Deirdre Conroy: Invest in your future health - for the price of a few beers
Excuse me while I park my dignity and ask a stupid question. We vote for people to run the country - which includes managing a functioning health service - but we have serial mismanagement, so why are those responsible paid more than some world leaders?
Elected politicians continue to appoint advisers and managers to execute their mandate, but systemic failure, particularly in health and housing, has been the outcome in the last five years.
Fifty-two new management appointments to the HSE have only added to the copper-fastened contracts beloved of the public service. In the private sector, most new jobs are devoid of contracts, even rarer are health insurance benefits or pension entitlements. 'Entitlement' is a foreign word for the self-employed.
Back in my 20s, the risk of becoming seriously ill one day, and possibly being maimed for want of treatment, made me think seriously about taking out health insurance.
I rather disingenuously thought that if I had a policy before I had children, I would enjoy a nice room to myself in the maternity hospital. Babies don't plan their arrival and I ended up in a noisy ward of six new mothers and babies.
Fast-forward a couple of decades, and thankfully there were no hospital emergencies or serious illnesses. My children had an accident or two and ended up in A&E in Crumlin, the most necessary and under-resourced of hospitals.
When I joined up there was a monopoly on health insurance. Now thanks to the EU, Ireland has four options. Sadly, just as you're getting over Christmas, they pick January to renew your policy, with glossy booklets on the benefits they will bestow at a considerable annual cost.
This time last year I had a serious accident which resulted in a smashed hip and femur, leaving me with one leg 3cm shorter than the other, in constant pain and unable to walk unaided. An emergency operation abroad had left me with a plate and screws holding the remaining joint in place. I went to an orthopaedic surgeon in Dublin, who gave me the bad news about the short leg - I thought I just had a limp. He would not be able to tell whether further surgery would remedy the difference until at least six months had elapsed. I had healthy bones before and no pain. I found myself praying he would give me a hip replacement and a femur extension so that I could walk again.
In August last year, I lay in my hospital room, post-op, and thought back to my twenty-something self. The morphine definitely helped. I worked out that the instalment cost of the medical care, expertise, engineering and whatever else went into putting me back together again, was less than €20 per week.
My policy excludes the fancier hospitals, but I knew I had an expert surgeon and the most efficient, sometimes very friendly, nursing care in what is a very business-like hospital.
I wondered why anyone would take the risk of permanent immobility or of prolonging their pain, particularly with a knee or a hip, by relying on what is a very sick public health service.
I hasten to add this is not a privileged viewpoint - there is a sacrifice to be made in paying €19 per week.
For some people this would not even buy 40 cigarettes, or even four pints of beer. It is worth thinking that through if you don't have insurance. Ultimately, it is a relief that Fine Gael did not introduce Universal Health Insurance. I can't think of anything worse than a government-run system. Even the suggested premium was 25pc more than I pay now.
Ultimately, premiums and benefits will improve if more of us took it upon ourselves to ensure we are treated in hospital when we need to be treated and not when a bed becomes available two years down the line.
Would you walk into a motor showroom and demand a car, because you need one to get around? Why would you expect a free hip replacement because you need one to get around? Would it not be something you would plan for?
One hip replacement can cost anywhere between €12,000 and €15,000 - not including the overnight hospital fees, the consultant visits and the X-rays.
I wish I hadn't had to go through the pain of those operations, but it was some consolation to be covered. The public health system is there for those who genuinely need access, whether through lifelong illness or lack of means. But if you can afford four beers a week, it might be time to take your health into your own hands.