Medics: Health insurance plan impossible to implement

Fears that the Government plan to introduce universal health insurance (UHI) is unworkable and based on a “utopian concept” which would be impossible to implement were raised by doctors at the weekend.

Speaking at the Irish Medical Organisation’s AGM in Co Kildare, Cillian Twomey described the recently-published white paper on UHI as “indecipherable gobbledegook” with a proposed funding mechanism that was “off the wall”.

Mayo GP Ken Egan questioned how patients could be offered a basket of procedures, including certain primary care services, under the new proposed model, without adequate resources in the community. “No-one is looking at the pricing supports needed in the community,” said Dr Egan.

There was also a shortage of occupational therapists, physiotherapists and public health nurses and deciding on baskets of procedures in advance of having the required infrastructure in place was unbelievable, Dr Egan said.

In addition, extension of free GP care was going to extend GP workload by 40%, he said.

“We’ll need €250 million for this; there isn’t a hope in hell of it happening. It’s stroke politics,” Dr Egan said.

The proposed UHI model is designed to end the existing two-tier system of public and private medicine and to make sure people are treated on the basis of need rather than ability to pay. Under the new model, everyone will have to have cover for a basic package or ‘basket’ of services on offer from competing insurers, with the Government either paying for or subsidising the cost for lower-income groups.

Those who want additional cover can pay extra but the Government has said the model will not allow queue-jumping.

In addition to acute hospital care, the package will include core GP and community nurse services. The Government said it wants full implementation by 2019. Public consultation is under way and is due to last until May 28.

The IMO meeting heard that the Dutch model of UHI had taken 30 years to implement but the Government here planned to introduce it in five yeas.

This led to questions of whether the Irish economy had the capacity to adopt such a model, particularly given the under-funded state of the Irish health service, the IMO said.

New IMO president Professor Trevor Duffy said the principles of universal health should not be based around the funding model but around equitable and timely access to all necessary healthcare.

He said the IMO believed the Government goals could be achieved through an expanded taxation model or a system of social health insurance.