‘Cos you deserve better

Have you noticed the sudden upsurge in radio and TV ads for private healthcare? Frankly, they sicken me.  “Because you deserve better” quotes one ad for a state-of-the-art private hospital. Because who exactly deserves better? Answer: Those who can afford private health insurance. But what about those who can’t, I ask? Don’t they deserve better too?

jack and jill

I hold private health insurance and I make no apology for it. I’ve a complex medical condition which requires regular medical supervision. Unfortunately, I cannot rely on our public health service to provide the care needed. Our health system has been so stripped of services that ‘public’ patients face long delays in accessing out-patient appointments and treatment. Privately insured patients can access care faster by paying for it. Such is the inequity of a 2-tier health service. Emergency care is different, it’s provided on the basis of need only. The delay in the public system, is putting people’s lives at risk. Remember Susie Long? I’m not prepared to risk my health because of our government’s failure to provide an equitable health service for all. I therefore see my health insurance as a priority, not a luxury. I choose to do without other non-necessities in life so as to afford the health insurance. I’m lucky to have that choice. Many don’t.

In these difficult times of recession, many people are struggling to maintain a roof over their heads/to afford enough food to feed the family. The advertisements for private healthcare appear very inappropriate in the circumstances. Of course, the real reason why these companies are advertising, has nothing to do with your welfare or mine. They are desperately trying to survive too.

Our Minister for Health has gone terribly quiet!

17 Responses to ‘Cos you deserve better

  1. Baino says:

    Hmmmmm . . .pay $528 a month for private health care “Because You’re Worth It” . .bloody expensive it is too! Frankly Health, Life and income protection insurance take up half my pay packet. I hate it!

  2. Steph says:

    Jeez! Baino – That’s about €300 a month! That’s a lot more than we pay here in Ireland. Mind you, it only takes one trip into hospital for surgery/treatment to realise the true cost of healthcare.

    The point I was trying to make in the above post, is that I have health insurance purely so that I can access medical care promptly. I’ve no interest in using private hospitals with cushy accommodation and á la carte menus. While these places are usually highly efficient, they do not necessarily offer the best medical care. I’d much prefer to pay into a system of universal health insurance which offers equitable healthcare for all.

  3. Nancy says:

    Hi Steph,

    I’m sure you know that the Universal Health Care Plan has caused a major uproar here in the U.S. Some desperately want the government to provide health insurance for everyone and others are terrified that their taxes will go up to the sky to pay for it. So the argument rages.

    My former DIL told us about a year ago that she was going to retire from school teaching this year. She has been teaching First Grade for 30 years. Yesterday she told us that if she retired she would have to pay her own health insurance for herself and her husband who recently lost his job.

    The cost to her each month would be $1,200. That is $14,400 a year just for health care. They can never afford that and they are both 57 years old and our Medicare (health benefits for those over 65) would not help them for 8 years.

    So, guess what? She starts her 31st school year in September and retirement is not in the cards anymore. It is far in the future unless President Obama is successful in passing his Health Care Reform Bill. Most us us hope that the Senate will pass the bill in honor of Senator Ted Kennedy. This health care for all has been his dream for many years…..

  4. Steph says:

    Nancy – Well-said! I’m following your healthcare debate with great interest.

    I’m sorry to hear about the reality of retiring in the US. I’m also sorry to hear that you’re talking about your ‘former’ DIL.

    RIP Ted Kennedy

  5. Nancy says:

    Steph,

    Yes, Patty is my former DIL. She and our son, Chris, have been divorced for 29 years and both remarried. We have stayed very close through all these years because we loved each other and our Grandson, Francis, was involved. Patty and her husband,Tim, had two more children together and those two kids think of Roy and myself as another set of grandparents…

  6. Lily says:

    I was so aware of Susie Long when I recently had the colonoscopy and thought how unfair it is that access to these procedures is based on having/not having health insurance rather than medical need. Like you I consider medical insurance a necessary expense because of the failings of our public health system.

  7. Steph says:

    Nancy – That last comment of yours, confirms something I’ve suspected all along… that all who come to know you, adore you! 😀

    Lily – Susie always said that they could not afford private health insurance “but even if we could have we wouldn’t have gotten it because we believed (and still do) that all people should get good care despite their incomes. We thought jumping queues was wrong”.

    Susie was right – queue jumping is wrong but so are the long waiting lists which caused her untimely death. Susie was a brave woman to stick by her principles but she paid the ultimate price, sadly.

    As I’ve already said in my post, I make no apology for holding private health insurance. I’d much rather pay into a social insurance funded system of healthcare which serves everyone but as I don’t have that choice, I choose to protect my own little patch. I prioritise my healthcare. Some choose to throw caution to the wind until forced to face the reality when illness/an accident strikes. Others, of course, don’t have any choice and continue to be discriminated against by our apartheid system of healthcare.

  8. annb says:

    Well said Steph. I get these knowing looks from people when they hear of our struggle to access Speech and Language therapy. They nod and mutter that of course “they would have gone private”. What they don’t realise is the multidisciplinary approach required in many complex cases is just not available privately. Give me a public teaching hospital any day over the plush lounge and a la carte care offered at high cost in the private sector.

    I’m of the “L’Oreal school of health care” – access for everyone to everything ‘ because you’re worth it!”

  9. mike says:

    Steph and Nancy
    Think of the ‘problem’ in another way. Who is going to fund the shortfall of services not being provided by the HSE or the gap in the US heathcare system left in between Medicare (for the over 65s) and Medicaid (for the ‘poor’)? And what would be the cost? in Ireland €1bn p.a.? or €10bn, or what?
    Next what would be the effect? More doctors/ nurses and other professionals, more equipment, more hospitals,less queues, better outcomes, more early diagnoses/ prevention, access to many more drugs.
    But, the real question remains. How would we ever know what the cost would be, if the more healthcare you provided, the more of it was demanded. What and how is treatment to be rationed. In the US, as I understand it, average spending on health insurance per capita is $8k, whereas in the UK it’s $3.5k (I don’t know the figures for Ireland). There is little rationing in the US in terms of healthcare provided (because it is felt that the insurance companies will pay). Healthcare costs are growing about 3% faster than the whole economy, and that is unsustainable. The HSE, and NHS (in the UK) ration by the old fashioned queuing system, and by regulatory restriction. NICE ‘decides’ which drugs will be a health benefit (to the patient) and of economic benefit (i.e. is an extra 3 months extention to someone’s life be worth the cost.) And, I have no idea how they justify some of their decisions, except, purely on cost grounds. The queuing system is effective at rationing only in the sense that it delays expenditure (but it could easily be argued that it increases expenditure in the long term as early diagnosis and treatment is cheaper than late treatment).
    If we look at cancer survival rates as an indicator of, say, effectiveness, or maybe just amount, of healthcare spending the US is way out on top at 63% for female and 66% for male. Ireland is 17th on the list for F and 12th for M, whereas England (the UK is broken down into individual countries) is 16th for F and 15th for M. (Those are oldish data (2000-2002), as I couldn’t find up-to-date rankings. I think more recent ranking place the UK much lower in the pecking order.) So, maybe there is a clear case to be made for little rationing, and lots of expenditure. But…How much? Should there be any rationing? How should the rationing take place? And, is it to be funded ultimately by the tax payers, or in the short term by government debt. Has anyone estimated the costs of improving the HSE such that it could provide near perfect service.
    So, as annb has said, ‘access for everyone to everything’sounds great, until we look at how it can be funded, it will have to sit alongside ‘advertising speak’ such as ‘because you’re worth it’ or, insultingly as Steph has pointed out ‘because you deserve better’. I think some analysts are required to look at these funding issues, and then the governments should propose ways of how to fund them, and ultimately the voting population decides on whether it likes the proposals….Power (or in this case, Rationing) to The People. (Hey, is that what Obama is proposing?!)
    Otherwise we continue to say, “Should do better, could do better, must do better” indefinitely.
    Hey. Hi to Jeanie, Charlie and Zoë.

  10. Steph says:

    Ann – You’ve totally hit the nail on the head with your comment. Private hospitals are not regulated and cannot provide the multidisciplinary approach needed for complex cases. The new co-located hospitals (if ever built) will not only duplicate services but will also ‘cherry pick’ the least complicated cases for transfer from A&E. Patients requiring complex medical care will always remain in the public system, regardless of insurance cover. I’ve always maintained that our health service should be ‘one for all, and all for one’. Privatisation will be the ruination of healthcare in this country.

    Mike – Hi! And your point is?

    In a nutshell, Ireland really needs to implement a system of universal healthcare. Here’s an example of ways it can be funded…

    http://www.wisegeek.com/what-is-universal-health-care.htm

  11. Annb says:

    Sorry Steph but Mike’s comment has been playing on my brain for a few days. I’m really not quite sure what he’s trying to say. I would like to know the source of some of his stats as they don’t really rank up for me. He talks about US survival rates for cancer, is that only among people who were insured and therefore received treatment? Does it also include those who just turned up dead from ‘treatable’ cancers because they couldn’t afford either diagnosis or treatment? When does a patient actually enter the stats race? When a system is as inequitable as that of the US, one would have to really question the data provided.

    While I understand that this must be paid for – taxes and universal health insurance, as you yourself point out regularly, would be an obvious route to take.

    I am not taking a naive, lets all love each other approach, I’m simply of the mind that access to good affordable health care is a basic human right and not a commodity to be bought and sold. While there are many things in this life that benefit from privatization and free market competition, education and health are not suited to this system. Human rights are not commodities to be traded, rather they are the corner stones of a civilized democracy.

    I personally would prefer to be closer to the Berlin model than the Boston one when it comes to civilized democracies.

    Sorry but I had to get that off my chest!

  12. Steph says:

    Ann – I wasn’t really sure what Mike was on about so I didn’t enter into his debate.

    I, like you, felt that he was talking about healthcare as a commodity which is to be rationed according to funding rather than provided on the basis of need. This is the very core of the problem with our government’s health strategy. Look at the waiting lists at Crumlin Children’s Hospital for spinal surgery. Children’s lives are being ruined by the failure of this government to provide adequate healthcare.These children need surgery urgently and they can’t wait until funding is put in place. It’s scandalous!

    Now I’m all hot and bothered 😡

  13. mike says:

    Like it or loathe it, health provision, like education, IS a commodity. And, commodities have prices.
    Most of us believe, Steph, Ann and myself included, that educating children is a human right for all.
    (I say most of us, because there are some parts of the world where it is still thought inappropriate to educate girls/ women, unlike in the West where the poor and females are considered, since the second half of the last century, eligible for education and to vote. However, even in the West, there are people who believe that although education should be freely available to both sexes, what women should be allowed to do with their learning is quite a different matter. Quoting from 1 Timothy 2.11&12 “A woman should learn in quietness and full submission. I do not permit a woman to teach or have authority over a man; she must be silent”. I hasten to add that I do not support these teachings in any shape or form. But, hey, I have digressed yet again.)
    Most of us believe too that health provision is a human right; that good health should be available. If we would like universal healthcare, and by that we mean the best care money can buy available to everyone, then funding needs to be found to provide it. If, by “universal healthcare” we mean as much healthcare as we can afford to give everyone, we need some way of rationing it. Steph in the past, on your blog site Health Access 26 Mar 09, you have advocated rationing in favour of people who are not fat, and who don’t cause health problems for themselves through alcohol and drug abuse. Often there are underlying (and often undiagnosed) health issues in those categories of people that you might wish to exclude. I’m merely saying that some form of rationing needs to take place.
    The point I’m making is that governments have really only got two sources of income – taxation and debt. They also have some limited ability to switch spending plans from one area to another. So, although “universal healthcare for all” is a nice mantra, I think what is meant is “improved healthcare for all, or for as many as possible, which could be rationed in a farer way than just on a person’s ability to afford it”. It doesn’t have quite the same ring to it. And, improved healthcare for more people needs to be funded, either from taxes of government borrowing. That’s really all that I’m saying. I hadn’t intended to ruffle feathers
    By the way, I would imagine that the ‘survival rate’ statistics refer to patients who have presented, or been diagnosed with cancer, and their survival or otherwise at a point 5 years later. The 5-year point is an arbitrary but commonly used time frame in which to judge efficacy of treatment, for instance, and is often used in discussions about survival rates too.

  14. Steph says:

    Mike – My mantra is universal and accessible healthcare for all, on the basis of need. The present government policy to privatise healthcare, has created an apartheid health service. Did you realise that private healthcare is unregulated and unmonitored in Ireland?

    I have always proposed that we should have a universal healthcare model funded by a social insurance fund which everyone is required to buy into through paying higher taxes. We have never paid enough for the really good quality health system that is required. Those who cannot afford/do not pay taxes would be assisted by government subsidies. If they can achieve universal healthcare in other countries, why can it not be implemented here?

  15. Annb says:

    Just 2 points Mike: 1. universal health care is possible, even practical, with some restraints of course, this is not a naive fantasy Island wish list. There are clear precedents, such as the nordic countries or Holland. 2. citing 5 year survival rates for cancer from the US is not representative of the population as a whole, it is only representative of those who can afford treatment. Do you have the survival rates for those who presented with cancer but without insurance? I think it would be interesting to compare with the survival rates of Irish people without insurance presenting with cancer.

  16. mike says:

    So, back to my original post. What would be the cost in Ireland of providing universal and accessible healthcare? €1bn pa,€10bn pa?, and what would that mean for ‘Joe the Plumber’ in terms of tax increases?
    Would an Irish Government be able to raise taxes significantly, from the present levels to the higher ones similar to those in Scandinavia? What would be the implications for the rest of the economy if everyone had to pay, say 60% tax, on all income over, say the first €5k? (I am just guessing at the tax levels because I have no idea of either the cost of such healthcare provisions or of how much revenue is currently generated from tax payers. Maybe the tax payer would have to pay tax at the rate of 75%.)
    Why hasn’t any Irish government ever proposed such a move? Possibly the answer lies in the fact that most tax payers would not be prepared to make such a contribution. The outcome would be a swift voting out of the government who dares to propose it.
    ( A minor point, but worth mentioning, whereas the social insurance fund would benefit from the government assisting those who cannot afford/ do not pay taxes by making payments on their behalf, the poor tax-paying public get to bear an even greater burden, because that’s where the government gets its revenue from.)
    I think those analysts that I mentioned in my original post are required to assist in coming up with some estimates of cost, and some estimates of tax burden, and to describe the effect on the Irish economy of those changes. Any analysts out there will to take on the challenge?

  17. Annb says:

    How much do we pay already between PRSI, private health insurance, regular GP visits and pharmacy costs – when all taken together, we may find that it may amount to the same as the necessary increased taxes.
    Of course universal health insurance we would still need to build in the element of choice – as with the French system.
    It is difficult, but not impossible – I think when we take all of the indirect non income related taxation we already pay VAT VRT, council charges etc I would imagine that our level of general taxation may not be that much higher than Scandinavia. They just have a more transparent system.
    It’s worth exploring.

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