Should Private Health care exist in a democratic society/ Pros and Cons of PMI

Don Keypunch

Should ones ability to pay have an influence on the type and ease at which they access health care?

Should we not all be treated the same?

Sigi

Yes

No

MagicMarker

No

Yes

epgc3fyqirnbsx

Good question. I think we should be able to wrap this one up tonight

MultiUmm

Healthcare is something that should never be considered a luxury.

Poorer people get sick just as easily as someone who's wealthier might.

Why should good healthcare be a privilege? For God sake, we're talking about peoples lives and well-being, having a two-tier system basically tells less well off people that their lives are pretty much less valid than those who have money to pay for insurance.

Although compared to the current system in the US, Ireland is pretty damn egalitarian in terms of healthcare. Still not half as good as other European nations though.

-Awaits barrage of accusations of being a commie pinko liberal PC brigade lover-

My name is URL

Private healthcare should take some of the burden off paying for public healthcare imo. Higher taxes for insurers maybe

The fact that the same level of care isn't available in both is down to how resources are managed mostly. Go into any private hospital and you'll notice that it's run more proficiently

Princess Consuela Bananahammock

Do you think the HSE would be as bad as it is if Mary Harney had to get the same public treatment as the rest of us?

plein de force

No
No

Kev_ps3

Title should read
Should Private Health care exist in a fair, modern, wealthy society/ Pros and Cons of PMI

The_Minister

Ikky Poo2 wrote: »

Do you think the HSE would be as bad as it is if Mary Harney had to get the same public treatment as the rest of us?

Both her parents died in public hospitals.

As for why the HSE is so bad; you can't reform something if everyone ****s a brick everytime you try and fire someone who literally has no role.

rossie1977

of course private health care should exist for those willing to pay for it

should the junkie on the street that gets into fights every day and adds nothing to the economy be treated the same as the ceo who creates thousands of jobs??

epgc3fyqirnbsx

The_Minister wrote: »

Both her parents died in public hospitals.

As for why the HSE is so bad; you can't reform something if everyone ****s a brick everytime you try and fire someone who literally has no role.

It's essentially this! How can something ever be efficient if you cut away the unproductive costs

Kev_ps3

rossie1977 wrote: »

should the junkie on the street that gets into fights every day and adds nothing to the economy be treated the same as the ceo who creates thousands of jobs??

No, he should be in prison.

MultiUmm

rossie1977 wrote: »

of course private health care should exist for those willing to pay for it

should the junkie on the street that gets into fights every day and adds nothing to the economy be treated the same as the ceo who creates thousands of jobs??

The same CEO's such as David Drumm from Anglo Irish?

Yeah, those CEO's sure did the country a wealth of good in terms of employment.

The_Minister

Don Keypunch wrote: »

Should ones ability to pay have an influence on the type and ease at which they access health care?

Should we not all be treated the same?

I posted this before.

The relevant piece is this:

Now I'm going to try and explain why private healthcare is not just nessacey - it is inevitable. This is based on the most basic medical care scenario. In real life people choose private health care for numerous reasons, most often comfort (private room/food etc) or speed of access, or to get a more expensive but more effective/less uncomfortable treatment), but I am going to use a life or death scenario, just to explain why there will always be some kind of private system.
This is not an explanation of Harney's policies in particular.

I may not explain this well, so other people please chip in.

First, some assumptions:
1. Resources are limited (Most people accept that).
2. The government does not control all resources (ditto, except the Communists).
3. Not all resources are spent on health, and to spend all resources on health would be undesireable (people also want education, social welfare, roads etc).
The 3 assumptions above mean that there is a cut-off point to healthcare - after a certain amount, the government has no more to spend. It can borrow against future resources, but it will have to pay that back, so it is unlikely to, unless it has no choice, because it is tying its hands in the future.

4. All lives are equal to the public health service.
This means that there must be a cut-off point for an individuals health care. For instance, if you spend €1,000,000 curing me of a fatal disease, but that money spent elsewhere would save maybe a hundred lives, then you should spend it to save the hundred (assuming that the health service cannot afford €1,000,000 per patient). If all lives are equal, and there is insufficient resources to cure both groups, then 100>1, ergo you save the 100.

5. This is the hard one. The public health service is concerned with saving lives all across society, not just those that it treats. Its goal should be to maximise the number of lives saved in society.

Now, the above assumptions, all of which are true in all Western countries, mean that a private service is inevitable. Why?
If there is a cutoff point for treatment, or (more realistically, a cutoff point from the best possible treatment), then there will be some people who will fall outside the the cutoff point, who will have their own resources, enough to purchase the treatment.
They have two choices:
1. They can choose to die.
2. They can go to a doctor with their resources, and purchase the treatment from them directly.

Even in countries where they made private healthcare illegal, there was still private healthcare, since people had nothing to lose by defying the government, and using their own resources to get the treatment.
This alone means that there will always be a private service.
Add to that that people are willing to pay extra for the private room and food, it is unlikely that any society could ever have no private healthcare.
Some argue that this healthcare should be banned as it is unequal, but in a free and liberal country, if private citizens want to pay extra to have better healthcare at no expense to the State, can they be forbidden?


The arguement that people use for having both a public and private system, is that if people go private, then less people are using the public system, so the resources in the public system are more concentrated. Harny herself said yesterday that (really rough quote) "The rich can look after there own healthcare, it is the disadvantaged who the state needs to watch over". The basic idea is that the government should focus on minding the "poor" directly, and allowing the "rich" (which is really anyone of middle income or higher), to use their own resources to decide their own healthcare.
This should, economically speaking, lead to more lives being saved among both the "well-off" (again middle-income rather than millionaires), because they can purchase super-fancy healthcare/ different treatment/extra face-time with doctors/ different food etc., while the "less well-off" benefit because they get more resources/ get to use facilities purchased by private individuals/ get to benefit from new techniques that are only developed due to private money*.

*For instance the author Terry Pratchett dumped €1,000,000 into research into his rare neurological illness recently - any benefit from that will be shared among all people with the disease.

The above is a crash course in some ideas in Health economics.. It is by no means exhaustive, nor does it even begin to cover the complexities of private versus public issues. There are whole journals dedicated to that.
The basic point that I am making is that a purely public system (which some people are calling for), is unworkable, retrograde, and would cause more people to die.

I'd write it differently today, but the basic points are still true.

MagicMarker

rossie1977 wrote: »

of course private health care should exist for those willing to pay for it

should the junkie on the street that gets into fights every day and adds nothing to the economy be treated the same as the ceo who creates thousands of jobs??

I see, only rich CEO's who create jobs gets the good stuff?

What about a CEO who cuts 1000 jobs?

Don Keypunch

The_Minister wrote: »

Both her parents died in public hospitals.

As for why the HSE is so bad; you can't reform something if everyone ****s a brick everytime you try and fire someone who literally has no role.

YES

Don Keypunch

Are we destined to have a two tier system forever?

Donkey Oaty

Don Keypunch wrote: »

I may not explain this well...

I agree with that bit.

mgmt

I think we should move to a complete private system. The government should be given very limited powers. Give liberty back to the people.

Teutorix

Two tier system and people complain? what about the millions of americans who have NO HEALTH CARE, count your blessings.

Stinicker

Private Healthcare should exist and Public healthcare should be abolished, it is a sad time in our civilisation when the working person and entrepreneur has to part with his hard earned cash to pay for the health of someone else and to keep others on the dole.

Cut the Public Healthcare system and every man for himself.

Richie860504

Jebus, AH got very serious since I was on it this afternoon.
Is boards.ie getting sued again?
That's it, isn't it?

rockmongrel

Teutorix wrote: »

Two tier system and people complain? what about the millions of americans who have NO HEALTH CARE, count your blessings.

Ah yes, the old things are **** here but ****ter elsewhere argument. Perish the thought that we should try to improve things.

Teutorix

Stinicker wrote: »

Private Healthcare should exist and Public healthcare should be abolished, it is a sad time in our civilisation when the working person and entrepreneur has to part with his hard earned cash to pay for the health of someone else and to keep others on the dole.

Cut the Public Healthcare system and every man for himself.

SO as the rich get richer they should support the less well off LESS? If a child is born with cerebral palsy and you come form a socially challenged background, never had to opportunity to go to university your child should be put down rather than be supported by state healthcare? wtf is wrong with you?

rockmongrel wrote: »

Ah yes, the old things are **** here but ****ter elsewhere argument. Perish the thought that we should try to improve things.

Erm explain how getting rid of private healthcare makes things better, considering the god awfull state of our pulic health service it would make things much worse. Private medical bills support the healthcare system, if they were abolished the government would have to spend billions to keep the hospitals afloat.

ascanbe

People who wish to and can afford to, should be able to avail of private health care; but private and public should be entirely separate.
Doctors who choose to work in private health-care should not be given work in the public system and should not be allowed use public health-care facilities.

My name is URL

Stinicker wrote: »

Cut the Public Healthcare system and every man for himself.

Sounds like a plan.. the more that die, the less sick days will be taken.

What % of people avail of private healthcare atm? Do you even know what private healthcare means!

ascanbe

Stinicker wrote: »

Private Healthcare should exist and Public healthcare should be abolished, it is a sad time in our civilisation when the working person and entrepreneur has to part with his hard earned cash to pay for the health of someone else and to keep others on the dole.

Cut the Public Healthcare system and every man for himself.

Using that logic, why have any government at all?
Every man for himself?
Barbarism, in other words.

Teutorix

ascanbe wrote: »

People who wish to and can afford to, should be able to avail of private health care; but private and public should be entirely separate.
Doctors who choose to work in private health-care should not be given work in the public system and should not be allowed use public health-care facilities.

Good money is paid for the use of the public facilities, as i said in my previous post, private fees are instrumental is keeping public hospitals running.

rockmongrel

Teutorix wrote: »

Erm explain how getting rid of private healthcare makes things better, considering the god awfull state of our pulic health service it would make things much worse. Private medical bills support the healthcare system, if they were abolished the government would have to spend billions to keep the hospitals afloat.

I wasn't making any point in the debate, just pointing out the ridiculous fallacy of your argument.

Stinicker

My name is URL wrote: »

Sounds like a plan.. the more that die, the less sick days will be taken.

What % of people avail of private healthcare atm? Do you even know what private healthcare means!

The attitudes towards this industry is asymptomatic what is wrong in the very core of Irish society, the troglodtyes in this country have no sense of any responsibility or striving to better themselves, all they care about is begrudging anyone better than him and backing the marxist sh1te that emanates from liberal politicans and trade unions.

In America if a person has a nice house, nice car, hot wife, successful job or business the average person will think well fair play to him, I wish I could better myself as well as he did.

In Ireland the caveman mentality is; someday, someday I'm going to get that c*nt and teach him a lesson, plus tis all borrowed money, I probably have money than him.

This is what is wrong in Ireland, and the oafs perusing Universal Healthcare are only helping destroy our freedom, liberty and successfulness.

DundalkDuffman

Teutorix wrote: »

Good money is paid for the use of the public facilities, as i said in my previous post, private fees are instrumental is keeping public hospitals running.

How do private fees fund public hospitals? I know from experience that any private fees are for the consultants only, the hospital doesn't get any slice of it. The reasoning that some of these consultants can use equipment, resources, staff on a public hospital is that it is built into their contracts, they are then only allowed to do a certain percentage of private in addition to their contracted public work.

ascanbe

Teutorix wrote: »

Good money is paid for the use of the public facilities, as i said in my previous post, private fees are instrumental is keeping public hospitals running.

Private companies are obviously getting a very good deal on using public facilities; otherwise they would develop their own.
Separate the two systems and there is no reason that the two won't sustain themselves; at the moment, what we have is a mess.

Teutorix

ascanbe wrote: »

Private companies are obviously getting a very good deal on using public facilities; otherwise they would develop their own.
Separate the two systems and there is no reason that the two won't sustain themselves; at the moment, what we have is a mess.

I dont think the government could afford to support all of the public hospitals given the current state of our finances.

ascanbe

Stinicker wrote: »

The attitudes towards this industry is asymptomatic what is wrong in the very core of Irish society, the troglodtyes in this country have no sense of any responsibility or striving to better themselves, all they care about is begrudging anyone better than him and backing the marxist sh1te that emanates from liberal politicans and trade unions.

In America if a person has a nice house, nice car, hot wife, successful job or business the average person will think well fair play to him, I wish I could better myself as well as he did.

In Ireland the caveman mentality is; someday, someday I'm going to get that c*nt and teach him a lesson, plus tis all borrowed money, I probably have money than him.

This is what is wrong in Ireland, and the oafs perusing Universal Healthcare are only helping destroy our freedom, liberty and successfulness.

Amateur psychology and libertarian posturing; there's already plenty of that on boards.

ascanbe

Teutorix wrote: »

I dont think the government could afford to support all of the public hospitals given the current state of our finances.

The government can't afford to do anything given the current state of our finances; that doesn't mean that people discussing how the country should be run should abandon all aspirations.
What i'm proposing could only be implemented when/if the country esatablishes a sound financial footing and could only be run successfully if accompanied by sound financial managememt; a coherent fiscal policy, in other words.
I'm not suggesting it could be implemented tomorrow.

Don Keypunch

Do people die because Consultants favour working in theie private practice over public hospitals?

Prof.Badass

Don Keypunch wrote: »

Are we destined to have a two tier system forever?

Yes. However that does not mean there should not be public healthcare.

Healthcare should be a basic right, paid for by taxpayers and guaranteed to every citizen (rich and poor). However, people should also have the right to provide and avail of private healthcare should they wish (this is basic freedom). The % of people using the public system should be taken as an indicator of how good it is (however, no matter how good the actual healthcare is, some people will always be willing to "go private" for a more spacious room/better food/ tv to themselves (with more channels) and whatnot).

In case you think this means increased taxes, not neccesarily. Ending the farce that is the war on drugs would free up loads of money we could use on a decent, free public health system .

eightyfish

Don Keypunch wrote: »

Should Private Health care exist in a democratic society?

People should be able to use their money for whatever they want in a democratic society.

twinQuins

Stinicker wrote: »

the oafs perusing Universal Healthcare are only helping destroy our freedom, liberty and successfulness.

You can't make this shit up.

thebigbiffo

abolish the HSE and essentially pay the entire health budget to a privately operated company - or a few of them.

the hse is run like **** and full of wasters (on the administrative side) and is nothing short of wasteful. it should be run like any private company, end of.

RATM

There was a report out only 8 weeks back that said for an extra 3% in taxation the nation could viably pursue a policy of universal health care along the lines of the European model. Harney outright rejected it because her political ideology is in favour of the American model, which has so far proven to fail many milions of Americans.

Private healthcare is always going to be present and so it should be. But at the core of this whole problem is the way in which the HSE is run- if it was in any way efficient and the public had confidence in being treated quickly and without difficulty then the demand for private insurance would be less. But as it stands it appears to me that people are almost scared into taking private healthcare when they read about such horrific injustices in the health care system such as that of Susie Long.

thebigbiffo

RATM wrote: »

There was a report out only 8 weeks back that said for an extra 3% in taxation the nation could viably pursue a policy of universal health care along the lines of the European model. Harney outright rejected it because her political ideology is in favour of the American model, which has so far proven to fail many milions of Americans.

Private healthcare is always going to be present and so it should be. But at the core of this whole problem is the way in which the HSE is run- if it was in any way efficient and the public had confidence in being treated quickly and without difficulty then the demand for private insurance would be less. But as it stands it appears to me that people are almost scared into taking private healthcare when they read about such horrific injustices in the health care system such as that of Susie Long.

that'd be another 3% of my money wasted by imcompetent, lazy and selfish civil servants, no thanks

eightyfish

RATM wrote: »

There was a report out only 8 weeks back that said for an extra 3% in taxation the nation could viably pursue a policy of universal health care along the lines of the European model.

Where did you read that? Let's just presume that, as all things in Ireland, this would fall over budget and say a more realistic figure is 5%. Can you imagine the reaction to a 5% increase in taxes in the current... ahem... "economic climate". There'd be uproar.

The HSE is a stinking mess, though. I don't blame Mary Harney really as she inherited an already dysfunctional system and she probably has the least-rewarding job in the country.

HavingCrack

eightyfish wrote: »

Where did you read that? Let's just presume that, as all things in Ireland, this would fall over budget and say a more realistic figure is 5%. Can you imagine the reaction to a 5% increase in taxes in the current... ahem... "economic climate". There'd be uproar.

The HSE is a stinking mess, though. I don't blame Mary Harney really as she inherited an already dysfunctional system and she probably has the least-rewarding job in the country.

To be honest if a 5% increase in taxes led to an Ireland that coudl be considered a world leader in health/education/public transport etc I'd actually say quite a few people might actually support it. However, this is Ireland and our current government has proven time and time again that they just squander hard earned tax payers money so this is a non starter.

Stinicker wrote: »

This is what is wrong in Ireland, and the oafs perusing Universal Healthcare are only helping destroy our freedom, liberty and successfulness.

While I can support some Libertarian standpoints this is just ridiculous. I personally know a family who have a child with Down syndrome. Without the support of public healthcare they would never have been able to cover the costs of their childs educational and healthcare needs. It literally was not an option. If you can explain to me what the Libertarian view would be on this individual case (remember you support everyone for themselves) Id be satisfied.

vinylmesh wrote: »

Yes. However that does not mean there should not be public healthcare.

Healthcare should be a basic right, paid for by taxpayers and guaranteed to every citizen (rich and poor). However, people should also have the right to provide and avail of private healthcare should they wish (this is basic freedom). The % of people using the public system should be taken as an indicator of how good it is (however, no matter how good the actual healthcare is, some people will always be willing to "go private" for a more spacious room/better food/ tv to themselves (with more channels) and whatnot).

In case you think this means increased taxes, not neccesarily. Ending the farce that is the war on drugs would free up loads of money we could use on a decent, free public health system .

eightyfish wrote: »

People should be able to use their money for whatever they want in a democratic society.

Agreed 100% with both.

Paddy Samurai

Don Keypunch wrote: »

Should ones ability to pay have an influence on the type and ease at which they access health care?

No..... proper healthcare should be a right for all citizens(rich and poor alike) in any developed country.

Should we not all be treated the same?

Yes.....Access/treatment should be based on medical need ,not on your wealth.

Private healthcare is about making profit from peoples illness.

Banned Account

Paddy Samurai wrote: »

Private healthcare is about making profit ..........nothing else.

Not necessarily - imagine our current tax rates of 20% and 41% with all tax monies going into a central pot with a large chunk of this being used to pay for the public healthcare system.

Now imagine dropping the rates to 15% and 36% respectively and introducing an additional 5% compulsory health insurance charge. This money is used to procure private healthcare for all those working and also to subsidise the same for those not working - now we are all private patients so there is no two tier system.

The providers of the heathcare insurance now ensure that the system is operating with minimum wasteage whilst a seperate body (like HIQA) ensures that the service granted meets expectations.

With a little imagination, a private healthcare system can work.

RATM

eightyfish wrote: »

Where did you read that? Let's just presume that, as all things in Ireland, this would fall over budget and say a more realistic figure is 5%. Can you imagine the reaction to a 5% increase in taxes in the current... ahem... "economic climate". There'd be uproar.

The HSE is a stinking mess, though. I don't blame Mary Harney really as she inherited an already dysfunctional system and she probably has the least-rewarding job in the country.

The report was produced by the Center for Health Policy and Management at Trinity College. It was backed up by the Irish Medical Council and Fine Gael & Labour also backed it to some extent.

article on it here http://archives.tcm.ie/businesspost/2010/04/18/story48668.asp

Personally I wouldn't mind paying an extra 3% in tax each year for a universal system based on medical need rather than the ability to pay. There's a thread in another forum at the moment of a person who needs to go to a GP but just can't afford it yet the state places them outside of the medical card system. There's lots of cases now where people have to ask themselves if they can afford to visit a GP and that situation is not what an equitable society is about.

I do take your point about it costing more than 3% though- I'd only support such a measure if it could be proven we would finally be delivered a health system that works for all citizens. People would still be given the option to go private if they wished but at the moment access to public patients to the health services is in a deficit. There's a lot more than just throwing money at the problem to be done though, the HSE is undoubtedly in dire need of a root and branch reform. But perhaps a reform along the lines of a universal system could go some way in trying to make that happen. Harney's had 6 years of her 2 tier model and its shown to fail people as a whole so perhaps its time for a change of tack?

Stinicker

HavingCrack wrote: »

To be honest if a 5% increase in taxes led to an Ireland that coudl be considered a world leader in health/education/public transport etc I'd actually say quite a few people might actually support it. However, this is Ireland and our current government has proven time and time again that they just squander hard earned tax payers money so this is a non starter.



While I can support some Libertarian standpoints this is just ridiculous. I personally know a family who have a child with Down syndrome. Without the support of public healthcare they would never have been able to cover the costs of their childs educational and healthcare needs. It literally was not an option. If you can explain to me what the Libertarian view would be on this individual case (remember you support everyone for themselves) Id be satisfied.





Agreed 100% with both.

I would favour abortion in this case but seeing as the child has already been born then this is where charities come in, I will re-iterate once again I am totally opposed to Public healthcare and to our current taxation model. We need to pay far less in tax and help encourage an entrepreneurship spirirt in Ireland.

Public healthcare is a manifest of communism and all people are not created equal, I am better than alot of people but am also well behind others this is how the world is, there will never be equality nor should there be, the egalitarian standpoint of Europe has plunged the continent into a crisis and wrecked many peoples personal fortunes, hopes, dreams and aspirations.

We need a laissez faire system in Ireland with absolute minimal government function, elimenate all the government quangos and about a quarter million jobs that exist as drones in the public sector.

All we need to prosper are:

Good private Education
Minimal Taxation
Proper 1st World Infrastructure
Proper policing and natural justice, including the death penalty and a right to firearms. Scumbags, chavs and other detritus should not be given a second change when they misbehave.

We have nothing like it and to make things worse the leftist greens with their egalitarian ideals now want to grant Irish travellers status as an ethnic minority. This country is sickening.

Nijmegen

Public healthcare is fine, but why punish those who want to use their money to get private healthcare?

At the end of the day, we all pay our taxes - PRSI, VAT, the whole schebang - and are entitled to a certain minimum as provided by the government in return for these taxes.

But what I do with the money in my pocket after taxes is my business.

RATM

Stinicker wrote: »

I would favour abortion in this case but seeing as the child has already been born then this is where charities come in, I will re-iterate once again I am totally opposed to Public healthcare and to our current taxation model. We need to pay far less in tax and help encourage an entrepreneurship spirirt in Ireland.

So now assuming you haven't got the chance to abort the kid with Downs Syndrome and his care throughout life is going to cost many hundreds of thousand euro. And you say charites will look after this. Are the public, on a voluntary basis, going to fund charities to the tune of many many billions per year to fund our health service?

You see there's a contradiction flowing right throughout your argument -on the one hand you condone a dog eat dog type of world where that kid with Downs Syndrome would be dependent on voluntary charitable donations instead of having a government legislate for his care throughout life. By proceeding in this manner you then create a society whereby those within it develop that same dog-eat-dog mentality and if contributing to charity to fund sick children is voluntary then the society you've created through such social conditioning won't bother doing so. Humans are greedy by nature- the recent banking/property crisis is just another in the long list of examples. So explain to me how greedy humans would in any way be incentivised to voluntarily donate thousands of their income per year to charities in order to fund other people's healthcare problems?