Healthcare reform - Fairness is the key

The Adelaide Hospital Society commissioned the Centre of Health Policy and Management at Trinity College Dublin, to report on how a single-tiered health system could be developed with equal access for all.

The report, suggesting effective foundations for social insurance, proposes that a system of equal access for all could be developed in Ireland with an extra 3% increase in payroll taxes, taking efficiencies into account.

A single person on €25,000 a year would pay an extra €20 a month for free access, at the point of care, to doctors, hospital services and drugs. The proposal would envisage a single social health insurance fund, separate from Exchequer funds, to buy services for patients from the public and private sector.

The aim of the report is to suggest a fairer system, at limited cost. It advocates that people contribute directly to a new system of social health insurance according to their means, instead of through general taxation as at present.

The proposed system would provide access to healthcare on the basis of clinical need, and pay for this on the basis of income or wealth. Equal access for all should be the goal of a good, effective health service.