Private Vs Public Healthcare in Ireland

Another big criticism I have of the private system is that it is extremely hard to know exactly what you are covered for in the event of needing treatment, moreso if entering by the limited emergency departments. I’ve encountered this many times. I will give one simple example:

I underwent a major elective surgery in 2016 in a Private Hospital, a panproctocolectomy with end ileostomy, in order to end the numerous unpredictable admissions I had endured from unstable ulcerative colitis and its complications. That is a total removal of colon, including anus which is closed over, and a stoma is fashioned from small bowel. It’s worked out pretty well, although the one occasion I had the emergency admission last year in a public hospital was for strangulated parastomal hernia. I checked up with VHI well in advance that I would be covered for this surgery and they said yes. Of course the outpatient visits to the surgeon in preparation and follow-up were only fractionally covered on my plan. I underwent a 7 hour surgery and suffered major bleeding complications which involved the hospital calling in emergency supplies (as the anaesthetist delighted in telling me when I woke up ), so I was sent into the small ICU where I received more transfusions and excellent care. When I returned to my normal private room, because my blood count was still very low, I suffered a cardiac complication and was put in the Cardiac Care Unit. Eventually back in normal room and discharged after 19 days.

Then came the bill. VHI wasn’t paying the ICU consultant’s bill. They would only pay part of the microbiologist’s bill, the man who treated me for the infection I developed-this infection developing in about half of people who undergo this surgery. VHI said I should have consulted them before agreeing to these extra treatments! I paid the microbiologist’s bill which was under €500, but the ICU bill amounted to a 4 figure sum so I wrote identical letters to consultant, hospital and VHI and said I would not be paying and if they pressed me I would consult my solicitor as I had not been forewarned of lack of coverage even though I made all effort to be informed. Lesson is, any surgery can have major complications, but the more serious the surgery is the more likely these are, and a private health insurance will never inform you of coverage in case of various scenarios. Private insurance is not really much good unless you have at least €10K spare in the bank to back up unexpected expenses, and most ordinary people don’t have that.

shesty

Jesus Catmania, I hope you have better health and less hospital visits now.

shesty

shesty wrote: »

Jesus Catmania, I hope you have better health and less hospital visits now.

I won’t tell ye about the knee replacement last January although the Liveline biardsies know all about it...bit of a running joke

However Re Public v Private I will give you the example of a relative who developed a very rare type of cancer that was not curable until very recent years. It used to be a sure death sentence where you literally starved to death in great discomfort as your abdominal organs became strangled, however it did not metastasize to lungs, brain or within any organs. My relative was always fairly well off and could afford top level health insurance, which they had.

It first looked like a form of irritable bowel or appendicitis, and scans revealed it to be the rare type of malignant disease (which usually starts in appendix) for which the Mater Hospital is a centre of excellence. It requires very specialised and initially severe treatment, but with the promise of being able to live a normal lifespan cancer free. There’s extensive surgery to debulk the disease, then a repeat washing through of the abdomen with a specialised type of chemotherapy, all taking several weeks. ICU is required, nutritional support, physiotherapy, followed by an annual day case laparoscopic check where any recurrence is easily put in check.

The consultant, though working in the Private hospital too, wanted them treated in the Public hospital where all the supports for this treatment are. All worked out well and they said they would never go for private care again unless it was something pretty ordinary, like a hip replacement, that could be slotted into a convenient time and not because of any superiority of care.

Lillyfae

Deleted User wrote: »

The consultant, though working in the Private hospital too, wanted them treated in the Public hospital where all the supports for this treatment are. All worked out well and they said they would never go for private care again unless it was something pretty ordinary, like a hip replacement, that could be slotted into a convenient time and not because of any superiority of care.

Your relative received private care in a public hospital. It was still private care.

Lillyfae

Lillyfae wrote: »

Your relative received private care in a public hospital. It was still private care.

No it was NOT private care, was referred by local rural public hospital to Mater Public. Had private insurance that would have covered the private hospital had that been the place of care and treatment. They simply made an initial enquiry about using his paid for cover in the private, but was told by the consultant that he could not handle the very complicated case in the more limited private hospital. It was all quite urgent, so not too much time to think, arrived very unwell in an ambulance.

Lillyfae

Lillyfae wrote: »

Your relative received private care in a public hospital. It was still private care.

Lliyfae I would love to know your own definition of private care. I’ll make it very clear, my relative did NOT receive private treatment at the Mater Public Hospital. I may have confused your understanding by saying that the consultant who treated them for the rare abdominal cancer as an emergency public patient also has a separate private practice in the Mater Private where he treats the much more common elective conditions. The bottom line is that when you get very rare and serious illness it ALWAYS needs to be handled in a major teaching hospital, and in Ireland that is a public hospital like Mater or St James.

Lillyfae

Deleted User wrote: »

Lliyfae I would love to know your own definition of private care. I’ll make it very clear, my relative did NOT receive private treatment at the Mater Public Hospital.

My apologies if I misconstrued your post. It's not my definition, but private care in Ireland for the most part consists of the use of public facilities, be that staff or infrastructure, paid for by patients with private health insurance, in fact that use is prioritised for them.

I'm not aware if public facilities are being covered by the taxpayer for those who have private health insurance. If that's the case it's just another aspect of the Irish healthcare system that doesn't make sense.

Lillyfae

Lillyfae wrote: »

My apologies if I misconstrued your post. It's not my definition, but private care in Ireland for the most part consists of the use of public facilities, be that staff or infrastructure, paid for by patients with private health insurance, in fact that use is prioritised for them.

I'm not aware if public facilities are being covered by the taxpayer for those who have private health insurance. If that's the case it's just another aspect of the Irish healthcare system that doesn't make sense.

The health dyssystem is a mess. If you have private health insurance and your are admitted to a public hospital they ensure that your insurance covers the cost, so the privately insured fund the public system more than the other way around. I have never, as a private patient, used public facilities... oh except once in the Coombe for a minor procedure and that was very many years ago. When using my insurance now it’s always the Beacon or Hermitage, that’s it. The matter of consultants spreading themselves across the system and using public facilities is another thing, and very messy indeed.

Lillyfae

Deleted User wrote: »

If you have private health insurance and your are admitted to a public hospital they ensure that your insurance covers the cost......The matter of consultants spreading themselves across the system and using public facilities is another thing, and very messy indeed.

Well that's what I said. Your relative received private care, in a public hospital.

Deleted User wrote: »

the privately insured fund the public system more than the other way around.

This is not exactly the case. Private insurance would never fund the public system. The public system costs many multiples of whatever private insurance costs at the moment. What does happen is that:

• public consultants who also practice privately use public facilities for both their public and private practice
• patients with private insurance receive prioritised care (where possible, on the basis of need as it arises) in public hospitals which is then paid for by their insurance

Private hospitals, obviously few and far between, are not suitable or equipped to deal with most highly specialised or acute cases for people with health insurance and would have to refer in alot of cases. How many private A&Es are there in the country, for example? Or private research/ university facilities?

Mrs OBumble

[Deleted User] wrote: »

If you have private health insurance and your are admitted to a public hospital they ensure that your insurance covers the cost

Not quite: they give you the option of having your insurance cover the cost. But if you decline to sign the form waiving your right to public treatment, they cannot charge your insurance company.

Lillyfae

Mrs OBumble wrote: »

Not quite: they give you the option of having your insurance cover the cost. But if you decline to sign the form waiving your right to public treatment, they cannot charge your insurance company.

Ya I forgot about this. Then they would be a public patient. Why anyone would do that is beyond me though.

tjhook

Lillyfae wrote: »

Ya I forgot about this. Then they would be a public patient. Why anyone would do that is beyond me though.

If signing the form makes no difference to the care you get, I can see why people would rather not increase the costs to their insurance company. These costs will inevitably be added to the premiums.


Plus, if I'm already paying taxes to fund the public system, I will feel justified in using it when I need it.

Mrs OBumble

Mrs OBumble wrote: »

Not quite: they give you the option of having your insurance cover the cost. But if you decline to sign the form waiving your right to public treatment, they cannot charge your insurance company.

I don’t pretend to know in detail what exactly funds what, except that is is a total and utter mess. It’s really easy to say from an armchair with an iPad in hand that you just refuse to sign the insurance form but I will tell you exactly what happened in my case when I was admitted to Vincent’s public last year with a strangulated parastomal hernia & ruptured bowel. If any of ye have had this you will know what I’m talking about.

If you are weak of stomach read no further please.

I was admitted with recurrent frequent vomiting of pure faeces in all its stinking glory, and just after the surgeon saw me, the insurance manager was in putting on the pressure to get me to sign. I was in such an awful mess they had me in a separate room away from the rest of the A&E. It took a strong stomach for that admin person to approach me bathed in unpleasant fluids. I refused to sign and sent them away. Was taken to surgery and put into a high dependency ward to recover. After four days a woman came to tell me I was going into Vincent’s Private to complete my recovery, but I needed to sign her form. I signed the thing and 10 minutes later the consultant surgeon told me I was to pack my stuff and go home. So that’s how I got signing.