Health insurance model is flawed – IMPACT

IMPACT has expressed its disappointment that the Government has decided to press ahead with a ‘competing private insurers’ model of Universal Health Insurance (UHI). The union also expressed disappointment in the ‘restrictive’ consultation process outlined in the Government’s white paper on UHI, which was published today (Wednesday 2nd April).

IMPACT national secretary Louise O’Donnell said “This scheme is fundamentally flawed, will place an immediate financial burden on families, and has been produced without any meaningful consultation process. The consultation is restricted to what this ‘competing insurers’ model will look like. There is no consultation taking place on any other options, such as those recommended in Dr Jane Pillinger’s 2012 report, The Future of Healthcare in Ireland.

“That report said that the competing insurers model, as proposed by the minister, should not be adopted before all the options have been evaluated in terms of quality, equity, access to services, and medium and long term value-for-money. The report was ignored by the minister.”

IMPACT has urged the Government to evaluate an alternative ‘single-payer’ social insurance model like those used in France, Germany and Nordic countries. Ms O’Donnell said “Families will be required by law to have health insurance, but there is a real risk that this will be an impossible financial burden from the very start, particularly for the growing number of people without health insurance who don’t qualify for a medical card. This group will be required to purchase health insurance for every member of their family, unlike the Dutch insurance model, previously lauded by the minister, where children are insured for free.”

Ms O’Donnell added “The question of cost remains, but it appears that no evaluation of any other funding model has been undertaken. We have been trying to get the message across to the minister that other options need to be considered, but until today, there’s been no engagement on these plans.”

While the final price of UHI had not yet been disclosed, it’s expected that it could be as high as €1,600 for an individual, on top of what is already paid in income taxes and charges.

Ms O’Donnell said “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. They’ve also experienced rising re-admission rates as more people experience complications after they’ve been discharged, because of the financial incentives to discharge patients early.

“The minister’s estimate of €900 per individual seems almost optimistic, but if this model is established, the costs are likely to continue to rise. The minister has also boasted that the scheme will ensure no additional cost burden to the state, which will mean that the only means of raising extra revenue will be through individual insurance premia. And, if we really want to get the measure of where this scheme is going, it is telling that the €100 charge for emergency departments will remain in place” she said.

READ: Louise O’Donnell’s letter in The Irish Times (Friday, 4th April)