Total National Spend on Healthcare

[orka]

Had a similar experience on my first child, discharged myself early against medical advice as I could not take being in a public ward any more without any sleep, the constant noise and heat.

Had paid for a private consultant who was on holidays when I went into labour. Had paid (and continue to pay) all my working life for private health care. Ended up in the same position as everyone else in the public health care system. Hospitals are the great levellers.

That was very poor service from your consultant. No consultant will guarantee to be there for your delivery but they should arrange cover from another consultant so you are getting what you paid for. You might not actually need the consultant as the midwives do a great job but it's nice to know your consultant or a replacement are there if needed.

Isn't semi-private a bit of an oxymoron anyway? You are either in a private room or else you have to share with other people.

There's a BIG difference between being in a fully public ward with possibly 20+ beds in it and a room with 4-6 people in it who have paid for private health insurance.

 

[DerKaiser]

I've also advocated here that private medical insurance should be banned. This would force everyone from the top down through the public system. I would imagine that the great and the good at the top (including TDs, ministers etc) would kick up enough to ensure radical reform in the HSE overnight.

Not sure that's what Purple had in mind.

I think his point was that everybody should pay medical insurance with a very large subsidy from the state for those who can't afford it.

Maybe if everyone feels they are paying for it they might demand better services and accountability as regards the wages of medical staff.

If half the patients are effectively getting it for free you get the attitude from consultants that they should be grateful for anything and the incorrect belief from patients that they have no real right to complain.

 

[Welfarite]

So what are the actual physical benefits of private V public? Forget about jumping waiting lists, getting private rooms, etc. when considering this.
Does one get better medical care and attention? Why do we actually opt for private cover at such huge cost?
Another issue I think is that the Medical Card. Doctor's waiting rooms are filled with people who do not really need to be there; they are there because they have amedical card and it does not cost them a penny. If there was a nominal fee for seeing a doctor this would eliminate a lot of this hypocondric behaviour. I actually agree with the nominal 50c fee for prescriptions.

 

[shnaek]

If there was a nominal fee for seeing a doctor this would eliminate a lot of this hypocondric behaviour. I actually agree with the nominal 50c fee for prescriptions.

I agree completely. People think services are free, but nothing is free - someone always pays. Like the water debate - we should PAY for water - we are already paying for water, just not directly. Drives me nuts when people talk about FREE services, when none of them are free.

 

[Purple]

+1 DerKaiser and +1 shnaek

 

[Bronte]

Anyone know what health insurance costs are and how it works in a country with a well run health system?

I spend €2,500 a year in health insurance for my family which seems high. .

I live in such a country, just paid the family cost of less than 200 ( but it also comes out in the PRSI is my understanding). For that we have a superb health system.

 

[Firefly]

removed

 

[Chris]

I was under the impression that the Swiss spend less per capita than us but I was wrong.

Keep in mind that the mandatory part of the Swiss system is a lot lower than the mandatory part of the Irish system. Like in Ireland, the Swiss choose to pay for additional cover, the main difference being that in Switzerland the basic cover encompasses a lot more than in Ireland and there is not a two tier system of waiting lists.
Ireland: €14bn health budget divided by 4 million people is €3500 per man woman and child
Switzerland: mandatory private health insurance depends on the canton you live in, but for an adult it is between SF200 and SF300 per month. Taking the average that means SF3000 per year or €2400 at current exchange rates. Children cost about half as much.

The problems in the Irish healthcare system are not confined to the public section. The problem lies with the funding structures, not the funding sources.

I agree 100% with this comment. Getting rid of a two tier system, through e.g. a private health insurance system like Germany or Switzerland, puts all patients on par, regardless of public or private hospital, which increases competition between individual hospitals as well as between public and private hospitals.

 

[Purple]

Ok Bronte, where do you live?

 

[onq]

The fact that so little seems to have been achieved in the health service hugely devalues the MBA's that adminstrators are trading on.
It seems to expose the vested interest in maintaining the status quo that seems to permeate every level of the health service.

The general gist seems to be that we need hospital administrators, but the consultants cannot stand the thought of hospitals being run by staff nurses.
Yet these are arguably the most competent people to run a ward and - by implication, with an MBA on top of their nursing degree and experience - a hospital.

The myth of theoretically based MBA's alighting from on high to dispense wisdom on running a health service surrounded by a warm glow of wonderment has to be utterly dispelled.
The only people impressed by someone who has an MBA [but no experience] is someone who runs a small pub or country solicitors practice - ulp - that defines half the Dáil, doesn't it?

Well there you go - quod erat demonstrandum.

If you leave the running of hospitals to adminstrators with no grounding in the health service you'll see a growth in the bureaurocracy but little improvement in the service.
Inexperienced MBA's trying to accommodate a hidebound hospital beauracracy ring-fenced by Nurses and Consultants organisations all trying to get a bigger slice of the bandage
We need a root and branch review of the health service, see who's delivering value for money and see what services need to be pruned back.
Otherwsie we'll never close the public service pay gap.

Of course, reducing the health bill starts with people taking better care of themselves and others.
Is an impromvement likely in this drug-addled, binge-drinking, society that we live in?
In the middle of a Depression/Recession/Whaveter.

The simple answer is that it MUST happen.

ONQ.

 

[horusd]

I have mentioned in other posts that there are alternatives (non EU style)that we might consider. A program on the issue a few yrs back suggested the Singaporean system. Apparently average health costs are in the order of $1200 p.a.Far lower than our figure of $4,000. They combine private cover, employer contributions and pricing gov.t controls to deliver one of the best health systems in the world.

http://en.wikipedia.org/wiki/Healthcare_in_Singapore


This thread is about what we might change, and healthcare must be a priority. But I believe that more fundementally we need to look at the principles that underly society and steer policy. There are many great ideas here about what should change, but they often lack an underlying principle. That's where we should start from. I'm opening a new thread asking this question.