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Three health systems: how they compare

WITH the dismantling of our healthcare system so much in the news, we would do well to compare it with the US and British systems.

The US system is private and costs $7,290 per capita per annum, more than twice the $2,986 average of developed countries, all of which are in the $1,000 to $4,000 range.

The figure for the ‘free’ British national health system is $2,992.

However, by any standard of mortality, such as life expectancy or morbidity, Americans suffer poorer health, and 20% of citizens have no health insurance whatsoever.

The problem is that few people are in a position to know whether a medical intervention is justified or simply a way of making money, so the American system of selling healthcare as if it were double-glazing inevitably exposes patients to overpricing and the cost of unnecessary interventions.

These problems hardly exist in the British national health system because healthcare is rationed and doctors are paid a salary rather than a share of profits. The centralised system is far more efficient in maintaining records, providing services, purchasing supplies and in employing staff. Further, with the British system, because visits to doctors and hospital are free, the old adage of a stitch-in-time-saves-nine applies.

For example, hypertension and other illnesses are detected at an early stage and can be treated effectively and cheaply. Because many Irish people cannot afford to or do not want to pay to visit the doctor they wait until they are seriously ill, suffering strokes, heart attacks, etc, which inevitably cost more money to treat and cost the state dear in disability payments and loss of income tax revenue.

The problem with health insurance is that it has to make a profit and it has high administrative overheads. The premiums are based on risk, which can make it unaffordable for those who need it most. It is a popular myth that competition benefits the consumer, but this is not necessarily so since costs are swallowed up in advertising and flamboyant facilities which simply create a better impression without providing better medical treatment. Choosing insurance on the basis of the lowest premium may be a mistake if it provides an inferior service, but by the time one finds out it may be too late.

An NHS-type system should be adopted by Ireland, completely free at point of use and paid for out of taxes. It is justified on economic grounds (it is cheaper for the state) and on moral grounds too, since no one knows when they are going to fall ill or be injured, and we will nearly all grow old..

Michael Job



Co Cork


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