‘Universal health insurance will be a win-win for all’ says Reilly
The comments were made at the launch of the complex policy, aimed at overhauling the existing two-tier health system and replacing it with a fairer, single-tier model by 2019.
Under the proposed plan — which in recent weeks has led to internal coalition disputes over whether it is affordable — standard care will cost the same for everyone, regardless of age or health condition.
This is because all people in Ireland will be told to take up health insurance, with the State subsidising them in certain cases.
Those who are unemployed, in receipt of medical cards or on low incomes will be fully or partially subsidised, while people who say they cannot afford private health insurance despite a Government means test suggesting otherwise will have a standard service purchased for them, with the cost being retrieved by the State.
While the specific services involved will not be finalised until after a public consultation process over the next two months, and an independent report early next year, Dr Reilly said free GP care, acute hospital care including inpatient, outpatient and day-case services, maternity and mental health are central to the policy.
Rehabilitative care will also be covered for up to one year, while step-down residential supports will be covered for two weeks.
However, despite being repeatedly asked for clarity during a two-hour press briefing at Government Buildings, the minister was unable to confirm how much the public should expect to pay — other than to say the “average” will cost less than the current €920-a-year health insurance average per person.
Insisting the policy “will be a win-win for everybody”, Dr Reilly said universal health insurance is “the biggest reform” for the system in years.
However, the minister said he “can’t possibly” clarify how much the plan will cost people when it is implemented in 2019 as the date is five years away.
Speaking on RTÉ News last night, he again declined to state what income level subsidies will stop at as the plan is five years away — outside the Government’s term of office.
The policy was supported by Taoiseach Enda Kenny and Tánaiste Eamonn Gilmore during yesterday’s launch in a joint show of unity over the initiative.
In particular, Mr Kenny said the plan is a “once in a generation opportunity to help build a health system which is fit for purpose in a modern republic”.
However, opposition parties have claimed serious gaps remain in how the policy will operate, while doctors and health insurers have raised concerns over the policy’s impact on their income — and ability to provide services.
Fianna Fáil health spokesman, Billy Kelleher, claimed the new system will cost some middle-income families “an awful lot more in the years to come” — a view repeated by independent health insurance expert, Dermot Goode.
The Irish College of General Practitioners and the Irish Medical Organisation both called for further consultation, a stance repeated by private group the Independent Hospitals Association of Ireland.
What is it?
In basic terms, the end to Ireland’s two-tier health system — if it goes according to plan. As part of the health minister’s initiative, public and private systems will be merged in a bid to ensure access to services is based on a person’s need, not the size of their wallet.
Will health insurance be mandatory?
A: Under the plan which James Reilly hopes to have in place by 2019 — three years later than first envisaged— everyone will have to take out health insurance. Insurers will be obliged to accept all applicants regardless of age or health condition.
What will it cost?
A: This is a question the health minister has yet to definitively answer. Speaking during a two-hour press briefing yesterday, Mr Reilly repeatedly said he could not definitively say what the cost of his plan will be, either to the State or to individual patients.
Is there a ball-park figure?
A: Well, it may come back to haunt him but the minister suggested the “average” cost of universal health insurance is unlikely to exceed €920 — the current average for health insurance coverage — due to subsidies.
The State, he said, will subsidise the cost for people on very low incomes, the unemployed, medical card holders, and others who say they cannot afford health insurance — subject to a means test.
And for others?
A: Everyone else will have to pay an as yet unspecified amount. As such, people receiving subsidised help will not face €920 cost figures. But the price for richer families could be higher.
If a person who does not fall within the subsidised help group fails to get health insurance coverage after a Government means test says they can afford it, standard cover will be purchased for them and the money retrieved by the State.
Will the health levy remain?
It is unclear whether the current health levy will still exist when universal health insurance is implemented.
However, the department said it is “likely” the €100 charge for attending an emergency department without a GP referral letter will remain.
Individuals will still be allowed to pay for extras such as what the Department of Health describes as “luxurious accommodation” while receiving care.
However, the proposed system will ban insurance companies from selling packages that allow some people to gain faster access to care than others — effectively levelling the playing field.
Depending on what side of the fence you are on, this either means better access to services or paying twice (taxes and the new plan) to run the same system.
What services will I receive?
The exact details are yet to be decided, but those expected to be covered include “primary, hospital, and acute mental health care”.
In real terms, this means free GP care, if the less than easy task of convincing doctors to agree to it proves successful, and faster access to hospital services, if the public-private waiting lists merger does not cause a backlog.
The finalised list of services to be covered, and which will be subsidised for certain groups, is expected to be detailed early next year after a public consultation process, which lasts from now until May 28.
This process will also help to decide the make-up of extra “service baskets”, which people who want more than standard care will still be able to purchase.
When is it being introduced?
If all goes according to plan, in 2019. The Government is taking part in an “extensive consultation exercise” with the public and key stakeholders until May 28 to finalise the costs and services available, which will be detailed in early 2015.
The service change will begin with the gradual rollout of free GP care starting later this year, as part of the first phase of the initiative.
CONNECT WITH US TODAY
Be the first to know the latest news and updates
