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Is the Irish healthcare system a monopoly?

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  • 26-02-2010 11:52am
    #1
    oq4v3ht0u76kf2
    Closed Accounts Posts: 2,028 ✭✭✭


    A random discussion got sparked between a friend and I last night on the question of whether the Irish healthcare system is a monopoly or not.

    Obviously, one of us believes it is and the other believes it is not.

    Briefly, the Irish healthcare system has a public side (HSE) and a private healthcare / private insurance market (VHI, Quinn, etc.) - all citizens are entitled to public healthcare, many opt to also purchase private health insurance.

    In the private market VHI, Quinn, and Hibernian / Aviva all seem to compete on price and features.

    People are free to choose any public GP they like (as long as the GP will accept them) with GPs charging between €45 and €80 a visit. Why is this not set by the HSE? Are GPs private or public?

    Public hospital visits cost a standard amount set by the HSE (a public body).

    Can it be argued that private healthcare in Ireland is a monopoly?

    Can a publicly provided service (the HSE) be considered a monopoly? Can it be considered anything but a monopoly?


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    #2
    RobFowl
    Moderators, Science, Health & Environment Moderators Posts: 11,667 Mod ✭✭✭✭RobFowl


    Private health care is not a monopoly as there are multiple different providers who you can choose from although the numbers are limited by the shortage of GP's and Doctors generally in Ireland compared to the EU average.
    Prices cannot be set by the HSE for Private Doctors including GP's.
    The HSE is allowed price fix as they are not (thanks Locum'motion) considered an undertaking by the competition authority and as such are exempt from competition law.


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    #3
    oq4v3ht0u76kf2
    Closed Accounts Posts: 2,028 ✭✭✭oq4v3ht0u76kf2


    So would most (all?) GPs be private entities entitled to charge whatever they want but generally sticking to a rough +/-€10 of €60?

    As far as I am aware, although feel free to educate me, there is a single entity responsible for granting licenses to practice medicine - can/do this body (presumably staffed by doctors) strictly limit the number of medical licenses granted each year thereby suffocating supply and increasing prices? Is there an economic term for this?


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    #4
    RobFowl
    Moderators, Science, Health & Environment Moderators Posts: 11,667 Mod ✭✭✭✭RobFowl


    Rayne Great Rucksack wrote: »
    So would most (all?) GPs be private entities entitled to charge whatever they want but generally sticking to a rough +/-€10 of €60?

    As far as I am aware, although feel free to educate me, there is a single entity responsible for granting licenses to practice medicine - can/do this body (presumably staffed by doctors) strictly limit the number of medical licenses granted each year thereby suffocating supply and increasing prices? Is there an economic term for this?

    Yes all GP's are entitled to charge pretty much what they want. The market tends to limit this though !.

    The medical council which issues licences to practice(certificates of registration) actually now has a majority of non'Doctors. The number of Doctors is limited by the State in terms of a limit on the numbers of places in medical school and then a limit on the numbers of training positions for GP's every year.

    If practicing Medicine in Ireland was attractive enough financially then presumably a large number of Medics trained abroad would be woving here when in fact the reverse is happening. This is largely to do with terms and conditions though not simply earning potential.


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    #5
    ergo
    Registered Users Posts: 770 ✭✭✭ergo


    don't forget though that the vast majority of GP's will be involved in taking care of medical card (GMS) patients and around now roughly 40% (and rising with unemployment) of the population are entitled to medical cards so it's important not to get too fixated on the private consultation fee being the main source of practice income, for many practices it may not be

    regarding medical school places well, I think the opposite is happening, they have effectively doubled the numbers coming through or about to come through so the market will be flooded with doctors and I'm not entirely sure where they are all going to go

    I'm not sure you can call the public hospital system a monopoly because technically speaking or theoretically anyway, they are competing against all the private hospitals etc and you have a choice about where you go (except after hours to A+E etc)

    back in the day, when VHI were the only player in town, now that was a nice monopoly


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