That's the issue in a nutshell.None of this is simple. It will take more than one lifespan of a government to do and it is unlikely that any party would have the political will to do so given how unpopular significant change will be at the ballot box.
not less doctors but improve IT infrastructure and incentives for right behaviour so we can improve services. Not less police but less bureaucracy and effective judicial system to deter crime. Make paper pusher accountable for making wrong choice or bad practices.And where do you cut? Less police? There's not enough. Less medical? There's not enough? Or is it just the civil servants and paper pushers you want to get rid of?
One area where we could definitely do some work is paying tax just to get it back in services.
For example, the Fair Deal Scheme. Why should the taxpayer be paying the nursing home costs of people who can well afford it themselves? The argument put forward is "Well old people paid taxes all their lives, so it's the least we can do.".
I think it would be much better if the state paid for nursing homes for those who can't afford it but the rest pay for themselves.
There are thousands of posts on askboutmoney from wealthy people or their children about how to minimise their contribution to the Fair Deal Scheme. I think that anyone who owns their own home should pay for their own nursing home. It shouldn't be for me to pay for it so that their children can inherit more.
You don't have to go to the UK to find examples of that. It's absolutely rife in this country.This could lead to people being neglected in homes, without the right support.
Sad to say, it happens in the UK. Families will push for their elderly relative to stay in the family home, with limited support and out of the nursing home. Even though they, almost certainly, need to be in a fully staffed nursing home.
Indeed, so maybe free universal care for the elderly, financed by increased inheritance tax is the way.You don't have to go to the UK to find examples of that. It's absolutely rife in this country.
Indeed, so maybe free universal care for the elderly, financed by increased inheritance tax is the way.
An example of this is the number of people I have told to go to The Chemists Warehouse for half price drugs. They say that it saves them no money as the state pays for everything over €80 a month, so if their bill is €200, they gain nothing by having it reduced to €100.
Brendan
Wouldn't that be an incentive to shove dad, mum or uncle Cyril into a nursing home at the earliest possible opportunity, regardless of whether or not they actually need to be there?Indeed, so maybe free universal care for the elderly, financed by increased inheritance tax is the way.
Wouldn't that be an incentive to shove dad, mum or uncle Cyril into a nursing home at the earliest possible opportunity, regardless of whether or not they actually need to be there?
What could possibly go wrong?
Universal healthcare and education are provided by the state, so why not a safety net of social care for the elderly.
Do you not see that the pressure may come from them, particularly as the State's provision of free-at-the-point-of-use services tends to entail shortages and waiting lists?Well, mum or dad, or Cyril, would still have agency, their own decision making. They might be pressurised by some, but I doubt it.
This is the entirety correct approach.At a meeting with a solicitor recently, I was struck by how, in a conversation about inheritance and tax, the professional advisor assumed that my default position would be to minimise my own ‘tax bill’ in relation to my potential inheritances, and to minimise my children’s tax bill in relation to theirs.
This is part of the source of wasted taxes. There shoukd be investment into rooting out the offenders.On the other hand, we should spend more on those who genuinely need it and can't afford it so that means taxing more.
The more layers of bureaucracy there are in an organisation the more waste there is and the greater the opportunities there are for efficiency. The Barber doesn’t have layers of management and forms to fill in. He just cuts hair. Talk to anyone who works in a hospital or in any relatively senior level in the HSE and they will list off teams of ways that things could be improved. LEAN is just listening to those people, measuring the waste and implementing what they suggest.To be fair to public services, many of them can't or don't experience the same increase in productivity as seen in industry.
Your industry, and many others, like making electronics, toys, etc. experience economies-of-scale, automation, leading to large increases in productivity, and falling unit costs.
In contrast, nursing, education, medecine, police, etc., are very labour intensive, and don't see the same increases in productivity.
This is known as Baumol's cost disease.
It's why I can buy a chicken at 4 euro, cheaper than ever before, but the price of a haircut keeps rising. A barber can't cut any more heads compared to 50 years ago.
However, in saying all this, we could still do with much more EHR, automation, ICT in the public service, especially in the HSE.
The lack of facilities in GP practices is also a good example of what’s wrong. In other countries GPs will perform minor surgeries, stitch cuts etc. The unwillingness of Irish GPs to do that sort of work or to invest in their business so that they can provide a better service to their customers (without handouts from the taxpayer) is emblematic of the problem with the health service.not less doctors but improve IT infrastructure and incentives for right behaviour so we can improve services
Similar experience living in France. Paid similar levels of tax to Ireland, but the benefits received were far better. Healthcare, infrastructure, public services, social insurance, all done to a much higher standard. You felt you got value for what you were paying in. I had an Italian colleague who thought similarly, so it would seem this isn't a universal throughout Europe.I've paid north of €1M in taxes over the past 20 years and got very little in return from the state for it. Before that, I lived in Germany for many years and recall that the taxation rates were similar but the services that I received (healthcare, public transport, public infrastructure, pay related state pension) were far better than in Ireland. Our public service and government waste far too much tax payers money and are inefficient and often poorly run / nepotism / vested interests. Giving them more tax would only result in more money being wasted by various government departments. Look at our health service which recieves as much/ if not more money per head from the state than countries that actually have a good public healthcare system but 15+ years after the A&E trolley list started they still havent manged to solve the issue.
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