EDITORIAL: Universal healthcare let-down

THAT financing universal healthcare through Universal Health Insurance (UHI) is a bridge too far for this country at the moment has been obvious for some time, especially for the past year when new Minister for Health Leo Varadkar admitted as much soon after taking office. Why we had to wait another year for the Economic and Social Research Institute (ESRI) to put the final nail in the coffin of UHI with its research report, ‘An Examination of the Potential Costs of Universal Health Insurance in Ireland,’ is puzzling, to say the least.

How long more are we going to have to wait for the government – or even the opposition parties – to come up with a realistically-costed plan for a public health service that will be based on medical need rather than the current inequitable model where people’s ability to pay, via private health insurance, enables them to jump long queues for treatment? This is a question that has been asked of several administrations over many years and there was a huge opportunity missed to do something about it during the Celtic Tiger era when the country was awash with money.

One can only conclude that the political will to take on the powerful vested interests that stand in the way of creating the conditions for meaningful reform of the health sector was never really there. And, it looks like it is still lacking as the current government seems to have decided that they are not going to do anything much about it this side of the general election.

Former Minister for Health James Reilly paraded UHI as the great white hope of financing a reformed health sector when he took office in 2011. However, all we got for the first few years of his tenure in office was an exodus of disenchanted frontline medical professionals from the service and a recruitment embargo that made matters even worse as those who left had to be replaced temporarily by more expensive agency staff.

Long-term problems, such as waiting lists and people being forced to wait for lengthy periods on hospital trolleys in accident and emergency departments due to a shortage of beds, are still not resolved. Piecemeal progress has been made in some areas, such as primary GP care for our oldest and youngest, as well as the cost of drugs, but there is still no sense that the government has got to grips with the underlying problems that the dog the health service and keep it inequitable. 

The fact that they have effectively sidelined any further action for the remaining months of their time in office is a terrible insult to the thousands of public patients on waiting lists for medical assessment and treatment. They hope that the Emergency Department Task Force will find enough hospital beds to ease the trolley crisis this winter and keep a lid on public disquiet about the matter ahead of the general election.

The best we can hope for is that the government and opposition parties will come up with properly-costed proposals to reform the health service, present them for scrutiny by experts and for public debate during the forthcoming general election campaign and let the people decide. Leading into the last general election, the UHI promise sounded very good in theory, but the problem was that it had not been costed properly.

Indeed, during the lifetime of this government, some €700,000 – most of it taxpayers’ money – was spent trying to scope out the viability of various UHI models. While it was no harm to rule them in or out, there was an element of putting the cart before the horse about it.

The fact of the matter is that we are still a long way off overhauling our public health service. What improvements that have been made are welcome, but without being part of a cohesive overall plan, they can really only be regarded as stopgap measures.

The radical overhaul that is necessary is easier said than done, but needs to be acted upon before another government comes and goes.