Sunday 23 November 2014

Reilly must get it right on major public reform

If this plan goes awry, great cynicism will manifest at the ballot boxes, writes Fionnan Sheahan, Group Political Editor

Health Minister James Reilly needs to get it right with universal health insurance
Health Minister James Reilly needs to get it right with universal health insurance

'THE white paper underpins the Government's resolve to deliver on the Programme for Government commitment to end the current unaffordable and unfair two-tier system and establish a single-tier health service where access to services is based on need and not on ability to pay."

Dr James Reilly's vision of the health service seems to send a shiver down the spines of many paying for health insurance to guarantee access to the private system.

The clash between the idealism of the creation of a utopian health service and the scepticism of the system operating efficiently threatens to derail the plans to introduce Universal Health Insurance.

In the post-recovery mood of the country, the Government is taking a big gamble on UHI, which is causing great uncertainty for the middle classes and will take years to assess its success or failure.

After seven years of higher taxes and cuts in services, there is little appetite for giving the benefit of the doubt to ambitious initiatives – the outcome of which is difficult to ascertain.

The Coalition is promising a "national conversation" – a dreadfully cliched concept, regardless of the topic – about UHI and the future of the health service.

Before the conversation has even begun, the opponents to the reform intent on protecting the status quo are already lining up to bog it down.

The Coalition's greatest obstacle is not the vested interests blocking the path to the change but the effect their actions are having on those with private health insurance.

Every criticism of UHI, whether based upon fact or perception, adds to the cynicism around the feasibility of the project.

Nobody would object to the promised land of an effective health system with adequate levels of staffing and services delivered promptly – if they thought it would happen.

But false dawns have been seen before and lavish spending during the Celtic Tiger days have not solved the problem.

The UHI template is by no means a waste of time.

A lot of the steps towards UHI make abundant sense, irrespective of whether the ultimate changeover happens.

A National Pricing Office, to determine the actual cost of treatments, makes sense.

The move to the Money Follows The Patient model, where hospitals are funded based on the numbers of patients treated, rather than just a block grant, makes sense.

A Public Safety Agency and a body to promote health and well-being makes sense.

The Government is not past the point of no return on UHI and all of these changes can happen without taking the final step.

Sunday Independent

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