independent

Monday 21 April 2014

Union calls foul over plan modelled on Dutch set-up

Minister for Health, James Reilly, T.D.
Minister for Health, James Reilly, T.D.

INSURANCE companies are expected to be allowed give hospitals financial incentives to get patients home as early as possible under government proposals to bring in health insurance for all in five years.

The warning about early discharge in a bid to cut costs was made by a union representing 30,000 health workers.

IMPACT national secretary Louise O' Donnell said Minister for Health James Reilly was basing his approach to universal healthcare insurance on the system in the Netherlands.

This includes financial incentives to discharge patients early, which has led to one of the highest hospital readmission rates in Europe because more people experience post-discharge complications.

A white paper on the proposal is now being revised to provide more detail on how it will be funded with a cap on spending. The plan is for the State to pay the premiums for the least well off, subsidise others and make the rest of the population pay for their own insurance.

Ms O'Donnell said the Netherlands has led to a system of competing private health insurers creating an inequitable and inefficient system of funding.

There are different tiers of entitlement, rising hospital deficits, and even bankrupt hospitals, she warned.

She said it would leave families facing a huge financial burden with no guarantee of universal access to healthcare.

"While the final price of UHI had not yet been disclosed, it was expected that it would be in the region of €1,600 for an individual.

"The experience in the Netherlands . . . has been a continuing rise in the price of compulsory insurance, coupled with increasing restrictions on the health services covered."

It risked creating inherent financial uncertainties "that could also put critical services at risk".

The union called for an alternative "single-payer" social insurance model like those used in France, Germany and Nordic countries. The 'competing insurers' model should not be adopted before all the options have been evaluated in terms of quality, equity, access to services, and medium and long-term value-for-money.

This was highlighted in the union's report, 'The Future of Healthcare in Ireland', written by independent healthcare expert Dr Jane Pillinger.

IMPACT said a full examination of a range of universal healthcare models was needed, not just the single 'competing private insurers' model outlined in the draft white paper.

Meanwhile, it has been established that a healthcare pricing office, which would examine the rates paid to hospitals for procedures based on factors such as states of health and age, can only be set up on an adminsitrative basis this year.

The "money follows the patient" system, where hospitals are paid per procedure, is still at a very early stage, even though it will need widespread roll-out before universal healthcare could be introduced.

Irish Independent

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