Hospital Co-location - are private patients subsidised?

SeanW

I just had a worrying thought about this mad "co-location" plan of FF (the PDs?)

If hospital co-location (read, giving away public land to privateers) is going to free up public hospital beds at no monetary cost to the taxpayer, and we know the cost of "bed" has more to do with staffing costs, like nurses, orderlies, consultants and whatnot, than building costs, then I have to wonder why private patients are occupying so much resources ATM.

Are the private insurers like VHI etc getting public beds free? Because that's the only way I can see private hospitals "freeing up" public beds without massive extra staffing costs.

And if that's the case, wouldn't it make more sense to prod the privateers into providing for themselves with bed-charges rather than more pork barrels?

Or did I miss something?

LostinBlanch

I' m not sure about the no cost to the taxpayer bit. Didn't Brian Cowen say last night that it would cost the exchequer €70 million per year for the next 7 years?

Apparently FF HQ has been having canaries over this and wheeled out Seamus Brennan who wasn't exactly sure what the cost will be. He was then supplied with information by an FF person who said that the cost would be only €40 million per year. That is if I heard Newstalk correctly.

cm2000

it's 300 mil over 7 years or 40ish mil a year. cowen read it wrong

nesf

There would be a financial shortfall because of the loss of private patients in those beds (i.e. private patients pay for them, public don't so you have to make up the difference).

This then is offset by the lease income, profit sharing and other instruments. I heard Cowen mention but I haven't seen in print so I'm not saying it's 100% accurate and I don't know the extent of them.

Afaik, the state would receive some of the profit and a lease income (and something else, I forget what it is) from the new hospital which to an extent (or possibly fully, I don't know) offsets the cost of the beds becoming public beds. Harney(or Ahern?) mentioned that the new private hospitals then might be used by the NTPF to serve public patients but I'm not 100% on that.


I haven't actually gone and read the proposals fully though.

gandalf

You sure, doesn't sound like anyone has a clue in FF. I mean last time Brennen was involved with anything involving budget the country got fleeced LOL

nesf

It doesn't exactly fall within Brennen's brief though to be fair. The only people I'd pay any attention to about the cost of a health service proposal are Cowen, Harney and Ahern (and Cowed did mess up the gross figure alright which was dissapointing).

edanto

Let's look at it this way.

It costs a certain amount of money to build and staff hospitals. Under this plan, the private sector would assume a proportion of that cost, and get tax breaks and profit share in return.

Without this PPP model (which has been shown to make roads much more expensive per kilometre to you and I), the capital and staff costs would have to be covered by central, which probably gives cashflow problems. But even with these cashflow problems, we wouldn't have to give tax breaks, public land, or healthcare profit share (what a fcuked up term) to developers.

I think the plan stinks. Good public management of the hospitals would be better than making them private. Why? Because there would be no incentive to make a profit off our healthcare system.

The criticism commonly levelled at this is some kind of wastefulness culture in the public service and while I've no information on that it is a very separate point. Making that criticism implies an acceptance that public ownership is the best way to go, as long as it's well managed.

btw, the spin doctors have attempted to clear up the confusion about the 40m/70m per year issue by blaming it all on 'not including tax buoyancy figures'. Translation - she made it up based on our optimistic forecasts.

"Party political adviser Colin Hunt eventually came to the rescue saying Mr Cowen's costings were accurate but had not included tax buoyancy figures, which Ms Hanafin's figure did." link It's remarkable how that story doesn't have a single quote from the Rainbow. Still, the fact that they're not as media savvy as FF won't stop me voting #1 for the marginal Rainbow candidate in my constituency.

AidoCQS

In America they are trying to work backwards from the Private Healthcare experiment. Health is simply not a market commodity. The supply/demand model goes out the window if you get run over on the way home from work tonight... SUPPLY SIDE can you afford to pay more - NO THE OPPOSITE
DEMAND SIDE - you can and will only go to the nearest hospital, you cannot open a tender process to see who will put you back togeter quicker/cheaper.

My brother got a splinter in his finger one day on a Union building site (read - he has got health insurance), they took him into the local hospital and did not release him for nine days - it cost the health insurance company the equivelent of €45,000 in todays money - READ - NOT CHEAPER - ANTICOMPETITION - PD's note.

When I was in the US i was actually prevented from going into business for myself because private insurance would have cost my family 18k/year. I had to stay with my employer because they had the besyt health insurance deal - READ: NO FREE MOVEMENT OF LABOUR - ANTICOMPETITION - PD's note.

And then when the brave few do take a chance, go into business for themselves, skip healthcare untill they are up and running, what do you think is the biggest source of bankrupcy? you guessed it - healthcare - ANTICOMPETITION - PD's note.

Even the bigger, more well established companies, trying to retain good employee's are crippled trying to make Health Insurance repayments - ANTICOMPETITION - PD's please note

I lived it, I saw it - you do NOT WANT TO SEE private healthcare here.

gandalf

The problem with bed capacity in our hospitals is not the number of private patients (sure the hospital ask you if you in VHI/Quinn/Vivas in A&E and if you are they start charging when you head to the ward no matter if you are in a private bed or not), its the number of elderly and patients who are recovering from operations who do not have convalescents facilities and proper nursing home facilities to go to.

If those needs were met alot of beds would be freed up immediately.

The only thing that should be privatised is the working conditions of employment for Department of Education and the HSE admin so the job blockers in there can be removed.

democrates

Spot on AidoCQS and edanto - Michael Moore's new movie Sicko will raise awareness of the anti-social brutality that privatisation in heathcare portends.

Co-location is one element, and it sickens me. The hospital land supposed to be used by this government of the Irish republic to provide adequate healthcare for we the people, is instead to be ringfenced for the pursuit of profit by a few. Off to a bad start.

We'll all pay via both the tax foregone and the loss of the ability to use this land for public healthcare, therefore those who can't afford private healthcare will subsidise individuals who can.

FF have been using the PD's as convenient scapegoats, the one trick pony which believes the answer to all problems is competition in a free market, that pursuit of profit is preferred as our motivation to co-operation on common goals, so ultimately, that man is a lazy being spurred to work only out of greed and selfishness, and no more should be expected. Speak for yourselves.

But FF can't distance themselves from this their own plan. It's straight out of the neocon guide to screwing the many to enrich the few.

nesf

AidoCQS wrote:

I lived it, I saw it - you do NOT WANT TO SEE private healthcare here.

Nobody wants to see only private healthcare here, including the PDs tbh.

AidoCQS

At the very least its another stealth tax - you pay your Tax's and now you are going to have to pay for insurance... The VHI insurance you and I now pay is going to be nothing if they start building hospitals. You can put that into they hyperinflation column as well.

Do your own research, invent an Americal social serurity number, and put in a requst for a quote to an american health insurance website. Skip the young healthy single bit and try wife and two kids. Try smoker (just laid off) at 58 with wife 60. You will be stunned... You know the way your big costs here are Morgage, Car. In America, unless you are with a big company with good health insurance, you can squeeze health insurance right in between Morgage and Car.

Rabitte is the only person who has been strong on this issue, I hate to say it but if there is a half decent local candidate I have to seriously look at labour.

daveirl

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gandalf

Well maybe there should be exact details. I mean FF can't even agree to what the actual costs are!!!

Its like Ahern, Cowan and Harney are playing Fantasy Health sometimes (and badly!).

AidoCQS

daveirl wrote:

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Why have it at all? Somebody tell me what is the benifit?

Explain to me how our capitalists are so much more virtuous than the American ones?

This country is full of multimillionairs and billionairs who made a bomb in the past decade, where to invest? I know Biffo is giving away public land....and tax rebates to boot. Lets lob a hospital on it. The continuous underesourcing of health by successive FF governments means there is a thriving market for private health. And what could be a surer investment other than peoples health, building booms come and go - but their will always be sick people!

Its a form of slavery, what father or mother is going to send their sons into a public hospital when they will have to join a queue with people who have gunshot and stabwounds?

edanto

daveirl wrote:

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Yes, they are a few years ahead of us in this endeavour, there's even been time for the Royal College of GPs to write a report on it back in 2002... which on the whole is ambivalent towards private sector involvement, and doesn't make any conclusions one way or another.

But to support my point above about this type of healthcare COSTING US MORE - I'll quote the NHS Consultant's Association from that report "the private sector is almost invariably more expensive than providing services within the NHS." The same association currently has a national campaign Keep Our NHS Public.

Here's a quote from the site:

But alongside the cuts, an unprecedented process of privatisation is under way: vital services and precious NHS resources are being handed over to the private sector, including companies run for profit for shareholders here and overseas. Now is the time to fight back to Keep Our NHS Public!

Is this what we want? Vote PD's to make investors rich when you're sick!!

Will we see this sign in our hospitals??
Sick, eh?! We bet you'll feel even worse when you realise that you're paying TWICE as much as you have to so that SOME RICH DUDE can buy another yacht! Oh and thanks for voting FF/PD in 2007 folks!

gandalf

Why when I think of this governments health strategy am I reminded of this scene from Robocop?

an ad for the Family Heart Centre plugs a "series seven sports heart by Yamaha. Finance, credit and warranty are also available!" The announcer adds: "And remember, we care."

daveirl

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gandalf

daveirl wrote:

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You mean we waste more, I would love the see the breakdown of where the funds go, how much gets to the coalface and how much has been wasted on the bloated admin side of the HSE and Department of Health. Thats the main legacy of this government unable to deliver value for money.

daveirl

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edanto

Dave, you're [not] confused. I'm not complaining about the existence of a private sector or the choice to go private.

daveirl wrote:

Choice, people are entitled to spend more money if they want more plush surroundings etc, that's their choice.

I'm complaining because a small party backed by big business and a big party with a history of making bad deals with our money (toll-bridges) are proposing a scheme to give away national assets for nothing!!

daveirl

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AidoCQS

Sure, up to now its been about 'plush surroundings' a private room, is far more plush than a public room.

But what’s on the table now is so much different, it is the apartheid of the health care system. Private hospitals can afford the best consultants, best facilities. Everybody else is on their own.

To speak of 'plush surroundings' in this debate is to miss the whole point of what the public service is about, I mean why not privatize the colleges - why - poor people will not get to go to school and will be stuck in a poverty trap. Why not privatise the prisons - well poor prisoners will get different accommodation to the drug barons (I know already happening ), Why not privatize the police service? Well poor people go to jail, the rich don’t.

There are some things you simply cannot privatize, certainly not in the underhand way this is happening, I mean where’s their mandate to give away public property?

There is no law, never has been one against opening up a hospital with plush surroundings, but to finance it using taxpayers land and taxpayers money. Who gave FF a mandate for that?

This will also create, as in the US, a powerfull private lobby group, who have an interest in keeping the public hospital system under resourced (remember a private hospital service NEEDS a bad public one to thrive), These people will finance, elect and support the governments that will underresource the public health system READ: FF/PD. So remember on Thursday, reelect PD/FF, the billionaires will thank you for it.

joecoote

Yesterday, I thought it was amusing how they were arguing over how much of the tax payer's money was going to be spent (forgone, whatever) in subbing private health care. Not to mention using public lands for private developers gains. They were throwing figures like 40, 50 and 70 million a year around as if this money was peanuts. A fraction of this money would improve services at Monaghan Hospital.

It just makes me wonder about the mentality of these people. I know figures in the billions are bandied about these days. However, people have died due to government cuts at Monaghan Hospital. This is a simple fact. (Sorry about the local issue, but its one I'm clued up on.) Has money and economics so taken centre stage that the health and other concerns of ordinary people are secondary - or worse irrelevant?

AidoCQS

Sure in Tralee General, some developer building houses away at the back, built some of the houses on hospital grounds, did not realise it untill he went to sell on the houses and the solicitor could not complete the conveyancy, then he had to buy them off the hospital first, its a Joke - no oversight, no control over the developers, the loonies are running the asylum