at 3 am being looked after by the public system.

Agreed

Futhermore we had clean hospitals, I remember them:we also had domestic staff,,,,,,yes the dreaded public servant who cleaned them. Now the cleaning is done by private companies employing people on low wages.We didn't value some of the most important people in the system.....yes the cleaners.......

I remember when nurses used to pick up the odd thing in hospitals. I remember when the ward sister used to make sure the cleaner did their job properly instead of chatting at the desk and then blaming the hospital management or the minister when the place was dirty. I even remember when nurses washer their hands and didn't spread MRSA.

I think people should be entitled to use private health care, I also think they have paid for the public system and should avail of both if it suits and there is no reason why if efficiencies in administration and management with extra funding were agreed on by the taxpayer , we couldn't have a good public system as well.

I agree but the consultants have accept change as well and nurses have to accept that just like any other group of people some of them are just no good at their job and/or lazy and should be sacked.

Incidentally the midwife who was not able to work the epidural machine could have been reported to the Chief Nursing Officer and also to An Bord Altranais; we have a highly regulated nursing profession and surely a reprimand with further training or conditions attached to her/his registration would be a better result.

Good luck with that one...

 

[redstar]

Purple;

I remember when nurses used to pick up the odd thing in hospitals. I remember when the ward sister used to make sure the cleaner did their job properly instead of chatting at the desk and then blaming the hospital management or the minister when the place was dirty. I even remember when nurses washer their hands and didn't spread MRSA.

Indeed. My father is in and out of hospitals for years and said exactly that ! He recalled being in hospital sometime in the 70's, when the matron would come around and inspect the ward for cleanliness. The nurses were terrrified of her so kept the place spotless !
I'm not advocating terror on the wards but the lesson here was that the wards were managed properly. Cleanliness was checked daily and staff were held accountable if the wards were not looked after.

In recent years, external cleaning companies have been brought in and nowadays some hospitals are manky. Accountability has now gone as health service management 'outsourced' cleaning without managing the contractors performance.