Why don't we have ACTUAL universal healthcare like the rest of Europe?

And let's be feckin honest here, charge a tenner for a GP visit to medical card holders and GP waiting lists here would evaporate.

I've never had to wait more than 3 days to see a GP, and my most recent visit was a month ago. Specialist services are another matter, especially since Covid. Following a scan recently, I found myself needing a specialist consultation - not for something life-threatening, but for something that would be unpleasant and sore and that would interfere with my day-to-day life. I was offered a private consultation in seven weeks, or a public appointment next September. I took the private appointment, but at least I can afford to pay the money. I am also aware of someone else whose GP was concerned he might have a serious respiratory condition - or a potentially devastating and fatal one, which he wanted to test for and hopefully rule out. The GP found the person a private appointment in the Beacon in about 2 weeks, but could not source a public appointment anywhere in the system for a year, despite the nature of the illness. Anyone who thinks either of the situations described above is in any way acceptable is utterly deluded.

As to the money, I just took a look at two publications, one British and one Irish, to compare their government health spending in 2019 (to avoid the distortions of the pandemic). UK spending was £2,647 per person. I don't have the prevailing exchange rates for 2019, but at today's exchange rate that's €3,140 per person. The Irish equivalent was €3,712. I appreciate that I could be making a methodological booboo somewhere since I looked this stuff up in a rush - but if it's right it means:

• Irish taxpayers are spending 18% more per head than their British counterparts
• But on top of that we still we have to pay for health stuff that they don't
• And 45% of us are also paying for private medical insurance, compared to about 13% of the UK's population

A mate of mine once described our system in a nutshell as paying too much money to too few people. I've no idea if that's actually the case - because it's so hard to get actual data to work with - but it's a plausible explanation.

https://assets.gov.ie/45117/6a4f970018d6477bac38f4539f80e927.pdf

OK, let's look at the public health system in both countries.

Prescriptions: Mostly free in UK. Mostly certainly not in Ireland. Prescription and non-prescription drugs cost a fuckton more here as well.

GP: Free vs 60 quid.

Consultants: Free v 200 quid.

Minor surgery following on: Free v €1-€2k?

Waiting lists. It's been making the news in the UK that waiting lists are over a year. 3 years isn't uncommon here. Again, despite the fact that fully half of the population have private insurance.

All of the above to despite half of our population having insurance separately.

Oh and dentists, Christ it'd be nice to just pay what they pay.

I have no gra for GPs but I agree with the basic minimum charge of 10 euro per visit. The free for under 6s really pushed them to the farthest edges of care and they might as well have pulled down the shutters. One free visit per year might have been a more reasonable solution for parents with lots of kids. It is a case of being self employed and under the same circumstances Pharmacists wouldn't be dictated to and fought for the prescription fee's in order to sustain their own business interests. These day's you go to a GP's and you're a customer, not a patient but I think it would be better for everyone if they were regarded as such and furnished for provision of their services. The care might improve and more options for care become available.

I know I should probably read the Slainte care programme (I'm just not getting paid to) but the German model is definitely one to look at and could be implemented here. A lot of other points have been made throughout the thread in relation to the NHS provision of care and it does cover a number of areas that are very lacking in our own, we don't have dental care at the moment (or at least very limited) and obviously provision of mental health services is stark. It is time to put the focus back on the public though and start providing them with the care that is needed.

I also had a family member live and work in Germany and his work contract included his healthcare plan, public health insurance of which his employers made a contribution equal to his own. The rate's might seem high in comparison to private health insurance here but his earnings were also much higher and rent and living more affordable too. (at the time at least) Adjusting for cost of living in Ireland and a threshold level that was sustainable might be workable, an advanced model of PRSI but with a greater range of care.

The cost for first GP visit is 10-15 euro, here we could extend that to everyone as a basic minimum charge and those who can afford private insurance and want it can opt into those models of private care if desired.

edited to add Germany's healthcare was rated in the top 10 until recently, understandably their economy was much better equipped to support statutory public contributions. https://www.expatica.com/de/healthcare/healthcare-basics/german-healthcare-system-103359/

Germany has traditionally had what could be described as the most restriction-free and consumer-oriented healthcare system in Europe, with patients allowed to seek almost any type of care they wish wherever they want it (“stronger on quantity than on quality”). The traditional weakness of the German healthcare system: a large number of rather small general hospitals, not specializing, resulting in mediocre scores on treatment quality seems to be improving – a tendency visible also in 2018, when Germany is sharing 8th place on Outcomes.

Ireland ranked 22nd at the time of this report

https://healthpowerhouse.com/media/EHCI-2018/EHCI-2018-report.pdf

Ireland has been dropping in the Index for one main reason: In 2018, Ireland is alone in last position for Accessibility, with patient organisations steadily giving very pessimistic feedback in the HCP survey. Unfortunately, this was confirmed by the Irish HSE and MoH after the release of the EHCI 2015 report, when they said in a memo that the programme initiated to reduce healthcare waiting times in Ireland aims at a target of no more than 18 months’ (!) wait for a specialist appointment. Even if and when that target is reached, it will still be the worst waiting time situation in Europe. The referendum in May 2018, resulting in allowing abortion in Ireland, helped regain points on Outcomes, where Ireland is doing considerably better than neighbours the U.K. 

The NHS is nowhere near perfect and is devolving, I won't argue otherwise. Even going privately over there did you pay anything like Irish prices though? I'd another mate here who couldn't get any dentist to see them privately here, waited til they visited their family in Spain. In the UK it's bad enough that you may end up going private, here you always go private and it costs more. If you can get in.

Again, your experience isn't familiar to me and doesn't fit at all with people I know where I live. If I ring my GP tomorrow for an appointment it will be a 2 week wait, probably more with the bank holiday etc. likely be the Monday or Tuesday just over 2 weeks later. And again, while being private I'm waiting 5 months for word on an appointment for a consultant. It will literally be a 30 second look to confirm I need what I need and my GP agreed I need over the phone without seeing it, then another month (hopefully) of a wait for a 5 minute procedure. This is all private. If I went public I would be waiting years.

The UK system isn't perfect and they've been running it into the ground for a decade now. Despite that it's still a damn sight better, cheaper and more efficient than what we have.

Just to add, any investment in the hospital system should be squarely in the area of e-health. As demonstrated by Macedonia apparently, as the most effective way to reduce wait times. It would be an astronomical investment but might have been better spent there than on the monstrosity that is the NCH. Our systems here are incredibly antiquated anyway and are in need of replacement, an overhaul at this juncture could easily bring GPs onboard a national system and inline with plans for reform. The benefits are kind of unimaginable really. (reduced waiting times, better care plans, GPs become primary points of care and reduced dependence on the clerical blackhole, software production and implementation and greater R&D in areas of medical and health care just to name a few)

25th place, 638 points. North Macedonia was the absolute “Rocket of the Year” in 2014, ranking 16th with a score of 700 points, up from 555 points and 27th place in 2013. ... The country has made a remarkable breakthrough in electronic booking of appointments – since July 2013, any GP can call up the booking situation of any specialist or heavy diagnostic equipment in the country in Real Time with the patient sitting in the room, and book anywhere in the country with a few mouse clicks. This has essentially eliminated waiting times, provided that the patient is willing to travel a short distance (the entire country measures approximately 200 km by 130, with the capital Skopje located fairly centrally). It seems that patients have caught on, with North Macedonia receiving high scores for Accessibility, particularly in out-patient care – still some distance to go for inpatient care and advanced diagnostics. 

https://healthpowerhouse.com/media/EHCI-2018/EHCI-2018-report.pdf

Er, if you look behind that report, you'll see that the people who developed the "think tank" also developed other "think tanks" linked to Swedish conservative politicians and Swedish business and employer groups. Their main objective is to remove the Scandinavian social democratic welfare state and replace it with something much more akin to policies promoted by the likes of the British Conservatives.

Nothing wrong in that opinion if it's what floats your boat, but it's no harm to mention in case anyone might get the idea that what you're quoting is independent or objective, which it isn't.