Universal health insurance (UHI) to cost families €3,600 a year

Government plans for universal health insurance (UHI) do not exclude children, which means the cost could run to €3,600 a year for a family of four, according to IMPACT trade union. Speaking at the MacGill Summer School in Donegal this evening (Thursday) the head of the union’s health division, Louise O’Donnell, said this figure was based on former health minister James Reilly’s “optimistic” estimate that the basic UHI package would cost €900 per individual.

Warning politicians of a huge political fall-out from the increased pressure on family budgets when UHI is introduced in 2016, Ms O’Donnell said the biggest burden would fall on families that currently have no health insurance and no medical card. “It’s safe to assume that most people in this category, which could be said to typify the so-called ‘squeezed middle,’ simply cannot afford private health insurance. Yet they will now be compelled by law to pay,” she said.

“Even if the seemingly optimistic official price estimate of around €900 per individual – including children – is correct, it will place an impossible financial burden on families and individuals. A family of four, which currently has no health insurance because they can’t afford it, could end up with a bill of €3,600 a year. Politicians beware! This will certainly make existing property taxes and water charges look modest by comparison,” she said. Those who currently have health insurance would also pay more “if the new minister sticks with existing plans to withdraw tax relief on health insurance,” she added.

Ms O’Donnell said the UHI system now being put in place falls far short of the ambitious vision set out in the Programme for Government. She also told the Glenties event that structures necessary to change the health service funding model, including hospital and primary care clusters, were “nowhere near working.” Current plans would leave Ireland with a “two-or-more-tier system,” with better services for those who can afford to pay more. Meanwhile, hospitals would continue to struggle to keep on-budget while meeting demand.

She criticised former minister Reilly’s “refusal to contemplate anything except a ‘competing insurers’ model of UHI, and the failure to require employers to pay into the fund as originally planned.

The union leader said there were also fundamental questions over what will be covered by the basic package of compulsory insurance, with the €100 fee for attending A&E expected to stay and huge uncertainty over whether post-hospital therapy services, mental health, dental, elder care and other services would be covered. In Holland, which has already adopted a similar model, “the costs to the taxpayer and users increased, while the basket of services covered by the basic package shrank. Most Dutch take out additional insurance to cover elder care, dental, and allied health services,” she said.

IMPACT says the recent consultation over UHI was a “sham” because it did not allow consideration of any approach except the ‘competing insurers’ model favoured by former minister Reilly. “There are many models, including successful models, of funding universal health provision. The ‘competing insurers’ model has been selected without consideration of the alternatives. In this respect, this rushed consultation has been a sham.

“A real consultation would consider the merits of other approaches to universal health cover, including those adopted in France, Germany and the Nordic countries. The single-payer social insurance systems adopted in these countries are providing equality of access to what, by Irish standards, are high quality, well-funded and efficient health services,” said Ms O’Donnell.

Download the full text of Louise O’Donnell’s MacGill Summer School speech.