Tuesday, 24 November 2015
Universal Health Insurance
I welcome the Minister to the House and thank him for coming in here to respond to my query on the plans or otherwise for universal health care insurance. I am sure he has responded to this matter in the Dáil and, if not, I am sure he will do so over the next couple of days. Of course, he has taken some media queries on the subject but it is useful that we avail of this opportunity for a brief exchange of views in the Upper House and I thank him for bringing some realism to the debate.
Everybody wishes that a magic wand could somehow be waved by a Minister and the Government in order that we would be in a position to put in place a perfect health care system and a perfect system for funding such care. Unfortunately, that is easier said than done. As long as I have been a Member of this House and the other House, the provision and payment or subsidising of health care has always been on the agenda. The matter has never been fully addressed and certainly not fully responded to.
It could be said, that over the course of the term of one Government or even two, it is possibly not easy to put in place a long-term system of health care delivery and funding. Therefore, we must think about what should happen beyond the lifetime of one, two or three Governments but start from a position of certainty.
Having had lengthy discussions here and elsewhere about Canadian, Dutch, Australian and every sort of model of health care provision, perhaps our new starting point must be to improve the current system, its funding, structures and delivery of service. Everybody concedes that once people access the health service in this country, notwithstanding the enormous challenges it is faced with, a very good service is delivered to the vast majority of citizens. The problem appears to be access and bed provision among other matters.
We must first address the improvement of the current system.Reinventing the wheel is fine. It has been tried by many Ministers and many Governments but it does not seem to have worked. If the Minister has brought the first phase of thinking on a universal health insurance to a conclusion, at least we know what is the new starting point. If I was lucky enough to hold the Taoiseach's position, I would say the same. He outlined last week that other possible methodologies of funding universal health care will be examined by the Government and the ESRI. No matter what report is produced, it will find that such a scheme will be very expensive. The days of expecting an insurance premium of €300 or €400 per person to cover universal health provision are long gone. The Minister was correct in pointing out last week that the concept of asking people to pay €2,000 or €2,500 for what would possibly be a basic cover package was not acceptable or politically expedient. I am interested to hear where the Minister thinks we should move next.
Everybody cheers about the concept of universal health insurance and the concept of universal health care itself but it must be funded. We are at a stage where we have to be realistic. The Minister and his colleagues in government are fortunate to be in a position where nobody expects miracles. Everybody must be realistic enough to know that health care is hugely expensive and there is no easy funding mechanism. We should look at all the options and everything should be on the table. However, at this stage, there is no point in tying ourselves into a universal health care insurance model as originally construed five or six years ago because, clearly, it does not appear to add up. I recall having discussions with the former Tánaiste and Minister for Health, Mary Harney, on the matter at a time when the political party of which I was a member was strongly advocating the Dutch health model and she strongly advised me of her dialogue with the Dutch health department and Ministers who were trying to move away from the scheme. I was always uneasy that we were going to introduce what we thought was the perfect system from a country which was already losing faith in that particular funding mechanism.
We have a blank sheet to work with to see how the present system can be funded better, administered better and work better. The glass is half full. On the whole, the people in the service do a very good job. A huge amount of work is done in the health service. We rightly hear of the hard cases, the people on the trolleys and the waiting lists. We must rid the system of those trolleys and waiting lists but I appreciate it is not easy.
I look forward to the Minister's initial observations on the future funding models and, perhaps, his broader plans. We cannot afford to be fixated on the concept of universal health insurance. It has been examined and people bought into it in good faith. It is not a sin to admit it was an impossible target to achieve and to look at other models both of a care provision and a care funding scenario.