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Saturday 23 August 2014

Universal Health Insurance by 2019 - report

Fionnan Sheahan, Group Political Editor

Published 08/02/2014 | 17:45

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Minister for Health, Dr. James Reilly
Minister for Health, Dr. James Reilly

THE new health service system, known as Universal Health Insurance, will be introduced within five years, a new Government report reveals.

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But how the system of mandatory health insurance and overhaul of the system will be funded is not clear yet.

The Coalition is planning to consult with the public, through a Citizens Health Assembly, in deciding what should actually be covered by the basic insurance package.

Ordinary members of the public will also be asked to assess the “willingness to pay for services” and be told of the cost implications for individuals and the Exchequer, the report says.

Under UHI, everybody will be entitled a basic health insurance package of GP and hospital care.

The Government will pay premiums for people on low income and subsidise those on middle incomes who can't afford the insurance.

The plan is supposed to do away with the two-tiered health service.

Health Minister Dr James Reilly will circulate a draft of the White Paper to Government colleagues in the coming weeks.

The UHI plan was a key part of Fine Gael's general election promise as part of Enda Kenny's five point plan.

But Dr Reilly has been coming under pressure from the Labour Party to show how he plans to advance UHI.

After it is circulated, the report will go to a Cabinet sub-committee for further development.

The White Paper will say UHI will be introduced by 2019 and will also set out a three-stage process to draw up the overall plan.

A commission will be established to outline a general structure to UHI.

The public will be consulted through a new Citizens Health Assembly.

Based upon the Constitutional Convention, members of the public selected at random will be asked to make choices on what should be included - and the cost.

The assembly will have access to experts and be advised by experts and make recommendations on what services should be covered, including:

*primary care;

*hospital care;

*acute care;

*mental care;

*drugs.

In some countries, the cost of medicines is not included under UHI and mental health is also rarely a component.

The White Paper says there will be “costed policy options” developed before deciding what to include in the basket of basic services.

But the public will also be consulted on what criteria should be included, such as how far a patient has to travel for treatment, the standard of service and how long an individual would have to wait for treatment.

The report also says the various elements of the health service will have to be consulted with, including the health insurers and private hospital sector.

It goes through the various hurdles that will have to be jumped before UHI can be introduced, such as the reduction of waiting lists and the introduction of the Money Follows The Patient model of funding hospitals.

When the plan is introduced, insurance with a public or private provider will be compulsory with payment related to ability to pay and not by gender or age or health status.

Health insurers will not be able to refuse any applicant.

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