Fianna Fáil shows true colours with policy that will prolong two-tier healthcare system
Published 17/04/2015 | 02:30
Fianna Fáil is about to break its long-established habit of being a health- policy-free zone. Its much-awaited health policy is due to be launched at next week's ard fheis.
The unfinished health policy, as seen by the Irish Independent, gives a nod to anyone who effectively lobbied Fianna Fáil in the last four years, promising lots more of everything - more primary care, more resources for hospitals, more mental health services, more nursing homes - to everyone - pharmacists, private hospitals, private nursing homes, public health doctors, GPs, nurses, allied health professionals...
It slips into default position with a few more quangos - a new mental health authority and a new Office for Alcohol Control. And in good Micheál Martin style, it also promises more reviews and strategies - a national strategy for long-term care and a review of the national mental health policy.
But fundamentally, it is just more of the same - maintaining the status quo of our two-tier health system funded through general taxation, which still allows private patients to skip the queue, with a little bit of something for everyone in the audience.
Speaking on 'Morning Ireland' yesterday, health spokesman Billy Kelleher said: "after consideration and a lot of in-depth analysis, we took the view that Universal Health Insurance (UHI) is not a model that will work in this country, we believe it is the wrong way to go and will burden a lot of families with excessive cost in provision of health care".
Mr Kelleher is right here - under the model of UHI as proposed by this Government, it would be compulsory for every citizen to have health insurance. Those who currently pay for private health insurance would continue to, those who can't afford to would have it purchased by the State and those in between would be subsidised.
This would in effect mean handing over €3-4bn of public money (either direct from citizens or through public money raised by taxes) to private, profitable insurance companies, who would have control over how that money is spent. The two countries where this model is used - the USA and Holland - have seen huge increases in the cost of care and increased rationing of healthcare services.
But, critically, what the Fianna Fáil policy conveniently fails to admit is that the party intends to prop up the two-tier system.
It does not even specify what it will do in relation to private health insurance but there is a paragraph which says it all - "we believe in a complementary private healthcare system, as this gives people who can afford private health insurance a choice while subsidising the public healthcare system through tax." This, in effect, is admitting that Fianna Fáil will do exactly what it did in its previous 14 years in government.
Private health insurance subsidises public healthcare but only a little bit and its main effect is to allow people who can afford to pay privately to access faster diagnosis and treatment. Increasingly, private health insurance covers the cost of private care outside the public hospital system. The most recent figures for Ireland show that in 2013, 45pc of the population had private health insurance, yet private health insurance accounted for just 13pc of all health financing.
The Fianna Fáil policy document defends its stance: "we believe a taxation-funded health system is more progressive, as it allows the government more control over the overall healthcare bill. It also prioritises healthcare for the most vulnerable and those who cannot afford to pay towards their care." Yet there is no mention of how the party will prioritise "healthcare for the most vulnerable".
This is classic Fianna Fáil guff - claiming to be in favour of a progressive system.
Yet, quite clearly, this policy is only interested in maintaining the status quo of our tax-funded public health system, alongside our highly subsidised private health insurance system.
This policy is one sure way to maintain our divisive, unequal, regressive two-tier health system that was perpetuated under previous Fianna Fáil governments.
One tangible step Fianna Fáil could have suggested would be to undo the prescription charges for medical card holders introduced during its time in office and undo the large co-payment non-medical card holders have to pay for drugs. But, oh no, the amnesia lives on and there is no mention of increased user charges, which are internationality proven to be the most regressive form of healthcare payment.
There is no mention of hospital groups or new community health structures, even though these are the main drivers of reform in the system right now. Interestingly, Fianna Fáil is supportive of free GP care, saying it will not undo anything already in place. This suggests that its memory is not too short, as it learnt a bitter lesson from taking medical cards off richer over 70-years-olds in the first austerity budget in October 2008.
There is lots in the policy document about "investing in primary healthcare" with an additional €120m per annum ear-marked for beefing up capacity of primary and community care. This is remarkably similar to the long-forgotten, never implemented, primary care strategy heralded in 2001 by the then health minister, Micheál Martin.
Fianna Fáil is showing its true colours in its first-ever health policy document.
The fact that it took four years to produce this badly written, ill-informed policy that does not even have the ambition of universal access to healthcare says it all. The party quite willingly and purposely wants to continue to prioritise those who have money over those who do not.