Ireland's Hospitals owned by the Rich

IAMAMORON

ILoveYourVibes wrote: »

He owns the place that was supposed to do the treatment for my dad's prostate cancer....just the night before he was due to begin treatment they rang to say they had stopped offering the treatment.

We ended up having to go down to waterford. Very difficult to travel at that time for my dad between treatments etc.

Maybe it was for the best though. He's fine now.

Which place was that ?

Where did your Dad get treated in Waterford?

1641

LuasSimon wrote: »

How much a day will Larry Goodman and Denis O brien make out of the whole Covid Hospital scheme ? .

Is your concern about Goodman and O'Brien or is it about private hospitals? You seem fixated on those two individuals.

There are many private hospitals in ireland Mater, St Vincent's, Hermitage, blackrock, Aut Even, Bon Secours,Galway Clinic, Whitfield, St Francis, etc, etc, etc. Goodman and/or O'Brien are involved in only a minority of them (as as far as I know not outright ownership, but could be wrong). So is your concern with all of these places or just two individuals?

Should the state expropriate them all? What do you think the impact would be on any company or entrepreneaur considering setting up a business of any sort in Ireland (or already owning one)?

TheCitizen

1641 wrote: »

I think you are misinterpreting Slaintecare and what is meant by a one-tier system. The aim of Slaintecare care is to deliver across the board, equal access to public health. I don't think there are many who would object to this - other, perhaps, than those medical consultants who have contracts that enable them to treat both public and private patients. Also, the HSE will be concerned about losing the income form privately insured patients who they currently charge for using the public system.

Certainly I think that most of those who have private insurance would welcome a single tier public system.


This, however, has nothing to do with private hospitals and clinics. These exist right across Europe (including UK) even though they have single tier public health systems. The point is that they must be totally seperate from the public system. A Consultant working in a public hospital would have no right to double job in a private hospital (and vice versa). The private hospital would be fully funded by the people who use it privately - whether directly by fees and charges or, indirectly, by insurance. If, as now, the vast majority of such users are Irish citizens/residents they would have already paid their share towards the public system through the taxation system. How they spend their discretionary money is up to themselves.


If the public system as developed (eg, Slaintecare) is as accessible as claimed, then there would be a big drop in the number paying for health insurance and using private hospitals.

Just as a by the way. A private hospital is different from a with-profit hospital operating in the public system. The latter operates by contract to the state to provide public health services on behalf of the state. These operate also in some single-tier systems. Access to these is nothing to do with private health insurance - they operate as fully accessible public hospitals with payments for their services coming from the state. I have no idea whether these will be considered by Slaintecare as one aspect of service - but either way, private hospitals are a different matter.

yes that's why I think a levy ( a form of universal insurance) would be required to fund the implementation of Slaintecare. A tiered levy depending on income.

A private hospital will still be there with hotel like rooms and mod cons etc.. The quality of medical care though and accessibility should be the same across the board in my opinion and that is what I hope Slaintecare means when it says it is committed to delivering a one tier health system.

The insurance company I imagine won't like Slaintecare but its up to the politicians to back up their stated intentions and implement Slaintecare and ensure all vested interests get on board.

TheCitizen

IAMAMORON wrote: »

I was called arrogant.

I said it before, but I am reiterating this again now.

Sláinte Care is nothing more than a rebranding of the HSE. You might refuse to admit that, but by ignoring this fact you are going to end up with an identical system in 5 years.

You forgot to add in your opinion, but your arrogance shines through on that as you think your opinion is fact.

IAMAMORON wrote: »

"sidelining" people who don't agree with you is evidence of a Nazi totalitarian attitude. You also now can not deny that. To turn your back on you own concept to encompass you own goals leaves other citizens behind, this defeats your own ideals in the first place. Pointless.

I mean sidelining those who are against progress like you. When progress is achieved you'll have to get on with it like it or not.

IAMAMORON wrote: »

I get the distinct impression this thread is turning into a rich vs poor debate. How boring.

You'd know about that.

IAMAMORON wrote: »

Thankfully Sláinte care will not get realised- and I can tell you why. As soon as private healthcare payers realise that the government has decided to charge them more taxes and remove their health benefits they will stop voting for them, that is how democracy works.

There's a poster above that says Slaintecare has already begun to be implemented.

Again you forgot to add in your opinion. Every political party in the country is endorsing Slaintecare so I don't know they're who going to vote for if some people you're referring to don't like it. They can still pay for private hospitals and nicer rooms if they want to, but the quality of medical care will be the same across the board is the crucial aspiration.

Change can be difficult for people but change in the Irish health system is necessary, I suggest that you should try to get over your difficulty.

1641

TheCitizen wrote: »

yes that's why I think a levy ( a form of universal insurance) would be required to fund the implementation of Slaintecare. A tiered levy depending on income.

A private hospital will still be there with hotel like rooms and mod cons etc.. The quality of medical care though and accessibility should be the same across the board in my opinion and that is what I hope Slaintecare means when it says it is committed to delivering a one tier health system.

The insurance company I imagine won't like Slaintecare but its up to the politicians to back up their stated intentions and implement Slaintecare and ensure all vested interests get on board.

Maybe accessibility should be the same but will it be? There will be huge demand pressures on a public system and limitations on its capacity to meet such demands. These limitations are universal, no matter what system. (To help alleviate excessive demand there should always be some fraction of cost to the user, no matter how small. Tier this if you want to). Also, as regards quality. There can be no guarantee that it will be equal. If people wish to pay private health insurance to access private hospitals and private consultants then that it is at their own discretion.


As regards paying for the system, I hope we are not back to "let the rich pay" bunkum. We have a heavily redisributitive tax system already (I have no objection to this in principle). But all payment for universal services (including childcare) should be by way of universal payment. Proportionate of course.

In Sweden, for example, the top 20% of income earners pay on average 36% of all income to the state, in Ireland it is on average 33%. However, in Sweden the bottom 20% of income earners pay 37% of all income to the state, whereas here it averages just 12%. Freely accessible and universal state services come at a cost - across the board.


I don't think there will be any significant objections from insurance companies to Slaintecare - it is just a matter of altering premiums. There will still be a market for private health. There will be plenty of objections and obstacles elsewhere though.

Yellow_Fern

TheCitizen wrote: »

yes that's why I think a levy ( a form of universal insurance) would be required to fund the implementation of Slaintecare. A tiered levy depending on income.

A private hospital will still be there with hotel like rooms and mod cons etc.. The quality of medical care though and accessibility should be the same across the board in my opinion and that is what I hope Slaintecare means when it says it is committed to delivering a one tier health system.

The insurance company I imagine won't like Slaintecare but its up to the politicians to back up their stated intentions and implement Slaintecare and ensure all vested interests get on board.

A lot of fluff and no answers to my point. Can you define what is a one tier system if private hospitals won't disappear?

TheCitizen

Yellow_Fern wrote: »

I have spent years of my life in Europe, there is no one system used in 'progressive' countries. There are many and they are not the panacea they are made out to be. When does a two tier system become a one tier, because all countries have a second tier? Is it when only 20% use private or 10%?

There are four qualities people desire in healthcare;
quality,
accessibility,
speed of availability
and cost to state or people.

There is a myth that elsewhere in Europe they achieve all four. That is easily falsifiable. The NHS has quality and good cost but slow delivery. The US has brilliant quality and great speed but high costs. Slaintecare is already being implemented and it is clear that speed of availability is deteriorating as GPs have growing waiting lists. Irish politics is extremely conformist and heavily driven by a small uncritical media so its not surprising that they are rushing towards Slaintecare.

Irish politics is conformist? Amazing the tripe people come out with just to suit whatever argument they've built up in their head.

How often do we have a set of proposals where all parties across the political spectrum in Ireland endorse it? Property tax, bin charges, water charges all of these had some opposition parties against what was proposed. Slaintecare has near universal political endorsement, but you're going to make that out to be a bad thing. Are you the type that will still find fault with something because there must be something wrong with it if "they're all for it"?

TheCitizen

Yellow_Fern wrote: »

A lot of fluff and no answers to my point. Can you define what is a one tier system if private hospitals won't disappear?

It means the quality and delivery of medical care will be the same across the board, but if you want to pay extra you can do so and be given a nicer room to stay in.

Yellow_Fern

TheCitizen wrote: »

Irish politics is conformist? Amazing the tripe people come out with just to suit whatever argument they've built up in their head.

How often do we have a set of proposals where all parties across the political spectrum in Ireland endorse it? Property tax, bin charges, water charges all of these had some opposition parties against what was proposed. Slaintecare has near universal political endorsement, but you're going to make that out to be a bad thing. Are you the type that will still find fault with something because there must be something wrong with it if "they're all for it"?

Water charges was forced upon Ireland by international obligations as was the property tax. There are plenty examples of Irish politicians lacking any diversity of thought. But I agree in some cases they don't agree and there is debate. I find fault in policy where is there is international evidence against it. Now my question is, what is a one tier system if private healthcare remains? It kinda sounds like fluff.

TheCitizen

1641 wrote: »

Maybe accessibility should be the same but will it be? There will be huge demand pressures on a public system and limitations on its capacity to meet such demands. These limitations are universal, no matter what system. (To help alleviate excessive demand there should always be some fraction of cost to the user, no matter how small. Tier this if you want to). Also, as regards quality. There can be no guarantee that it will be equal. If people wish to pay private health insurance to access private hospitals and private consultants then that it is at their own discretion.


As regards paying for the system, I hope we are not back to "let the rich pay" bunkum. We have a heavily redisributitive tax system already (I have no objection to this in principle). But all payment for universal services (including childcare) should be by way of universal payment. Proportionate of course.

In Sweden, for example, the top 20% of income earners pay on average 36% of all income to the state, in Ireland it is on average 33%. However, in Sweden the bottom 20% of income earners pay 37% of all income to the state, whereas here it averages just 12%. Freely accessible and universal state services come at a cost - across the board.


I don't think there will be any significant objections from insurance companies to Slaintecare - it is just a matter of altering premiums. There will still be a market for private health. There will be plenty of objections and obstacles elsewhere though.

That's what I said

TheCitizen

Yellow_Fern wrote: »

Water charges was forced upon Ireland by international obligations as was the property tax. There are plenty examples of Irish politicians lacking any diversity of thought. But I agree in some cases they don't agree and there is debate. I find fault in policy where is there is international evidence against it. Now my question is, what is a one tier system if private healthcare remains? It kinda sounds like fluff.

Was it? I have no recollection of that and besides Water Charges have not been implemented?

Other query answered above.

1641

1641 wrote: »

As regards paying for the system, I hope we are not back to "let the rich pay" bunkum. We have a heavily redisributitive tax system already (I have no objection to this in principle). But all payment for universal services (including childcare) should be by way of universal payment. Proportionate of course.

In Sweden, for example, the top 20% of income earners pay on average 36% of all income to the state, in Ireland it is on average 33%. However, in Sweden the bottom 20% of income earners pay 37% of all income to the state, whereas here it averages just 12%. Freely accessible and universal state services come at a cost - across the board.


.

TheCitizen wrote: »

That's what I said

So you accept that those on all incomes will have to pay more for universal and freely accessible state services, but proportionately this will apply most to lower earners?

IAMAMORON

TheCitizen wrote: »

It means the quality and delivery of medical care will be the same across the board, but if you want to pay extra you can do so and be given a nicer room to stay in.

Sure you can do that now?

TheCitizen

1641 wrote: »

So you accept that those on all incomes will have to pay more for universal and freely accessible state services, but proportionately this will apply most to lower earners?

No the opposite. Proportionately will apply most to higher earners, unlike (if it's accurate) the Swedish example you outlined above.
I think those figures re Sweden above btw factor in that those on lower earnings spend most of their income on goods and services that have taxes built into it?

Those who can afford it best would be asked to pay a little bit more would be my suggestion, but all would be asked to pay a levy which means all are stakeholders and all buy into the reforms.

I suppose that's a mad idea for some around here :pac:, for me it's the most practicable way of funding such reforms.

TheCitizen

IAMAMORON wrote: »

Sure you can do that now?

That's the objective. If the political will is there and people including health workers buy into it, yes.

Carrying on like before isn't an option unless you're happy to continue to fail.

1641

TheCitizen wrote: »

No the opposite. Proportionately will apply most to higher earners, unlike (if it's accurate) the Swedish example you outlined above.

Those who can afford it best would be asked to pay a little bit more would be my suggestion, but all would be asked to pay a levy which means all are stakeholders and all buy into the reforms.

I suppose that's a mad idea for some around here :pac:, for me it's the most practicable way of funding such reforms.

So it is the usual bunkum. You pretend to aspire to European social democratic models of state service but reject the taxation implications that go with that. We already have a highly redistributive tax system. The "rich", or higher earners pay disproportionately more.

https://www.esri.ie/news/irish-tax-system-does-most-in-europe-to-reduce-inequality


If you are for real (and not just promoting populist nonesense) you will look also at European taxes and charges. Yes Sweden is one of the countries frequently referenced as to services we should have - so why not the taxes and charges that go with that? Or, maybe you prefer Germany? In 2019 an Irish (single) worker on €25,000 would have had approx €3,150 in state deductions. In Germany it was approx €7,500. But they do have an excellent health system apparently! And they also have water charges - that is extra!
https://www.irishtimes.com/business/personal-finance/what-is-the-truth-about-paying-tax-in-ireland-1.4101097

TheCitizen

1641 wrote: »

So it is the usual bunkum. You pretend to aspire to European social democratic models of state service but reject the taxation implications that go with that. We already have a highly redistributive tax system. The "rich", or higher earners pay disproportionately more.

https://www.esri.ie/news/irish-tax-system-does-most-in-europe-to-reduce-inequality


If you are for real (and not just promoting populist nonesense) you will look also at European taxes and charges. Yes sweden is one of the countries frequently referenced as to services we should have - so why not the taxes and charges that go with that? Or, maybe you prefer Germany? In 2019 an Irish (single) worker on €25,000 would have had approx €3,150 in state deductions. In Germany it was approx €7,500. But they do have an excellent health system apparently! And they also have water charges - that is extra!
https://www.irishtimes.com/business/personal-finance/what-is-the-truth-about-paying-tax-in-ireland-1.4101097

It's not bunkum just cos you disagree with it. You're suggesting that the cost of funding the change to Slaintecare should be disproportionately levelled on the lower earners. I think all should make a contribution but it should be levied on higher earners who can afford to pay it best proportionately.

In Germany is refuse collection paid for by general taxation? What about childcare costs, is that better subsidised? I know in Sweden paternity and maternity costs are much generous. It's easy to pluck a few figures here and there to back up whatever argument you're making up, oftentimes though it can be comparing apples and oranges.

1641

TheCitizen wrote: »

It's not bunkum just cos you disagree with it. You're suggesting that the cost of funding the change to Slaintecare should be disproportionately levelled on the lower earners. I think all should make a contribution but it should be levied on higher earners who can afford to pay it best proportionately.

In Germany is refuse collection paid for by general taxation? What about childcare costs, is that better subsidised? I know in Sweden paternity and maternity costs are much generous. It's easy to pluck a few figures here and there to back up whatever argument you're making up, oftentimes though it can be comparing apples and oranges.

It is bunkum because your are talking about European level state services but refuse to accept European level state taxes and charges. High earners in Ireland already pay disproportionately more (https://fdw.ie/personal-tax-uhy-study-2019/). Sure they will have to pay some more to come up to European level standards but not much. It is the lowest earners who would need to come up most. It is populist nonesense to suggest that there is a free lunch here.
I don't have up to date statistics to hand on the extent of the disproportionate amount paid by higher earners but I reckon these haven't changed much. Also ,even middle earners pay considerable tax, although proportionately less. But lower earners pay disproportionately little.


"The increases in the proportion of taxes paid by high income earners has become notable in recent years. For example, in 2015, the top 1% of income earners paid 19% of all personal taxes while just twelve months later this is estimated to be 22%.

In 2017, it is estimated that the bottom 50% of income earners will pay 3.6% of the income tax take."

https://taxinstitute.ie/wp-content/uploads/2018/03/The-Budget-Book-2017.pdf

IAMAMORON

TheCitizen wrote: »

That's the objective. If the political will is there and people including health workers buy into it, yes.

Carrying on like before isn't an option unless you're happy to continue to fail.

Do you not accept that the Irish State already provides universal healthcare?

Yellow_Fern

TheCitizen wrote: »

In Germany is refuse collection paid for by general taxation?.

No.

TheCitizen wrote: »

What about childcare costs, is that better subsidised?

yes it is subsidized (although not normally free but I think Berlin is an exception here) but it is so over subscribed you need to reserve a place before a child is born, unless you live in an aging area.

TheCitizen

1641 wrote: »

It is bunkum because your are talking about European level state services but refuse to accept European level state taxes and charges. High earners in Ireland already pay disproportionately more (https://fdw.ie/personal-tax-uhy-study-2019/). Sure they will have to pay some more to come up to European level standards but not much. It is the lowest earners who would need to come up most. It is populist nonesense to suggest that there is a free lunch here.
I don't have up to date statistics to hand on the extent of the disproportionate amount paid by higher earners but I reckon these haven't changed much. Also ,even middle earners pay considerable tax, although proportionately less. But lower earners pay disproportionately little.


"The increases in the proportion of taxes paid by high income earners has become notable in recent years. For example, in 2015, the top 1% of income earners paid 19% of all personal taxes while just twelve months later this is estimated to be 22%.

In 2017, it is estimated that the bottom 50% of income earners will pay 3.6% of the income tax take."

https://taxinstitute.ie/wp-content/uploads/2018/03/The-Budget-Book-2017.pdf

It isn’t bunkum at all. I m talking about funding the implementation of slaintecare specifically and I m saying clearly that in my view the cost should be levied across the board with it tiered proportionately towards higher earners as our tax system currently is tiered.

Why a suggestion to implement a levy on all but tiered proportionately towards those best able to pay would cause such consternation around here with certain posters is rather revealing.

As for the end of your post, well yes that’s as it should be, are you complaining about that.

1641

TheCitizen wrote: »

No the opposite. Proportionately will apply most to higher earners, unlike (if it's accurate) the Swedish example you outlined above.

The Swedish system is proportionate. For example, on average a person on €75,000 would have €27,000 state deductions. A person on €25,000 would on average have €9,250 deductions (these are direct deductions and do not take account of spending taxes). The level of universally accessible state service are considerably higher.



Would you be ok with this type of tax proportionality for social democratic style state services?

Dorakman

1641 wrote: »

The Swedish system is proportionate. For example, on average a person on €75,000 would have €27,000 state deductions. A person on €25,000 would on average have €9,250 deductions (these are direct deductions and do not take account of spending taxes). The level of universally accessible state service are considerably higher.


Would you be ok with this type of tax proportionality for social democratic style state services?

The difference between take home pay between Ireland and Sweden for someone on 75k is 2.5k on the year. Going by that measure, the high and middle-earners already pay their fair share for Nordic style services. The problem is that those on 30k and less pay sweet **** all in tax.

TheCitizen

1641 wrote: »

The Swedish system is proportionate. For example, on average a person on €75,000 would have €27,000 state deductions. A person on €25,000 would on average have €9,250 deductions (these are direct deductions and do not take account of spending taxes). The level of universally accessible state service are considerably higher.



Would you be ok with this type of tax proportionality for social democratic style state services?

Nope there’s no need, stick to a dedicated levy for Slaintecare along similar proportions of current tax levels with the exception perhaps that all including the lowest earners will pay at least a small amount so that all are stakeholders.

For those on higher earnings if Slaintecare is fully implemented and is successful they can save on private healthcare that they currently pay through the nose for. It’s a win win for those who currently pay private health care premiums. They’ll get a better health system probably for less than what they currently spend on health care. They can still hand over more if they want to stay in a nicer place.

It’s curious to know what exactly are the naysayers against Slaintecare and healthcare reform on here are snowflaking about? Have they thought it through at all one wonders.

1641

TheCitizen wrote: »

Nope there’s no need, stick to a dedicated levy for Slaintecare along similar proportions of current tax levels with the exception perhaps that all including the lowest earners will pay at least a small amount so that all are stakeholders.

For those on higher earnings if Slaintecare is fully implemented and is successful they can save on private healthcare that they currently pay through the nose for. It’s a win win for those who currently pay private health care premiums. They’ll get a better health system probably for less than what they currently spend on health care. They can still hand over more if they want to stay in a nicer place.

It’s curious to know what exactly are the naysayers against Slaintecare and healthcare reform on here are snowflaking about? Have they thought it through at all one wonders.

At least that is clarity. You are confirming that you have no aspiration towards a Nordic/Scandinavian/European social democratic model of state services, solidarity and taxation. What you are actually on about is Maduronomics. More Caracas than Berlin.

TheCitizen wrote: »

It goes back to the old Boston v Berlin argument

TheCitizen

1641 wrote: »

At least that is clarity. You are confirming that you have no aspiration towards a Nordic/Scandinavian/European social democratic model of state services, solidarity and taxation. What you are actually on about is Maduronomics. More Caracas than Berlin.

Nonsense

LuasSimon

https://www.thejournal.ie/tax-exiles-revenue-relaxation-catherine-murphy-5067420-Apr2020/


Looks like Denis O brien and other super rich tax exiles won’t have to spend time outside jurisdiction to qualify for low tax rates in their countries they pay low tax in this year , be able to buy another hospital or two after it all

IAMAMORON

LuasSimon wrote: »

https://www.thejournal.ie/tax-exiles-revenue-relaxation-catherine-murphy-5067420-Apr2020/


Looks like Denis O brien and other super rich tax exiles won’t have to spend time outside jurisdiction to qualify for low tax rates in their countries they pay low tax in this year , be able to buy another hospital or two after it all

The ruling is a dispensation been offered to non ordinarily residents who are stuck in Ireland as a result of a Force Majeure. Typically this would mean they cannot get a flight out of here.

It is a biased piece of journalism. Irish citizens will be unable to avail of this dispensation, it does not apply to Irish Domiciles or citizens. The majority of the Irish super rich would all be domiciled in Ireland, even if they do not live here. These high earners cannot avail of this dispensation.

It only applies to NOR's ( non ordinary residents), this would include people who are not Irish but might be working here. For example PLC directors who might work here for less than 183 days or 6 months a year. Their tax liabilities could change dramatically if they were forced to stay here for a few extra weeks due to changes in flights etc. The rule change is facilitating such earners.

Denis O'Brien is Irish Domiciled and non ordinary resident. But the fact that he is domiciled here means that he is susceptible to Irish income which is made in Ireland and other worldwide income he transfers to Ireland ( which they won't for tax reasons alone). O'Brien does live here, but for less than 6 months a year. Most of the super rich do this, it makes economic sense. Given the amount of international travel they do anyway, it is generally not an inconvenience to them.

But this ruling does not apply to Irish domiciles/nationals, so they cannot utilise it.

One of the main reasons why super wealthy Irish nationals invest in out health sector is the tax benefits offered through their investment. They are not investing to profit from individuals poor health, they are investing to shelter their income from unnecessary tax liabilities. The Irish state is offering these incentives to benefit from the wealth created. If it didn't it is highly likely the money would be spent elsewhere.

jimmycrackcorm

FVP3 wrote: »

But not like roads, or ports.

Like PPP motorways for example?

JJJackal

LuasSimon wrote: »

I thought the state owned them but only for Private Heathcare members. OK i was wrong , now i realize that Larry Goodman and Denis O Brien own them and unless you have enough money to purchase private healthcare your not allowed in.

Do you think that Larry Goodman and Denis O Brien should fund public healthcare?