Plan for a 'health utopia' involves high-risk surgery
The promise of a "health utopia" where services are free and quickly accessible to all regardless of income is back to tempt us.
Within a decade, most of us should have free GP care, wait no longer than three months for surgery or 10 weeks to see a specialist, and any scan we need can be done in 10 days.
No patient will be on a hospital trolley for more than four hours.
It's the holy grail the Dáil Committee on the Future of Healthcare wants to reach, having been given the task of drawing up a permanent blueprint for how services are delivered. The aim is to end the cycle of policy changes by different governments.
The committee is made up of a range of TDs of various ideologies, including left-leaning deputies whose imprint is already very evident in the first draft of its report.
Everyone aspires to a one-tier service, but how to get there, and who pays, has us back to the same old crux.
While the initial controversy centres on the proposal to cut tax relief for private health insurance premiums - a move swiftly rejected by the current Government - there is also other radical surgery that will prove difficult to sell to governments.
For instance, the committee believes public hospitals should no longer accept fee-paying private patients. This would mean a loss of €621m in income to public hospitals.
There would be a lot of patient support for its proposal to reduce the prescription charge for medical card holders from €2.50 to 50c.
The maximum private patients in the Drug Payments Scheme would pay every month would be reduced to between €72 and €85 from €144.
The overnight charge of €80 for a hospital stay for non-medical card holders would also be abolished.
Much of this would be phased in over a decade. But how would it all be paid for?
It is estimated to cost around €5.4bn over six years. The aim would be to take the funding currently subsidising private health insurance and divert it towards public services instead. There may also be specific funding generated through general taxation or specific taxes.
But around €500m in transitional funding will have to be found annually for the next six years by the government of the day.
Hospital consultants have much to lose - they would no longer earn fees for private patients in public hospitals, but receive a higher State salary as a result.
A leaked copy of some of the discussion documents betrays comments that reveal deep uncertainty.
The final report is due at the end of the month and the committee must be given time.
As waiting lists soar and trolleys pile up, we cannot afford to be cynical. But it risks being yet another report coming with a big health warning.