Government and Health Insurance Companies

oscarBravo

Mucco wrote: »

The public system treats the vast majority of patients in Ireland very well, those of you saying you have been glad to have private healthcare do not know what treatment you would get under the public system, so you cannot say that private insurance is worth the money.

I saw a consultant with some vague symptoms; no severe pain. On a hunch, he referred me downstairs for a CT scan, for which I was called just as I finished the paperwork. After a brief pause for a cuppa, I went back upstairs to the consultant where he showed me the results of the scan and booked me in for surgery a couple of weeks later (could have been sooner, but I had travel plans).

My experience with the public health system is largely anecdotal, but most of the anecdotes I've heard don't involve getting a CT scan the same day you're told you need one, never mind getting the results 20 minutes later. In fact, when referring me to the consultant, my GP asked if I wanted to go private and get a consultation the next week, or go public and maybe get a consultation seven months later.

micosoft

Sure - we all have anecdotes. I was being treated very well by one consultant whose Registrar noticed something wrong with my bloods, called me, and had me seen by two seperate specialist consultants within the space of two days and began systemic treament immediately. All on the public healthcare system. On the other hand I've heard horror stories with some private consultants who are not fit to practice. Anecdotes are not evidence.

• If it's an emergency you will get treated well on the public system.
• If you attend a good university hospital (and in the sytem) you will get treated well on the public system.

BUT
Where public health falls down are the diagnostic and elective pieces where overwhelming demand and the increased defensive medicine practiced due to the level of lawsuits means that you will wait.

Private health insurance buys you a ticket to the head of the queue.
Personally I find that immoral as a system (though understand individual choice especially when it comes to family).

oscarBravo

micosoft wrote: »

If it's an emergency you will get treated well on the public system.

Yes. Those were my choices: wait seven months for a consultation, go see a consultant immediately, or be admitted to an emergency department in some of the worst pain imaginable.

When I can see a consultant at short notice without (a) paying for health insurance or (b) being in crippling pain, I'll stop paying for health insurance.

edit: I'll follow up by saying that, in the case of my eye operation, the consultant told me that if I had seen him through the public system he would have slotted me in for priority surgery anyway, because it was necessary to save my eyesight. The problem is that I probably wouldn't have seen him for the first time for more than a year after the initial referral, and that's a year during which my sight would have deteriorated irreversibly.

I don't like that I can get better access to medical treatment just because I can afford the insurance premiums, but I like the idea of going blind a hell of a lot less.

creedp

oscarBravo wrote: »

When I can see a consultant at short notice without (a) paying for health insurance or (b) being in crippling pain, I'll stop paying for health insurance.

You can see a private consultant any time you wish by handing over the mullah. You'll find private consultants have no ideological issues about prioritising a non-insured patient so long as he has approx €200- €250 in his pocket, preferably in cash. Mostly you'll find if you pay for the consultant and are diagnosed with a problem you will be fasttracked relatively quickly into the public hospital system. The real blockage in the current system is the consultant who currently controls access to the pubic hospital system almost like the toll operator controls access to a tolled motorway. This is why the current system is morally wrong and unethical IMO. Well paid consultants control access for public patients while at the same time can prioritise and fast track their own private fee paying patients into the same public hospitals - you couldn't find a better example of a conflict of interest.

oscarBravo

creedp wrote: »

You can see a private consultant any time you wish by handing over the mullah. You'll find private consultants have no ideological issues about prioritising a non-insured patient so long as he has approx €200- €250 in his pocket, preferably in cash. Mostly you'll find if you pay for the consultant and are diagnosed with a problem you will be fasttracked relatively quickly into the public hospital system. The real blockage in the current system is the consultant who currently controls access to the pubic hospital system almost like the toll operator controls access to a tolled motorway. This is why the current system is morally wrong and unethical IMO. Well paid consultants control access for public patients while at the same time can prioritise and fast track their own private fee paying patients into the same public hospitals - you couldn't find a better example of a conflict of interest.

Maybe. Both my kidney and eye surgeries were in a private hospital. What you've described above sounds particularly repugnant.

creedp

oscarBravo wrote: »

Maybe. Both my kidney and eye surgeries were in a private hospital. What you've described above sounds particularly repugnant.

Of course if we really wanted an alternative private health insurance market in Ireland we would ensure private health insurers are incentivised to treat all their members in private facilities rather than the current system which allows insurers to encourage members to use public facilites as much as possible by designing insurance packages with excesses/co-payments in place for the use of private hospitals. The State encouraged this practice in the past by massively subsidising the cost of treating private patients in public hospitals. At least this is being addressed in more recent times.

While insured people argue that their treatment should be subsidised in public facilities becasue their taxes fund these facilities, this argument would be more palatable if the subsidy provided them with upgraded accommodation and greater access to the consultant once admitted to the hospital. However, because consultants control who and when patients are admitted to hospitals, in effect this public subsidy is enabling insured people to crawl over the backs of sick public patients and gain preferential access to public facilities which are supposed to be equally available to all citizens.

The issue that needs to be addressed is whether Ireland's small population can support a private health system operating independently to the public system in the absence of significant public subsidisation or whether it would be better to scrap the public/private system of access and decide that all health care will be funded through a compulsory health insurance system with everyone having the same access to a standard package of services provided by both public and private providers. This would provide an element of competition among suppliers helping to drive down cost and improve service quality (if properly regulated of course!) while at the same time making the Irish health system more equitable. I presume (although its hard to tell at this stage) this is the approach FG are advocating but I wouldn't hold my breath as to what if anything they will actually deliver. Given past experience there is a real danger that the whole proposal will be fudged to try and cater for all the vested interests and we will end up with an even more (if thats possible) incoherent system than we already have.

micosoft

creedp wrote: »

While insured people argue that their treatment should be subsidised in public facilities becasue their taxes fund these facilities, this argument would be more palatable if the subsidy provided them with upgraded accommodation and greater access to the consultant once admitted to the hospital. However, because consultants control who and when patients are admitted to hospitals, in effect this public subsidy is enabling insured people to crawl over the backs of sick public patients and gain preferential access to public facilities which are supposed to be equally available to all citizens.

And despite saying I don't think Private patients are subsidised as they pay tax I completely agree on this point. Private health care should just be for the frills - private room, Sky+, Venison for Dinner, convenient consultant appointment times. It should absolutely not be about speed of access to the system or treatment when it is co-funded by the public purse. That is wrong and immoral.
If course we do have an extremely well paid lobby group in the form of the consultants who want to retain this system so they can get "tipped" like a doorman to jump the queue.