Health insurance - Services need to be equitable

ONE of our great failures is that our health system does not treat us all equally.

If you have private insurance cover you can, or so we have come to believe, get attention when you need it, not when our too often over-stretched, top-heavy, trolley-dependent health service might provide it.

It is easy to criticise this system, especially for those who rightly advocate that everyone should get health services more or less as soon as a problem is identified. Just like the service Susie Long needed to save her life but was denied.

Unfortunately, shamefully, this ideal, widely realised across Europe, seems beyond us either practically, intellectually or, most pertinently, politically.

We have decided that Boston is right and profit should be a driving force in health provision. Rather, it has been decided for us by Health Minister Mary Harney and Taoiseach Brian Cowen who, by putting the ‘for sale’ sign up outside the VHI headquarters, continued the move away from Berlin, initiated when they endorsed the deeply suspect co-location hospital process. This is especially ironic as America seems to be moving towards Berlin with President Obama’s recently passed legislation on health insurance.

The pragmatic reality is that being a member of a private health insurance scheme is no more than agreeing to pay a super tax to try to ensure the level of health service we should all get anyway. Just like AVCs to a pension scheme, it allows those who can pay for security they might not otherwise get to do so.

Or at least it is as long as the VHI remains in public ownership. If, after a very significant injection of taxpayers’ rescue remedy — €338 million this time — the VHI is sold off it will become no more than a sub-branch of a business that may make a contribution to the profits of some faceless conglomerate.

Announcing the sale, Ms Harney assured us, even though a buyer has not even been identified, that premiums would not rise. This and assurances about jobs are patently nonsense. Premiums may not rise under new management but Ms Harney is not in a position to give that commitment.

Those promises should be seen in the same light as assurances made before Aer Lingus and Eircom were sold off. They are as useless as the “golden share” retained by the Government in Aer Lingus.

The VHI is, like emigration, a safety valve that ensures that the failures in public health services are never really confronted because the 2.2 million people lucky enough to have private health insurance can resort to private services. If by selling off the VHI that valve is closed, some good may come of the announcement and services may be forced to improve.

When he announced the sale on Thursday, Taoiseach Brian Cowen spoke about “a society bound together by solidarity”. It is a great pity that he does not feel this notion of solidarity strongly enough to work towards establishing a public health system that does not force such a significant proportion of the population to take out health insurance. It would be a significant step towards a fairer and more humane society.