Wednesday 28 September 2016

Jim Dowdall: Let's encourage healthier lifestyles with lower insurance costs

Jim Dowdall

Published 18/03/2016 | 02:30

Photo: Getty
Photo: Getty

What comes to mind when you think of the health of the Irish nation? Comments like "long waiting lists", "hospital trolleys", "A&E crisis", "poor experience" and "health budget overruns" generally pop into your head. Imagine if this wasn't the case and that Ireland was instead rated as a nation with a health system that provided a quality of care that we are all satisfied with.

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Unfortunately, we have a long way to go for that to be a reality.

It's positive that people are living longer than ever before as healthier lifestyles, new drugs and advancements in medical science improve survival rates.

This and our changing demographics due to an ageing population will result in a continuous increase in the demand for healthcare.

Some experts estimate that the health budget needs to increase by 4pc per annum just to maintain the current level of service.

In 2015, the Exchequer provided €13.2bn for healthcare services with a further €4bn paid through health insurers or by citizens directly.

A CSO report shows that Ireland spends the second highest amount on healthcare as a proportion of Gross National Income compared to other OECD countries. But there is no doubt that we don't get the required outcome for this spend.

So what changes could a new government make quickly and easily which would have a real impact on the Irish health service?

Firstly, a new government has to accept that the health system can't continue as it is. Every group within the health service is fighting for even more resources while patients continue to feel that their healthcare needs aren't being met.

Even if we had it, throwing money at the problem on an ad hoc basis doesn't work. We need new thinking from the government and Department of Health.

We need to urgently change the annual budget grant model of funding for the public system as this incentivises inefficiencies and the existence of long waiting lists. We should move to a model that aligns funding to results.

The annual budget cycle also limits the public health sector's ability to fund major change programmes. We need to fix this by providing a budget for a number of years which would allow for medium to long-term planning.

In addition, both the public and private healthcare systems need to be considered as part of the solution. No developed country can afford to provide for the healthcare needs of its population through a public health system alone.

The private health system carries out 250,000 theatre procedures annually, including 50pc of all heart surgeries and 65pc of all spinal surgeries. Imagine the state that the public system would be in if the private system didn't exist. Now think how, if used strategically, we can further alleviate the burden on the public system and help deliver a better overall health service.

If we look back to the benefits achieved through the National Treatment Purchase Fund in the past, we can see this played a big part in reducing waiting lists.

Let's restore a similar model and provide the managers of the seven public hospital groups with the ability to procure services from the most cost-effective setting.

We need to take more actions to encourage people to lead healthier lifestyles. Interventions can work.

Imagine the positive outcomes that could result if the government took firmer steps to improve, for example, the health of children by putting a tax on sugar, immediately banning junk food being sold in schools, and increasing the focus on physical activity within the education curriculum.

At my health insurance company, GloHealth, we have seen a 22pc increase over the past two years in the number of claims for preventative health treatments such as cancer and cardiac screenings.

While this is really good news, more can be done to encourage individuals to become more health aware and responsible for their well-being.

But in Ireland health insurers are not allowed to reward customers in any way for leading a healthier life and this has to change.

Take smoking as an example. If the regulations were changed, we could offer non-smokers, or those who give up and stay off cigarettes over a period of time, a discount on their premium.

Any new government that wants to create a better overall health system can implement these solutions straight away. Of course, they won't fix all of the issues but they will make a significant - and immediate - difference. We can't ignore the elephant in the corner any longer. The current system is not sustainable and simply has to change.

There is no doubt that with a committed political will, interventions can be made that will help us move towards a quality healthcare system in Ireland that we can all, finally, be proud of.

Jim Dowdall is CEO of GloHealth

Irish Independent

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