The cost to families of universal health insurance (UHI) will vastly exceed the property tax or planned water charges, according to IMPACT. In its submission to the consultation on the Government’s white paper on UHI, the union today (Wednesday) said this would place “an impossible financial burden on families and individuals who don’t currently have private health insurance and don’t qualify for medical cards.” It said health minister James Reilly was “optimistic” to estimate that UHI would cost €900 per individual.
The union’s submission calls on the Government not to proceed with the implementation of UHI until the likely cost to individuals and families is “assessed, publicised and understood.” It also calls for more clarity – including over costing – on what services and procedures will be covered by the basic package, and says safeguards should be put in place to provide cover, at no additional cost, if a private insurer fails.
According to the IMPACT submission: “It has been claimed that UHI can be introduced with no additional cost to the exchequer, which means any extra revenue would have to be raised through individual insurance premia. By far the biggest cost burden would fall on individuals and families who do not currently have private health insurance and who do not qualify for medical cards. Given the fact that private insurance delivers better access to health services, it is safe to assume that most people in this category simply cannot afford private health insurance. Yet they will be required by law to pay for private insurance for every family member. Even the minister’s seemingly optimistic estimate of a cost of €900 per individual would create an impossible financial burden on families and individuals who don’t currently have private health insurance and don’t qualify for medical cards. The Dutch experience suggests that this financial burden would then increase over time.”
IMPACT’s detailed submission argues that the UHI funding model set out in the White Paper is deeply flawed and is likely to place a universal financial burden on families with no guarantee of universal access to healthcare. “The experience in other jurisdictions, with similar models of competing insurers, has been a continuing rise in the price of compulsory insurance, coupled with increasing restrictions on the health services covered. Lessons from the Netherlands show that this profit-driven commercial model leads to an inequitable and inefficient system of funding, different tiers of entitlement and rising hospital deficits with increased hospital re-admission rates because it creates financial incentives to discharge patients too early.” it says.
The union has urged the health minister to examine and consider the merits of an alternative approaches like those adopted in France, Germany and Nordic countries. “IMPACT recommends an alternative based on a single-payer social insurance model, along the lines of suggestions made by a growing number of social justice organisations in Ireland. A social insurance model would provide an equitable one-tier funding model capable of providing equality of access and a ‘right to health’ in Ireland. The Government is urged to consider this social insurance model,” it says.
Delivering the high quality, accessible and affordable universal healthcare system required to meet future healthcare needs requires the Government to properly cost the implementation of UHI, put in place a system of risk equalization, and ensure there are “sufficient resources from taxation to provide UHI for young people, older people, people with disabilities and long-term sickness, and people who are unemployed.”
“Implementing the wrong model will have ramifications for the healthcare of future generations. A realistic timetable for a phased introduction should be planned for. This should set out in a transparent way the costs of setting up and implementing a social insurance model,” it says.