I'm quite worried about these Fine gael plans for health

[Supermanpolitician]

As a responsible political party, Fine Gael have of course considered the importance of stable insurance companies to its Universal Healthcare Insurance policy. Per Faircare.ie:

"UHI will require the insurance industry in Ireland to play a much greater role in negotiating contracts with hospitals and other providers, and in driving innovation, than has been the case to date. Fine Gael will not introduce UHI until it is certain that the insurance companies are capable of taking on the expanded role required of them. A Fine Gael Government will encourage insurance companies from other European countries, who have experience of implementing social insurance models, to enter the Irish market."

Don't confuse PJOZ with facts, Sam. He'll probably say our propposals stem from our facists origins!

[pjoz]

I'd really like to know how flaging a very serious pitfall to the FG plan is trolling. Please do explain?

[pjoz]

PJOZ, you have four posts in a row. Nobody pays any attention to your trolling.



Except me.

I know this is a crazy idea superman but maybe nobody bothered to reply because they had no argument with my contentions.This FG plan needs to go back to the drawing board. I hear Cuba have a world class health system despite all their problems, maybe FG could have a look at that?

[hiding behind a poster]

I know this is a crazy idea superman but maybe nobody bothered to reply because they had no argument with my contentions.This FG plan needs to go back to the drawing board. I hear Cuba have a world class health system despite all their problems, maybe FG could have a look at that?

FG looked at lots of health systems, and decided the Dutch model suits Ireland best. Personally, I think Dutch models are marvellous, so I'm right behind FG on this one.

[TommyO'Brien]

This is never going to happen.

It is.

First, we've two players in the market at present public and private. I've a number of questions.

1. If FG is introducing universal insurance, what's going to happen to private hospitals?

They will be competing with all other hospitals on an absolutely equal playing pitch.

2. Are the insurance plans providing basic hospital cover across the board ie. beaumont vs. Blackrock vs. Bons. all at the same premium price?

Yes. The provision of services will be the same. The access will be the same. You and your insurer will be able to negotiate deals with hospitals. If two hospitals can provide the same service, but one is more expensive than the other, which one will the patient choose? The cheaper one. And that will force the other to bring down its costs to complete. But strict controls will ensure that cost savings cannot impact on medical care, because if a hospital gives substandard care and someone has to go in again, the patient's costs will be paid for by the hospital, not the patient. Ditto if it is the insurer that negotiated a bad deal - it will cost them, not the patient. So hospitals and insurers will be forced to ensure quality provision of services because if they don't provide adequate services, (a) the insurer will send other patients elsewhere, and (b) it will hit them where it hurts, their profits, if they do not get the patient the best quality care.

3. Where's the money going to come from to provide health insurance and free access to secondary care for increasing numbers of persons who will not working in this economic climate?

MFTP systems function far more cheaply than command-and-control models and produce massive savings. Those savings will pay for access for those who cannot afford their own UHI.

4. They are planning to introduce free GP care - GP's are independent so do they think they are going to sign up to a state primary care system and how is this going to be funded?

They enthusiastically back it, have endorsed it and moving emphasis to primary care from hospital care has been proven, universally to be much more cost effective. The cost of preventative care at primary care level that reduces the demand on hospitals is only a fraction of the cost of not investing in primary care and instead leaving treatment until it has reached the much more expensive stage of hospital-based care.

5. Hospitals are going to be funded on a money follows the patient lark - this in the UK and it aint working.

The NHS does not follow the MFTP model. It is based on the command-and-control model which has been found to be one of the least efficient and most costly.

6. Are FG going to deconstruct our existing health system.

Yes. It will take place in stages over five years, with sectors when they are ready to moving over to the new system. When all sectors have moved, the HSE will be abolished. In the interim, while the new system is being set up, the Northern Irish central-command model for dealing with waiting lists, which worked in the North, will be used to deal with the immediate queue model, before being phased out when the new MFTP system is ready to replace it. The process of changing it will begin on day 1 of a Fine Gael-led government.

7. What ideology is going to underpin this new health service and rooted in equity?

Full equality of access and treatment without reference to the means of the patient and based entirely on need.

8. Who's going to provide the insurance - the State or the market?

A controlled market in which the each patient will have a right to change ensurer annually if their current insurer does not meet their needs, and in which the quality of the provision is strictly controlled. Free movement between insurers forces ensurers to guarantee the centrality of the patient in the system. Hospitals will also have to earn contracts through the provision of quality services, and those that do will be able to invest the profits made from the services in developing their own services, negotiating local wage rates, etc. The MFTP system forces both insurers and hospitals to up their game because if they do not provide a quality service, the patient can go elsewhere, with the new service provider gaining resources and the one that failed the patient being hit where it hits most, in their pockets.

9. Will there be cherry picking by health insurers?

No. But there will be cherry-picking by patients, who will be able to choose annually whether to stay with their current insurer, if they are satisfied, or move if they are dissatisfied. So insurers will have to be on their toes making sure that they provide coverage, treatment and access of sufficient standard to keep their patients. If they let their patients down, their patients can dump them. So the patient is in control of the system, not the insurers.

The bottom line is simple: hospitals and insurers must put the interests of the patients, not their own interests, first. If they don't, the patient can dump them and take away the thing that will hurt the insurer and hospital in the most effective way possible - the income that would have come from treating that patient and which will have moved to someone else able to provide a better service. The current command-and-control model is based on the supremacy of the system over the patient, with patients having to match the needs of the system. MFTP reverses that, because each patient ceases to be a drain on a hospital's resources, but becomes a source of income. So, for example, rather than a theatre being closed because the hospital is out of money, the pressure will be to keep it open longer, because by using it more it earns the hospital more money, enabling it to invest in its services and negotiate pay deals in the hospital. MFTP shifts the role of the patient from the user of resources in a block fund to being a source of income in their own right. That is why MFTP systems like in the Netherlands are far cheaper, far more efficient, have far less queues and far more patient satisfaction than command-and-control models.

[drzhivago]

2 big problems with this plan.

Firstly, private health care has higher administration cost plus a cut fot profit, so it will always be more expensive that a comparable public system.

Secondly, Ireland has had a severely underfunded health care service for years, privatising the gains wont change that.

to answer 1st point private hospitals have lower admin costs than public hospitals

[drzhivago]

Quinn group have about 20% of the health insurance market, Hibernian another 20% and VHI hold the balance. What exactly is your definition of "domination"?

Whatever you may think about Quinn I respect him for bringing jobs to the border region at a time when your crowd were kidnapping, bombing and murdering and the only economic activity being carried out was smuggling, diesel laundering and racketeering.

I know who I respect more.

Not sure the figures are as high as that certainly Hibernian lower than 10%

[drzhivago]

The actual standard of Irish health care is seemingly rated highly, there are plenty of nice shiny new hospitals being built, there is tons of medical research (disproportionate to the country's size) - that's all fine. It's just the way it's organised, everything needs to be amalgamated, middle men need to be cut and an over-arching organisations needs to be set up that will ensure the same health care present today is dished out fairly to everyone.

Money isn't the question in the case of an Irish NHS, unlike say, in the US. Ireland has all the components of a national health service, it just lacks the organisation on a national level due to pig ignorant politicians.

The costs of doing this wouldn't be that high, and you could pay for it by cutting the appallingly high wages of doctors in Éire.

Hmm you should check what the wages are in US, a country with similar research reputation and production