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The IMO in favour of universal health coverage
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Amhran Nua wrote: »
Hold on a minute, why should this be any harder for doctors from abroad than Irish doctors? If the bottleneck is training course positions, that should be relatively simple to rectify.
Training COURSE positions? No. Post graduate training is done in the form of being a junior doctor. A ....drum roll....Public Service Employee! Often joined to a union and everything. While overtime has been slashed, the government still has to pay them salaries and annual leave and all the other stuff for years while they are staffing the hospitals until they become consultants or GPs. So not only is it far from easy-as those coming from overseas as well as those from Ireland have to be Garda vetted, have their qualifications recognised, have the right amount of experience, be registered with the Medical Council on the appropriate register, and then the Dept of Health has to find the money to pay them. Scheme positions, especially Specialist registrar conditions- which is the training scheme that leads to consultancy, usually require that in addition to all of the above, one has their membership exams (which can only be obtained at a post grad level, while working in a hospital).
So, no, not at all easy to rectify.Amhran Nua wrote: »Sure, if you think privatisation would help you financially so much, why are you opposed to it? Do you think patient care would suffer? If you do, why is the Netherlands, upon which this policy is based, rated as the best in Europe?
Oh my goodness.
Well, this is a shocker, but not all people value financial gain ahead of everything, literally, everything else, people's lives, human suffering, morality etc.
Yes. I might stand to gain financially from working in a private hospital as opposed to a public one. However, we'll all be ice skating in hell before I work in one, as long as we have a two tier system. The exception would be if we all had universal health insurance, and all hospitals in the country were equal, and took all patients.
My position is: as long as I can make a living from medical care, enough so that I and my family do not suffer hardship, then that is the job I will do. More money at the expense of my moral beliefs holds no attraction for me. It never will. Most right wingers cannot understand that.
Opinion guy, sorry for the OTT reply.
I just get tired of the accusations over on P.ie that all junior doctors are on 100k, and they don't seem to have heard of the new (****e) contract either, so I tend to bristle when it's mentioned. 0 -
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Amhran Nua wrote: »Under the proposed system patients cannot be refused insurance on the basis of previous illness, and by risk equalisation won't pay much more. And if they can't afford it, they get subsidised. I see no moral difficulties here, patient care shouldn't suffer (quite the opposite with the Dutch system, it apparently gets better). Besides which, is jumping the queue not a problem already?
Jesus. I'm done here. But I just want to say you need to get someone involved with your party who understands health.
You can't just "allow more consultants". There are HUGE gulfs in standards and training internationally, so you cant just import as many as you like.
Private hospitals deal in profitable things. They will happily plough money into cataracts, adenoids and mole removal, as they provide lots of cash for straightforward procedures. But globally about 30% of healthcare resources need to be expended on the sickest 5% of the population. This subgroup are mostly unprofitable chronic disease patients, drug abusers and alcoholics. Private enterprise have zero interest in these patients. Zero. They will, as is the case in Holland, do the bare minimum for these people. But the old lady's arthritis pain doesn't register on their health stats. The fact that she's been prescribed some steroids will be though.
With universal health coverage, we wil still have the same amount of patients vying for treatment. The private sector don't provide better care then the public sector now, when they can cherry pick their patients, and they're going to find it difficult of they have to see the same patients as the public sector.
But making health the responsibility of the private sector means the end (or significantly reduced standards) of care for the elderly with chronic illness, abusers of alcohol and drugs, those with psychiatric illness.
We need free GP services, while giving the GPs an income that won't send them to the UK or Oz. But most of all we need to look at health A) in the long term and
in all it's facets (primary, secondary, tertiary care). It needs more resources. We need staff to come back from overseas. I've worked in Ozzie hospitals exclusively staffed by Irish and UK docs. There are enough Irish docs overseas to make huge dents in waiting times.
Harney needs to go, too. And really soon.
BUt the fact that you are king for "an evidence based country" to base our healthcare on means that I would never vote for you. Ireland has particular problems and a particular burden of disease that requires a solution tailored to Ireland. Pick and choose the good from other countries, but you don't just superimpose a Dutch model into an Irish situation.
The answer is highly complex, and is beyond the scope of a forum like this. BUt you need to wake up to the fact that the private sector doesn't provide better healthcare. It just cherrypicks and over-investigates. You also need to stop looking at simple tables as indicators of health performance, and look at detailed health indices.
This is highly complex. I know everyone on here has an opinion. BUt if you want to win the confidence of healthcare staff, hire senior healthcare staff to advise you on health.0 -
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I know its great isn't it ?Amhran Nua wrote: »Yes, large red underlined fonts make your argument more persuasive.
Its very easy to handwave away new ideas with terms like "reductionist" without looking into the details of those ideas first, which I am almost certain you have not. The Irish healthcare system, of which consultants form a small part, is not anywhere near optimal, so we're talking about ideas to address that.
Ok no I do understand the concept of free market, supply and demand etc. But unfortunately it doens't work for healthcare because as tallaght points out it maringalise those whose treatments are unprofitable. And you are being reductionist - incredibly so. I'd also say niaive.
Acutalyl I disagree with that. There sohuld be a nominal fee. Not the EUR60 as present, but say 20EUR. If its totally free the system gets abused.tallaght01 wrote: »We need free GP services, while giving the GPs an income that won't send them to the UK or Oz.Ireland has particular problems and a particular burden of disease that requires a solution tailored to Ireland. Pick and choose the good from other countries, but you don't just superimpose a Dutch model into an Irish situation.
EXACLTY! Amhran Nua your website says the Dutch spend twenty years refining their system. You can't just graft their end result on to the Irish system and expect it to work. We have a different starting place with different needs.tallaght01 wrote: »Can you send me a link for that. I joined p.ie there to see if their forum is any more sensible than here. Would be nice to actually discuss politics online again.
hahaha I alwyas assumed the users and politics.ie and baords.ie were the same people just with different usernames/personalities :P0 -
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I might point out that the Netherlands also has a fairly loose narcotics policy which attracts people from lots of other countries, bringing with them a host of their own problems, including poverty. Now, since you are quoting these numbers with some authority, I'd like to know the exact source you are getting them from, is there some sort of link you can provide?tallaght01 wrote: »But if you want to look into this more, look at WHO marginalised death rates (ie chronic disease death rates, and diseases associated with marginalised, poor groups), despite Ireland spending less per person on health than holland.. Ireland has lower diabetes death rates than Holland. We also have lower rates of old people dying from dementia-related disease. The 2 countries have almost identical TB death rates (a disease of poverty). Ireland has (marginally) lower HIV death rates (a disease seen in very high levels in our refugee population). The netherlands have significantly higher death rates resulting from psychiatric illness than Ireland. We have almost identical cirrhosis death rates, even though we have more cirrhosis.
Where are you getting the per capita rate of health spending for Holland?tallaght01 wrote: »I could go on. But Holland spend more on health than we do
You can say what you like, as long as its not in bold red underlined giant letters.opinion guy wrote: »Ok no I do understand the concept of free market, supply and demand etc. But unfortunately it doens't work for healthcare because as tallaght points out it maringalise those whose treatments are unprofitable. And you are being reductionist - incredibly so. I'd also say niaive.
Nonsense, the fact that they spent so long refining theirs means we can take advantage of their experience, not that we're starting from scratch. They aren't an alien species.opinion guy wrote: »EXACLTY! Amhran Nua your website says the Dutch spend twenty years refining their system. You can't just graft their end result on to the Irish system and expect it to work. We have a different starting place with different needs.0 -
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Sure, so I'm to take the random internet person's word for it.tallaght01 wrote: »I'm only posting this while watching TV, so I'm not going through all my stuff t get data. But the spending per capita will be easy to find on the WHO site (its about 3300 USD Vs 3100 per capita).
Yeah, compare our resources with the likes of FG, who advocate the exact same thing, and you might be surprised at what has been achieved. You still didn't address the point about the narcotics, however.tallaght01 wrote: »The disease data comes from a number of very important WHO reports that you should have read, and will be easy to find on their site, though you may have to order paper copies, or download massive reports But you should have done this work before now if ur a political party comparing irish healthcare with other countries.
At the end of the day, I genuinely don't believe that the institutional changes (particularly in administration and management) that are required in the Irish health service, to provide an optimal health environment, can be done as things stand. The reasons for this are well understood by everyone, I think, inertia among other things.
These changes need a different platform to move them forward.0 -
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Amhran Nua wrote: »Sure, so I'm to take the random internet person's word for it.
Yeah, compare our resources with the likes of FG, who advocate the exact same thing, and you might be surprised at what has been achieved. You still didn't address the point about the narcotics, however.
At the end of the day, I genuinely don't believe that the institutional changes (particularly in administration and management) that are required in the Irish health service, to provide an optimal health environment, can be done as things stand. The reasons for this are well understood by everyone, I think, inertia among other things.
These changes need a different platform to move them forward.
I don't care if you take my word for it. I work in Oz, so none of this affects me directly.
But you should be reading these reports. Doesn't require resources to read. Start with the world health statistics report is as good a place as anyone.
I don't understand your point about the narcotic issue. If you're arguing that Holland has more poor people than us, you may be right. I don't know. But drug users don't explain the cirrhosis stuff, the diabetes figures or the TB figures. I guess you'd need to examine gini coefficient data for the netherlands, to see how the wealth is distributed.0
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