Health Insurance

rodento

Have I lost the plot by thinking its not in the national interest to drive everyone away from private health insurance, when our national one is bursting at the seems

http://www.independent.ie/national-news/health-insurance-fees-to-soar-50pc-next-year-3339494.html

THE price of health insurance is to rise by almost 50pc next year under a scheme devised by Health Minister James Reilly.
Premiums will soar as the Government drives through plans to charge insurance companies for anyone with health cover who uses a public hospital.
The change will mean everyone with insurance will be charged by the hospital, whether they get a private bed or not.

Its the only conclusion i can make given the fact that in a time of falling incomes the cost of health insurance has risen so much

uberalles

M

Frynge

Taxing the rich would not be a bad idea if the purpose was to get things in order. But it seems they are taxing everbody down to the same level of poverty.

RichardAnd

I've always believed that insurance is one of the greatest scams humanity has ever devised and I actually work for one of the largest insurance companies in the world . . .

smcgiff

RichardAnd wrote: »

I've always believed that insurance is one of the greatest scams humanity has ever devised and I actually work for one of the largest insurance companies in the world . . .

I tend to agree. But, Health insurance is the one exception (apart from legally required insurance such as car insurance).

The reason being if you get sick you will get treatment a lot sooner for serious conditions.

The government are taking the piss with this though, as it should see 10's of thousands of more people cancelling their insurance.

GCU Flexible Demeanour

smcgiff wrote: »

The government are taking the piss with this though, as it should see 10's of thousands of more people cancelling their insurance.

In the general scale of things, that won't matter much. Health insurance has nearly doubled in cost since 2008, but overall coverage has fallen by less than 10%. The people who drop out tend to be those least likely to claim.

Health insurance is typically price inelastic. The increase in cost will, therefore, more than compensate for any fall-off in demand. Its fair enough to make public subsidy of private medicine explicit. Half of all private patients in the public system are being accommodated in public beds - which represents a cost to the taxpayer of a few hundred million.

We've needed to disentangle the public/private complexities in the acute hospital sector for decades. This is only being done now because the system absolutely cannot afford to carry these hidden subsidies any longer. Nothing to complain about; a reasonable and necessary change.

worded

How many jobs offer health insurance these days?

smcgiff

GFD,

If it goes up by 50% (okay, that figure comes from the independent, but if true) in 2013 then the elastic may snap.

GCU Flexible Demeanour

smcgiff wrote: »

GFD,

If it goes up by 50% (okay, that figure comes from the independent, but if true) in 2013 then the elastic may snap.

That's possible, but coverage has a long way to fall before (at the strategic level) you'd be worried about any significant impact on the public system.

Look at the composition of who takes out health insurance, and who gives it up. The people you want to keep in the system are typically older groups, who are less exposed to pressures on income. Putting it quickly, if you are a relatively well-off pensioner you don't have a mortgage or family expenses and you can't be made redundant. You're well able to take a sharp increase in the cost of cover, and you've every incentive to prioritise this above other expenditure.

We've far, far more to gain by eliminating the hidden public subsidies for private healthcare than we risk losing by a contraction in the numbers taking out health insurance.

tails_naf

smcgiff wrote: »

I tend to agree. But, Health insurance is the one exception (apart from legally required insurance such as car insurance).

The reason being if you get sick you will get treatment a lot sooner for serious conditions.

The government are taking the piss with this though, as it should see 10's of thousands of more people cancelling their insurance.

I personally don't agree that it should be the case that those with health insurance get to the front of the queue, or get better treatment. That said I do have health insurance because it is given to me by my employer - but I would prefer a system where health insurance would not be needed.

I'd hate to see us become like the US, where health insurance has become a yoke around people's neck (I have lots of family in the US and see first hand how bad it can be there).

maninasia

RichardAnd wrote: »

I've always believed that insurance is one of the greatest scams humanity has ever devised and I actually work for one of the largest insurance companies in the world . . .

Not at all. In many areas of the world social insurance is non existent. If you lose your job or die your family would be in very serious trouble. Insurance is also the lubricant which facilitates world shipping and trade. It's a great invention when used in the right way.

maninasia

GCU Flexible Demeanour wrote: »

In the general scale of things, that won't matter much. Health insurance has nearly doubled in cost since 2008, but overall coverage has fallen by less than 10%. The people who drop out tend to be those least likely to claim.

Health insurance is typically price inelastic. The increase in cost will, therefore, more than compensate for any fall-off in demand. Its fair enough to make public subsidy of private medicine explicit. Half of all private patients in the public system are being accommodated in public beds - which represents a cost to the taxpayer of a few hundred million.

We've needed to disentangle the public/private complexities in the acute hospital sector for decades. This is only being done now because the system absolutely cannot afford to carry these hidden subsidies any longer. Nothing to complain about; a reasonable and necessary change.

Did you see the scale of increase talked about- 50%?
You think it won't have much of an effect, I'd bet you are wrong on that. What happens if revenue is further reduced?

While I agree things should be righted if they are wrong, it seems this is not going to help with improving healthcare for people with either private or public insurance. Workers in Ireland already subsidise medical card holders AND pay high fees. This needs to be changed too.

Gumbo

Never had health insurance. Can't afford it, so won't affect me......until its too late I suppose.

rodento

Guess its a question on whether or not you have dependents and can afford to wait to get treated, its another workers tax

hmmm

Productive members of society can't sit around waiting for the incompetent public system to cure them, so many feel they need to have health insurance. Why these people should be penalised, or else forced into a system where they are competing with the person who has never paid tax in their life for priority access to healthcare is a disgrace.

avalon68

I was clearing out old bills the other day and found an old one from Bupa - My insurance used to be 320 euro a year, now its 750 or so with Laya or whatever they are called now. If it doubles again, its gone. Couldnt afford to pay it if it goes up again. And Im just paying for myself - how many families could afford to pay double? Im sure that would be significantly more.

dissed doc

avalon68 wrote: »

I was clearing out old bills the other day and found an old one from Bupa - My insurance used to be 320 euro a year, now its 750 or so with Laya or whatever they are called now. If it doubles again, its gone. Couldnt afford to pay it if it goes up again. And Im just paying for myself - how many families could afford to pay double? Im sure that would be significantly more.

For single people who don't realise (yet) what is happening and how they are screwing working couples. E.g., VHI HealthPlus Choice is €4235/year for a family of two adults and two children. That is around €7000 of gross income. Throw on the estimated costs of running a basic Band C car of €8000/year and you are rapidly into a zone of pay to work using the car and have no healthcare (no-one except the medical card holders get free healthcare), or else simply have your famiyl become a ward of state.

Quit your job, don't work, be taken care of.

GCU Flexible Demeanour

maninasia wrote: »

Did you see the scale of increase talked about- 50%?
You think it won't have much of an effect, I'd bet you are wrong on that. What happens if revenue is further reduced?

Yup, I saw the figure floated. Taking it at face value, coverage hasn't dropped that much in the face of increases of this order.

And the point is that overall revenue of insurers won't really decrease. VHI is pulling in more money today than it did in 2008, out of fewer subscribers.

As an aside, I think comments about the impact on working families and children need to be assessed in the light of who actually claims. People aged over 60 claim a multiple of the amounts claimed by younger age groups. Claims in respect of children are very low indeed - children, mostly, are very inexpensive users of healthcare.

maninasia

I defer to your greater knowledge of the subject . I'm just wary that this will add further burdens to working families. I believe pensioners are well looked after in Ireland.

Edit: read dissed doc take, and it seems private health insurance is out of the range of the middle class now. Which is pretty damn weird especially when you consider the state of the public health system, working people get screwed both ways. These are all things the government need to look at, I read this and think how in the hell am I ever going to move back to Ireland with my family?

GCU Flexible Demeanour

maninasia wrote: »

I believe pensioners are well looked after in Ireland.

I don't disagree.

maninasia wrote: »

<..> it seems private health insurance is out of the range of the middle class now. Which is pretty damn weird especially when you consider the state of the public health system, working people get screwed both ways. <...>

What might be hoped (although there is little sign of it) is that the increasing cost of private health insurance would enocourage a coherent political demand for the public system to unambiguously prioritise the efficient delivery of healthcare above all other concerns. People see the public medical system as being there for poor people, rather than seeing it as the way that we've collectively decided to organise healthcare.

It sounds strange to say it, but the political objective of the HSE is as much about preserving jobs and expenditure at local level as it is about healthcare. There's plenty of examples of that - including the current Minister for Health seemingly intervening to get primary care centres for his constituency bumped up the list.

Public health systems, funded out of tax, are actually typically the most efficient way of providing healthcare. Insurance based systems cost more, but don't actually deliver better outcomes.

avalon68

GCU Flexible Demeanour wrote: »

It sounds strange to say it, but the political objective of the HSE is as much about preserving jobs and expenditure at local level as it is about healthcare. There's plenty of examples of that - including the current Minister for Health seemingly intervening to get primary care centres for his constituency bumped up the list.

Agreed, but it really doesnt bother me that he got one in his area - I see these centers as the way forward, and if he has one in his backyard than he had better monitor it closely and make sure it succeeds so that more can be implemented across the state. Id rather he have his nose right in there from the start and make sure it works rather than having it fail miserably like almost every other change that gets pushed in the HSE

Geuze

dissed doc wrote: »

(no-one except the medical card holders get free healthcare),

Note that there are just four charges for healthcare in Irl:

(1) GP fees
(2) AE fee if you arrive w/o a GP letter
(3) Drugs up to max 132 pm, now 144?
(4) Hosp costs 75 per day/night, up to 750 max pa

All the rest is covered by tax.

Bullseye1

Is health insurance considered a luxury? It appears to be by our government opinion.

dissed doc

Geuze wrote: »

Note that there are just four charges for healthcare in Irl:

(1) GP fees
(2) AE fee if you arrive w/o a GP letter
(3) Drugs up to max 132 pm, now 144?
(4) Hosp costs 75 per day/night, up to 750 max pa

All the rest is covered by tax.

Wow you#re right. Once you exclude the fees for a primary care service, emergency services and tertiary hospital services, along with medications, healthcare is completely free in Ireland for all taxpayers!

The taxes are really high, much of it paid by a small group of middle income earners from aroudn 35-40k up. They get very little in return but pay a lot for the services if they need it.

tony81

I cancelled my policy 2 years ago when it went from €500 to €720 to €840. I'm 31 now so I might take out a policy when I'm 45 or so.

It makes no sense to charge a healthy 29 year old almost €1000 in addition to the portion of income tax that goes towards healthcare... And even that policy covered very little. It didn't cover g.p visits and only 50% of certain consultant visits. It didn't cover dental, loss of earnings, medicine, and as pointed out if I were hospitalised I'd have ended up in a public bed anyway.

smcgiff

The point though, Tony, is that you would be hospitalised

GCU Flexible Demeanour

tony81 wrote: »

It makes no sense to charge a healthy 29 year old almost €1000 in addition to the portion of income tax that goes towards healthcare... And even that policy covered very little.

I don't necessarily disagree. But I think we have to recognise that our system of Community Rating and linked system of Risk Equalisation are explicitly designed to pass the costs of older subscribers on to younger subscribers. Community Rating has been a core value of the regulation of private health insurance here since the VHI was established in the 1950s, right down to the present day.

I'm not defending this - but, then, I don't think insurance is an effective way of approaching healthcare. I just think you need to bear in mind that no-one (that I can recollect) ever tries to contradict the concept of "intergenerational solidarity" used to justify the present approach to health insurance regulation.

tony81

GCU Flexible Demeanour wrote: »

I'm not defending this - but, then, I don't think insurance is an effective way of approaching healthcare. I just think you need to bear in mind that no-one (that I can recollect) ever tries to contradict the concept of "intergenerational solidarity" used to justify the present approach to health insurance regulation.

Well look at it this way. I lost my no-claims discount because I went without a car for 2 years. Despite not claiming, Quinn saw it fit to double the cost of my car insurance. So f*** solidarity, I don't have a choice with car insurance but I'll take my chances with health insurance.

Mucco

GCU Flexible Demeanour wrote: »

Community Rating and linked system of Risk Equalisation are explicitly designed to pass the costs of older subscribers on to younger subscribers.

I'm not defending this - but, then, I don't think insurance is an effective way of approaching healthcare.

You have to have a form of risk equalisation, otherwise you get insurance companies cherry picking the young, fit, and healthy people. Older, less healthy priced out of the market. What's happening now is adverse selection. Healthy people opt out of insurance (like Tony, above), higher risk (expensive) people are left, so premia rise, and then more people opt out, and the cycle continues. Compulsory insurance is the solution to this - see Netherlands.

BTW, the price rises are because the government is attempting to pass on the full economic cost of the treatment of private patients in public hospitals to the insurers. A lot of PHI patients end up being treated by the same doctor, with the same equipment, in the same hospital as public patients. PHI is just for queue jumping - rich people buying access.
You could argue that private patients are already paying for the health service in tax, so the government should absorb some of the cost of treating them.

p1akuw47h5r3it

RichardAnd wrote: »

I've always believed that insurance is one of the greatest scams humanity has ever devised and I actually work for one of the largest insurance companies in the world . . .

Can I ask why you say this? I've always thought insurance was pretty logical, though I've never thought about it in any depth

323

rodento wrote: »

Guess its a question on whether or not you have dependents and can afford to wait to get treated, its another workers tax

Exactly. Like many others, as a self employed contractor with dependants, cannot afford to wait for treatment and miss out on work.

Not claimed in 12 years but a bit much that it has increased in cost by about 400% in that time.

50% increase on present prices just confirmes its time to join the club a leave Ireland (again).

GCU Flexible Demeanour

Mucco wrote: »

Compulsory insurance is the solution to this - see Netherlands.

I wouldn't describe compulsory insurance as a solution. It's more of a prison sentence. Let's all see the Netherlands

http://www.dutchnews.nl/news/archives/2012/10/health_insurance_to_soar_to_ne.php

People earning more than €70,000 a year will have to pay €482 per month in health insurance fees when the new cabinet’s system comes into force, according to calculations by Nos television.

The broadcaster says people on welfare benefits will have to pay around €20 a month, slightly less than they pay now when health insurance benefit of up to €70 is taken into account.

<...> People on an average salary of around €33,000 a year will have to pay €140 per month, Nos calculates.

OMD

GCU Flexible Demeanour wrote: »

I wouldn't describe compulsory insurance as a solution. It's more of a prison sentence. Let's all see the Netherlands

But what does the health insurance pay for. At present we spend about 12 billion on health in this country. That works out at about €7000 a head for every worker. Despite that over a million still pay for health insurance. Not to mention the extra for GP visits, prescriptions and prescription charges

dissed doc

GCU Flexible Demeanour wrote: »

I wouldn't describe compulsory insurance as a solution. It's more of a prison sentence. Let's all see the Netherlands

It's actually spot on with what it will cost in Ireland as well.

ON a salary of 70k/year, the net cost per month is ~14% of your income (70k = roughly 41k net. €482/month = 5784/year). This is not far off the 15% total paid in Germany. On 33k, net salary in NL is around €1730/month, so 8%.

In Ireland, the comparison at 70k is 44k net (private) and 39k (public) net income. AT the moment, the premiums are way less by salary. At €120/month in Ireland, it's around 3.5% of net income compared to Netherlands (tax is roughly the same for someone on 70k in Ireland and Netherlands).

For someone on 33k in Ireland, they pay only 19% overall tax (private sector) (compared to 37% overall tax on 33k in NL). So, relatively speaking, Irish people on 33k get off with paying way less tax and also pay virtually nothing relatively for healthcare.

At the moment medical specialist salaries have been cut by 60% since 2008. So, premiums in Ireland will skyrocket (assuming people want a healthcare service) and also become compulsory, because at the moment, a huge amount of people pay nothing for the health service, will refuse higher income taxes (even though they are low) so the only way to maintain basic services is make health insurance mandatory for people on salaries of 30-40k.

Mucco

GCU Flexible Demeanour wrote: »

I wouldn't describe compulsory insurance as a solution. It's more of a prison sentence.

TBH, in Ireland, we pay for the health service through taxation, which is more or less compulsory insurance. It's probably better, as it's progressive.

I'm always intrigued that so many people think they must have health insurance. If you think about it, most ill-health is concentrated at the end of life. Therefore, older PHI subscribers will cost a lot more than younger. Therefore, the younger subscribers are paying a lot more than their risk would suggest ie subsidising older subscribers. They seem to want PHI for catastrophic health issues. If I were an insurer, I would look at offering high deductible catastrophic health insurance targeted at younger people, and at a lower price.

Good presentation on Netherlands:
VAN DE VEN, W. P. M. M. (2011) Choice of providers and mutual healthcare purchasers: the Dutch reforms. Meeting the medium term challenge of the financing of health and aged care: Are there lessons from the Netherlands? The Royal Society, London, Gresham College.

AlekSmart

dissed doc wrote: »

It's actually spot on with what it will cost in Ireland as well.

ON a salary of 70k/year, the net cost per month is ~14% of your income (70k = roughly 41k net. €482/month = 5784/year). This is not far off the 15% total paid in Germany. On 33k, net salary in NL is around €1730/month, so 8%.

In Ireland, the comparison at 70k is 44k net (private) and 39k (public) net income. AT the moment, the premiums are way less by salary. At €120/month in Ireland, it's around 3.5% of net income compared to Netherlands (tax is roughly the same for someone on 70k in Ireland and Netherlands).

For someone on 33k in Ireland, they pay only 19% overall tax (private sector) (compared to 37% overall tax on 33k in NL). So, relatively speaking, Irish people on 33k get off with paying way less tax and also pay virtually nothing relatively for healthcare.

At the moment medical specialist salaries have been cut by 60% since 2008. So, premiums in Ireland will skyrocket (assuming people want a healthcare service) and also become compulsory, because at the moment, a huge amount of people pay nothing for the health service, will refuse higher income taxes (even though they are low) so the only way to maintain basic services is make health insurance mandatory for people on salaries of 30-40k.

OH Doctor you're in trouble.....For delivering an accurate summation of the Irish Malaise.....Our taxes are LOW!!!....I'll lend you a tin hat :eek:

GCU Flexible Demeanour

Mucco wrote: »

TBH, in Ireland, we pay for the health service through taxation, which is more or less compulsory insurance. It's probably better, as it's progressive.

Yup, I don't disagree on either count. Private health insurance accounts for a relatively small share of health expenditure here, and what it does contribute is overwhelmingly limited to the acute hospital sector.

Stheno

GCU Flexible Demeanour wrote: »

Private health insurance accounts for a relatively small share of health expenditure here, and what it does contribute is overwhelmingly limited to the acute hospital sector.

Do you mean it is overwhelmingly used for acute cases? And not chronic cases/people choosing to go private?

Or that the majority of income recouped by the HSE from the Insurers goes to prop up A&E/Outpatients etc?

Sorry if that sounds stupid, I've health insurance, and generally use it to access the private system for faster care.

tony81

GCU Flexible Demeanour wrote: »

Yup, I don't disagree on either count. Private health insurance accounts for a relatively small share of health expenditure here, and what it does contribute is overwhelmingly limited to the acute hospital sector.

I completely disagree (that healthcare through taxation is a good system). The health service is a black hole.

Leave people with more money to pay more of their own bills, and to take out their own health insurance policies in a free health insurance market. It's the only way to drive costs down.

As for the unemployed who don't have insurance, they could be given an allowance that represents a basic health insurance package and it would be up for them to decide how and where to spend it. I'm sure they'd do some shopping around too, and insurance companies would be competing for their business.

The government can legislate to ensure no-one is getting screwed by shoddy practices by insurance companies (e.g. trying to shake off customers who have been paying their whole lives), and also ensure that emergency services such as A&E and ambulance are covered for all. Also to pay an extra premium for disabled people incapable of providing for themselves.

Charities could take care of people who "fall through the cracks" in this system. Basically, unemployed alcoholics without healthcare would be an example. The HSE was not built to fix people like that.. therefore they are charity cases. So by taking their burden off the tax system, people could contribute more to charity.

GCU Flexible Demeanour

Stheno wrote: »

Do you mean it is overwhelmingly used for acute cases? And not chronic cases/people choosing to go private?

Or that the majority of income recouped by the HSE from the Insurers goes to prop up A&E/Outpatients etc?

Sorry if that sounds stupid, I've health insurance, and generally use it to access the private system for faster care.

No bother.

The State spends over €13 billion on healthcare. That includes expenditure on things like disability services and mental health services, that private health insurance doesn't really cover. (I know there's some cover for psychiatric services, but it isn't really significant.)

By comparison, private health insurers pay out about €1.7 Billion in claims in a year. That's supported by tax relief on premiums that's worth about €300 million, and by accommodation of private patients in public beds in public hospitals, worth about another €200 or €300 million (this can only be estimated.)

The bulk of that claim income is in respect of hospital services - that's mostly what health insurance is used for, although some policies do cover some amount of GP visits too. However, the bulk of hospital expenditure in Ireland would be undertaken by the State - bear in mind that everyone is entitled to avail of public hospital services, although if you don't have a medical card you will be subjected to charges up to a maximum limit of (I think) about €700 in any one year.

The key point I'm drawing out of all that is, while 46% of people have health insurance, that private insurance only accounts for maybe 10% of
our total national spend on healthcare.

GCU Flexible Demeanour

tony81 wrote: »

I completely disagree (that healthcare through taxation is a good system). The health service is a black hole.

I don't think your view is supported by the evidence. The USA has a private dominated system. They spend far more on healthcare than anyone else, but only have much the same average life expectancy as Irish people.

There's evidence that countries adopting a social health insurance model, where you require all or most to subscribe, end up paying significantly more for services without getting any identifiable benefit in terms of better health outcomes.

Healthcare isn't a normal product, subject to normal principles of supply and demand. If there was a BOGOF offer on heart transplants, would we all queue up to fill our boots?

Stheno

GCU Flexible Demeanour wrote: »

No bother.

The State spends over €13 billion on healthcare. That includes expenditure on things like disability services and mental health services, that private health insurance doesn't really cover. (I know there's some cover for psychiatric services, but it isn't really significant.)

By comparison, private health insurers pay out about €1.7 Billion in claims in a year. That's supported by tax relief on premiums that's worth about €300 million, and by accommodation of private patients in public beds in public hospitals, worth about another €200 or €300 million (this can only be estimated.)

The bulk of that claim income is in respect of hospital services - that's mostly what health insurance is used for, although some policies do cover some amount of GP visits too. However, the bulk of hospital expenditure in Ireland would be undertaken by the State - bear in mind that everyone is entitled to avail of public hospital services, although if you don't have a medical card you will be subjected to charges up to a maximum limit of (I think) about €700 in any one year.

The key point I'm drawing out of all that is, while 46% of people have health insurance, that private insurance only accounts for maybe 10% of
our total national spend on healthcare.

Thanks I'd be one of those who's had it for years, but until last year didn't claim most years as I'd not even hit the excess. Have had to use it in the past year, but went through GP (private) and a private hospital. That said, I've already claimed two years worth of premiums to access those services, not counting the money I've paid myself for services, that I can part claim back as I've one of those policies that cover day to day expenses.

So overall I'd not use the healthcare system much, though having had to use it to access treatment with a condition quickly I'd not be without it. I'd sooner not have sky, or go out less than not have healthcare.

tony81 wrote: »

I completely disagree (that healthcare through taxation is a good system). The health service is a black hole.

Leave people with more money to pay more of their own bills, and to take out their own health insurance policies in a free health insurance market. It's the only way to drive costs down.

As for the unemployed who don't have insurance, they could be given an allowance that represents a basic health insurance package and it would be up for them to decide how and where to spend it. I'm sure they'd do some shopping around too, and insurance companies would be competing for their business.

The government can legislate to ensure no-one is getting screwed by shoddy practices by insurance companies (e.g. trying to shake off customers who have been paying their whole lives), and also ensure that emergency services such as A&E and ambulance are covered for all. Also to pay an extra premium for disabled people incapable of providing for themselves.

Charities could take care of people who "fall through the cracks" in this system. Basically, unemployed alcoholics without healthcare would be an example. The HSE was not built to fix people like that.. therefore they are charity cases. So by taking their burden off the tax system, people could contribute more to charity.

That sounds like real American healthcare to me.

spank_inferno

Stheno wrote: »

That sounds like real American healthcare to me.

Tony's preference, as he outlined, is pretty close to what Obamacare is (or aims to be).

The Irish system is a hybrid, similar to what America has/had.
It works better because it is much cheaper to access and remain in.
It works less well because there is insufficient capacity.

Personally I prefer how we do things here in Ireland (blasphemy I know!)
I cannot afford the taxes levied on Germans / Dutch.
When I am old I will probably avail of the generously priced PHI.

creedp

spank_inferno wrote: »

When I am old I will probably avail of the generously priced PHI.

Unless you are already fairly mature I think its a pretty safe bet that PHI won't be that genoursly priced when you are 'old'!

Problem with Ireland is not that we have a tax -v- social insurance -v- PHI funded system is that we have a hybrid system and continue to try and maintain both even though this is simply not possible without accepting massive inequity and perverseness. However, we have been prepared to accept/support that position over a long number of years now so why change?

IMO there is no justifiction for the Govt to be supporting PHI with community rating, etc when we already have a tax funded healthcare system which all are eligible for. If we consider PHI the way forward then so be it .. ditch the tax funding approach and concentrate on PHI. Otherwise forget about supporting PHI and let the market prevail for those who wish to access it. The idea that someone can opt not to not take out PHI until they are old and then expect everyone else to subsidise their premium is ridiculous in extreme .. however welcome to Ireland.

OMD

spank_inferno wrote: »

When I am old I will probably avail of the generously priced PHI.

Remember though you cannot claim for pre-existing conditions for a 10 year period after the age of 65. That means for just about any illness between the age if 65 and 75 you probably will not be covered but will have to pay.

With Health Insurance as with all insurance the average person can expect to pay in more than they get out. That is the nature of insurance

rodento

What most ops are missing out on is how many people who work can afford not to be on health insurance, god forbid if something goes wrong but can you afford weeks out of work, to be at the very least just diagnosed, let alone actually treated.

Lorna Dooley

Am going home to the west of Ireland! German health insurance is really good but very expensive and can't keep it up living in Ireland. Any advice on health insurance in Ireland? My sister is with laya

ted1

This doesn't make sense. As a PRSI payee I am entitled to healthcare, if I decide to top it up with private healthcare then I should be entitled to use the contribution I pay to PRSI.

If the proposal is to remove entitlement to the Public hospital well then I would expect to opt out of PRSI.

Or else I'll cancel my insurance and become another burden on the public system

GCU Flexible Demeanour

ted1 wrote: »

This doesn't make sense. As a PRSI payee I am entitled to healthcare, if I decide to top it up with private healthcare then I should be entitled to use the contribution I pay to PRSI.

If the proposal is to remove entitlement to the Public hospital well then I would expect to opt out of PRSI.

Or else I'll cancel my insurance and become another burden on the public system

Healthcare is funded out of tax, rather than PRSI. And public hospitals are only one part of the healthcare system.

People who cancel private health insurance tend to be people who are reasonably confident that they don't have a high probability of needing healthcare.

I'm not saying you should or shouldn't cancel. I'm just correcting the errors of detail in how you've put it.

dissed doc

ted1 wrote: »

This doesn't make sense. As a PRSI payee I am entitled to healthcare, if I decide to top it up with private healthcare then I should be entitled to use the contribution I pay to PRSI.

If the proposal is to remove entitlement to the Public hospital well then I would expect to opt out of PRSI.

Or else I'll cancel my insurance and become another burden on the public system

Doesn't work like that in the socialist utopia of Ireland. You are meant to pay PRSI, get no access to healthcare, and have to cough up lots of cash when you need it. Your taxes safely pay for healthcare for the unfortunates who get free housing, healthcare, education and don't have the luxury of working.

Tea drinker

GCU Flexible Demeanour wrote: »

That's possible, but coverage has a long way to fall before (at the strategic level) you'd be worried about any significant impact on the public system.

Look at the composition of who takes out health insurance, and who gives it up. The people you want to keep in the system are typically older groups, who are less exposed to pressures on income. Putting it quickly, if you are a relatively well-off pensioner you don't have a mortgage or family expenses and you can't be made redundant. You're well able to take a sharp increase in the cost of cover, and you've every incentive to prioritise this above other expenditure.

We've far, far more to gain by eliminating the hidden public subsidies for private healthcare than we risk losing by a contraction in the numbers taking out health insurance.

Well, lets see how far they drop the government public subvention , and how much they increase the take from insurance companies. Will service decline further? Will it cost more overall? I'm guessing yes on both.
Basically a stealth tax to pay for crap health service. Meanwhile troika bleats about overpaid consultants, 6 years into the crisis. If only there was something that could be done :pac: