Equity of Care?

April 26, 2009

Misdiagnosis and inappropriate treatment are common concerns for individuals suffering from a serious medical condition. In Ireland more than 1.5 million people can access a second opinion service at no additional cost to themselves. Best Doctors helps people facing serious illness to get the most appropriate care. It’s unique database has harnessed the knowledge of over 50,000 doctors identified by their peers as the best in their specialities. Access is available through three insurance companies in Ireland – VHI Healthcare, Hibernian Life & Pensions and Combined Insurance (IRL) – who pay an annual fee for the service.


The service operates as follows. An insured person who is diagnosed with a serious illness, has the option of having their case reviewed by Best Doctors. On the patient’s request, the health insurance company arranges for Best Doctors to contact the patient. A Nurse Advocate is then assigned, who contacts the patient or their doctor for a copy of all the patient’s medical records. Using their database, Best Doctors identify the most appropriate specialist from around the world to assist in reviewing the patient’s case. The selected specialist(s) comprehensively reviews the test results, diagnosis and prognosis and a report is sent to the patient and their doctor. Doctor patient confidentiality is maintained at all times throughout the process. Patients wishing to have Best Doctors review their medical file continue to have medical care with their own consultant who now has the back-up of other world renowned specialists.

This all sounds very reassuring until you realise that almost 50% of the Irish population hold no insurance cover added to which, not all health insurance companies pay into the scheme. Surely every patient facing serious illness, should have access to the best and most appropriate care available? Do all patients not deserve access to the skill, experience and insight of these highly trained doctors? Nope, sorry! Unless you’re a member of an insurance company which is participating in the scheme, access is denied. It seems care is given based on a person’s ability to pay for health insurance instead of their medical need. There is a fundamental struggle going on over the soul and shape of Irish healthcare.