Why insurance row will do nothing for the patient

THE spat between BUPA and VHI over risk equalisation is a storm in a teacup. It will not have any affect on patient care.

Meanwhile, our public hospitals are obliged to continue subsidising both the health insurance companies and the private hospitals.

Let me explain. Half of our citizens have chosen to buy private health insurance, even though we all have a statutory entitlement to care in a public hospital. Maybe they believe they will be treated better and more quickly in a private hospital.

However, public and private hospitals in Ireland are not the same and do not have the same function.

Public hospitals treat all illnesses. No patient and no illness is ever turned away.

Private hospitals, in contrast, are niche specialists and focus on a narrow range of conditions, with a particular strength in planned operations. If your illness fits their niche, you will be very well cared for. Unfortunately, very few patients currently occupying beds in public hospitals fit into the private hospital niche. This is why there are patients with top-level VIVAS, BUPA or VHI cover on trolleys in our A&E departments. This is why building private hospitals will not solve the A&E crisis.

Furthermore, all emergency care — the most expensive care — is carried out in public hospitals.

This is true even for a patient discharged from a private hospital, following a planned operation, who develops a complication and requires emergency care.

It is unreasonable to expect the private sector to provide this care as the costs and risks are so high. It is important that this is understood.

The bizarre situation is that the private hospital bill will be fully paid by the insurer. Meanwhile, the public hospital may get little or nothing for providing the crucial emergency care because there is a ceiling on public hospital charges. This is a massive subsidy to the insurance industry and the private hospitals.

The Minister for Health has flagged her intention to increase the public hospital charges to insurers. I would encourage her to do this. The public hospitals should be paid for the job they do and the money should be ring-fenced to build new wards in our public hospitals.

Otherwise, our A&E departments will soon be so over-crowded we will indeed have a two tier system — we will need bunk beds in A&E.

Dr Christine O’Malley

Consultant Geriatrician

Nenagh General Hospital


Irish Medical Organisation

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