Mick Wallace (Wexford, Independent)

I also used to be in the VHI, but a couple of years ago I decided that the system left a lot to be desired, so I opted out of it. About two months ago I had to get an operation on my arm and I went to Beaumont Hospital under the public system. The only problem was getting in there, but once I got in, the people were so nice. The surgeon was wonderful and the nurses were fantastic. It seems to be accepted that we have a fantastic system, if we could only get into it. The notion that we can get better care under the private system than the public system needs to be questioned.

Approximately 47% of the public pay for private health insurance at the moment, but the State is paying 90% of their care. The main reason for people to opt for private health care is a fear that they will not get into the public system in time. Private health insurance allows them to be bumped up the waiting list. Most people who take out private health insurance are not looking for extra privileges, but they are afraid that they might have to wait too long, given the need for some serious medical treatment.

I recently read a very good article by Fintan O'Toole, and I would like to finish by quoting some of it:

There are, for example, four different categories of patients: medical card holders, who are entitled (in theory at least) to fully free services from GPs and in public hospitals; "dual cover" patients who have both a medical card and private health insurance; "non-covered" patients who have neither a medical card nor private health insurance; and patients with private health insurance only. How could such a system not require a vast bureaucracy to run it and how could it not lead to inefficiencies?

As with so much else, however, this vicious and absurd system was tolerated so long as the middle classes could afford to manoeuvre their way around it. But the illusion that middle class people could actually benefit from systematic inequality was just another Celtic Tiger con job. What was actually happening was that middle class people were being conned into paying twice – through taxes and private insurance – for an inadequate, inefficient and unfair system.

A system that depends on people paying again for services they have already paid for through taxation is inherently unsustainable. It is now unravelling. No amount of insurance can buy you out of an overcrowded A&E. And the cost of fattening up the VHI for privatisation is simply too high for most people to pay.

The truth is coming home: the rotten injustice of our health system is bad even for those who thought they could avoid it. A fair, one-tier system of social health insurance is not just less shameful and better for the poor. It is also more rational, more efficient and better for everyone.

See this speech in context