Reshaping our health service - Pragmatic assessment on promises

Speaking on RTÉ radio yesterday afternoon nurses’ union leader Liam Doran said that a universal health system is the mark of a civilised society and, in the most general terms, it is very easy to agree with him and share his noble ambition.

That after so many years — and so many governments with determined ministers — myriad efforts to establish one have failed points to a degree of complexity and disagreement that have become real barriers to long overdue, meaningful social progress.

The fun starts when you try to define a universal health system and who should pay for it and how. Do we, because we will all need its support at one point or another in our lives, pay for it through increased taxes, mandatory government levies or by paying premiums to private health insurers? Would everyone, irrespective of income, make some contribution or would the usual burden fall in the usual place? Might it be the very best of public service in action or a route to profit for private health and insurance providers? One-tier? Two-tier? One queue for everyone?