Is health insurance actually necessary in Ireland?

smallbrowncat

Hi there

My husband and I (late 20s, early 30s) have lived in Ireland just over a year now. Seems like lots of people I know have health insurance - but from the quotes I've got it seems like a massive ripoff (I got a quote of €120 a month for the two of us from VHI on a basic plan)!!

Here are my thoughts so far:
- there don't appear to be true private hospitals in Ireland as I have experienced them to exist in other countries eg Singapore - ie only available user pays or through insurance, vastly superior facilities and quicker treatment than in public system. Ie you might get treated faster, but you're still in a public hospital being treated by public healthcare staff (who are still overstressed and over-worked).
- even if you have private health insurance you may still be treated on a public bed in a public ward - there is no guarantee of a private bed
- if you have an accident you will get treated straight away in the public system anyway, your insurance is not relevant
- it's bloody eye-wateringly expensive and I don't know how most people can afford to pay it...

In New Zealand I had insurance to cover me in the event of long-term illness, cancer etc, specialist fees etc. It cost me $20 a fortnight (about €12-15). Given the cost of health insurance here I just can't seem to understand whether it's actually worth it?! Would really appreciate your views/thoughts/experience! My husband and I are both healthy and rarely get sick (I have not been to the doctor other than for contraceptive pills in the year since I moved here).

Thanks!!

bryaner

Its necessary but completely unaffordable for most folk..:(

daigo75

In my experience, it could be useful, but I wouldn't say it's necessary. If your health is very bad and you require continuous medical assistance, it might be more important. Personally, I never had one and had no issues so far; I had to go to hospital a few times, but even by paying out of my pocket I still saved a lot of money.

bryaner

A few years ago I gad to get a colonoscopy, waiting time with VHI was 4 weeks waiting time without was 8+ months, lucky enough there was nothing wrong with me, but if there was I'd imagine 8+ month waiting time leading to severe problems..

smallbrowncat

Thank you for your responses!!

Bryaner - that is exactly the kind of situation I had health insurance for in New Zealand. However at the prices Irish insurance companies you start calculating how LIKELY it actually is that you would need the insurance - you don't feel like it's a worthwhile investment when you pay a huge amount year after year and get no use out of it. After all - you're not getting rewarded by the insurance company for being healthy! Is it possible to pay the state or a private consultant for the procedure/treatment you provide, if you need it? Ie, pay like an insurance company would?

It does really rankle with me that the insurance prices here are not based on individual risk - meaning that my premiums are effectively subsidising both those who happen to be more sickly through no fault of their own, those who are old, and also those who are sick through to their own bad lifestyle choices. I do not see why I have to subsidise old and sick people if I want private health cover. Errr.... free market, anyone??? I mean, of course that's what happens when you pay taxes for the publicly funded healthcare system (and that's ok) - but if I'm choosing to take part in a private system I would prefer to pay based on my actual risk profile (admittedly a very good one!)!!!

bryaner

Yes there is no problem paying cash/ self insure if thats the way you want to go..

dvpower

smallbrowncat wrote: »

My husband and I (late 20s, early 30s) have lived in Ireland just over a year now. Seems like lots of people I know have health insurance - but from the quotes I've got it seems like a massive ripoff (I got a quote of €120 a month for the two of us from VHI on a basic plan)!!

That's pretty good - try Switzerland where basic compulsory insurance costs about €290 a month

bryaner

dvpower wrote: »

That's pretty good - try Switzerland where basic compulsory insurance costs about €290 a month

Impossible to compare Switzerland with Ireland..

smallbrowncat

What about a situation taking advantage of the North? I wonder if it's possible for me to get insurance with a UK company (eg BUPA) and then if I need private treatment, head to the North or somewhere else in the UK? Has anyone heard of this being possible?

smallbrowncat

dvpower - the difference is in Switzerland is that I presume you're not also paying for universal social healthcare through your taxes? But also as Bryaner says, impossible to compare the two countries.

getz

smallbrowncat wrote: »

What about a situation taking advantage of the North? I wonder if it's possible for me to get insurance with a UK company (eg BUPA) and then if I need private treatment, head to the North or somewhere else in the UK? Has anyone heard of this being possible?

yes

careca11

smallbrowncat wrote: »

What about a situation taking advantage of the North? I wonder if it's possible for me to get insurance with a UK company (eg BUPA) and then if I need private treatment, head to the North or somewhere else in the UK? Has anyone heard of this being possible?

with VHI you can go north , you end up getting about 85% of the cost back

smallbrowncat

Sorry could you give me more detail about the North option? I don't want to pay VHI... I want to see if a UK company is cheaper than VHI because I am young and low-risk (ie cheap)..... and then get private treatment from consultants/hospitals in the North.

coylemj

smallbrowncat wrote: »

- there don't appear to be true private hospitals in Ireland as I have experienced them to exist in other countries eg Singapore - ie only available user pays or through insurance, vastly superior facilities and quicker treatment than in public system. Ie you might get treated faster, but you're still in a public hospital being treated by public healthcare staff (who are still overstressed and over-worked).

There are several genuinely private hospitals in Ireland, Blackrock Clinic and Beacon being two of them. There are also private hospitals attached to public hospitals, St. Vincent's Private being an example.

smallbrowncat wrote: »

- even if you have private health insurance you may still be treated on a public bed in a public ward - there is no guarantee of a private bed

If you are going for elective surgey and the health insurance is paying for it then the consultant will almost always see to it that you get a private bed.

If you enter the hosptal via A & E because of an injury or for non-elective surgery such as an operation to remove an appendix then you will almost certainly end up in a public bed though when the hospital finds out that you have insurance they will magically (and retrospectively) redesignate the bed as 'semi-private' and charge the insurance company accordingly.

On two occasions I have had treatment in public hospitals and after I had the treatment I was asked to sign a document asking to be admitted as a private patient. On the first occasion it was after I had my appendix out and was about to be discharged, on the second occasion I was already home when they discovered I had insurance so they posted me the form to fill in and sign!

smallbrowncat wrote: »

- if you have an accident you will get treated straight away in the public system anyway, your insurance is not relevant

True but as soon as the consultant discovers that you have private insurance you will find that the follow-up consultations will be in his/her private rooms and you will be a private patient.

smallbrowncat wrote: »

- it's bloody eye-wateringly expensive and I don't know how most people can afford to pay it...

Agreed, most people who have health insurance have it so that they can jump the queue for things like MRI scans and elective surgery and (most important) they will have a choice of consultant and will always see only that consultant on follow-up consultations whereas this is not guaranteed in the public system.

dvpower

smallbrowncat wrote: »

dvpower - the difference is in Switzerland is that I presume you're not also paying for universal social healthcare through your taxes? But also as Bryaner says, impossible to compare the two countries.

I think in Switzerland the cost of insurance covers more of the real cost of the healthcare than our insurance does.

Agreed that it's not possible to directly compare the two countries, but its equally impossible to compare it to New Zealand as the OP is, or to say if the quote the OP got was a rip off or not based on the quote alone.

byhookorbycrook

Treatment I am on cost €2,500 A MONTH and most public hospitals won't take you on without VHI or whatever for it,as it comes from their
budget.

mw3guc

coylemj wrote: »

On two occasions I have had treatment in public hospitals and after I had the treatment I was asked to sign a document asking to be admitted as a private patient. On the first occasion it was after I had my appendix out and was about to be discharged, on the second occasion I was already home when they discovered I had insurance so they posted me the form to fill in and sign!

Did you sign after the event? This happened to me - I can't remember if I signed as I was just too ill when I was discharged to care. I got one day out of a week in a private room (the other 6 days in a ward with 8 others) and the whole stay was charged as private.

I have to confess to being a little cynical about health insurance - I was sent for a lot of questionable tests and follow-up appointments that I don't believe would have been considered necessary if I didn' have it and, in retrospect, were just overkill. But you're at their mercy with fear and anxiety.

When my son was in hospital as a child there were 2 other children in the same ward as him suffering from EXACTLY the same vomiting/stomach bug symptoms - child A was private, child B was public. B was kept in overnight, examined briefly on the rounds the following morning and sent home with the usual platitudes that he would be fine in a few days.

Child A, however, was subjected to every test and specialist going - they were round him like wasps at a honeypot. After a few days, he too was sent home (like I'm sure Child B was eventually) fully recovered, with no other treatment. The nurses were extremely cynical and told me quite plainly that this was the hidden price of having health insurance! I still remember how miserable that wee child was with all the poking, prodding, blood draws and fasting ...

But I still have health insurance (for now anyway) though I'm a lot more aware of the 'income stream' effect and the perils of getting sucked into an escalating black hole of medical over-treatment.

Jim2007

dvpower wrote: »

That's pretty good - try Switzerland where basic compulsory insurance costs about €290 a month

You can't compare it to Ireland, because for a start there is no public health care system... everyone must have health insurance, but at the same time Insurance companies can not refuse to insure you. And people on low incomes can apply for a grant to cover the costs of health insurance.

Jim.

henryporter

smallbrowncat wrote: »

What about a situation taking advantage of the North? I wonder if it's possible for me to get insurance with a UK company (eg BUPA) and then if I need private treatment, head to the North or somewhere else in the UK? Has anyone heard of this being possible?

Has anyone actually done this? The only response so far was not very informative.

broker2008

Technically, it is not possible because of residency rules. There are people who have addresses in north and south but if one got very sick and questions were asked, one could find themselves not covered when it really mattered.

coylemj

mw3guc wrote: »

I have to confess to being a little cynical about health insurance - I was sent for a lot of questionable tests and follow-up appointments that I don't believe would have been considered necessary if I didn' have it and, in retrospect, were just overkill. But you're at their mercy with fear and anxiety.

I would have the suspicion that if a consultant has private rooms in a private hospital that he/she has an incentive to send you for lots of scans and tests in the same hospital.

The cynic in me says that the consultant gets a reduction in room rent if they send patients for lots of tests which the insurance company pays for but I'm sure they're far more ethical than that

NuMarvel

coylemj wrote: »

I would have the suspicion that if a consultant has private rooms in a private hospital that he/she has an incentive to send you for lots of scans and tests in the same hospital.

The cynic in me says that the consultant gets a reduction in room rent if they send patients for lots of tests which the insurance company pays for but I'm sure they're far more ethical than that

Health insurers keep an eye out for that kind of activity, and I know of at least one case where a health insurer struck a consultant off it's list for something similar.

That's not necessarily a foolproof mechanism either, but a cost conscious insurer will take steps to control costs without jeopardising patient care.

Jose1

Question: If I relinquished my current Plan B VHI membership and decided to go it alone, how would that work with regard to private hospital treatment and consultancy charges. I was told that when I reached a certain threshold (900Euro) within a given year, I would not have to pay any more.I'm a bit sceptical of it, is there any truth to it?

coylemj

Jose1 wrote: »

Question: If I relinquished my current Plan B VHI membership and decided to go it alone, how would that work with regard to private hospital treatment and consultancy charges. I was told that when I reached a certain threshold (900Euro) within a given year, I would not have to pay any more.I'm a bit sceptical of it, is there any truth to it?

Urban myth, not true.

NuMarvel

Jose1 wrote: »

Question: If I relinquished my current Plan B VHI membership and decided to go it alone, how would that work with regard to private hospital treatment and consultancy charges. I was told that when I reached a certain threshold (900Euro) within a given year, I would not have to pay any more.I'm a bit sceptical of it, is there any truth to it?

There are limits to what you can be charged as a public patient, but there's no such limit in the private sector.

Jose1

Yeah, thought so!

Thanks for your replies.

jocotty

its easy say that health insurance not wort it - while your not ill.

what if your diagnosed with cancer , without healt insurance - your screwed!!!!

im payin 450 a year with laya, and think its worth it , give us some home in this miserable country if we get sick!

Jumboman

With 20 billion of tax payers money going into the health system that should be more than enough to cover everyones health needs.

lonestargirl

jocotty wrote: »

what if your diagnosed with cancer , without healt insurance - your screwed!!!!!

I disagree - if you are diagnosed with cancer you will be very well taken care of in a timely fashion in the public system. The issues are more with 'elective' procedures, some of which may be causing significant impact on a person's quality of life.

Gael23

Yes I think so, I certainly wouldn't be without it anyway. A friend of ours had no health insurance and was put on a waiting list for diagnostic tests back in June which he got in September,3 months later. The next day he was having chemotherapy and was dead 6 weeks after that.

Its a rip off but you still need to pay.

Its mainly about waiting times. Do you really want to wait for six months for something that you should be able to get in three days?

The single greatest thing they could do to reform the health service is to break the link between the consultant and the GP ( the referral letter to Mr X).

Once that link is broken (as it is in other countries) and people can shop around to see not Mr X ( the buddy of the GP) but a cardiologist or a neurologist, watch the waiting lines drop and service improve.

uck51js9zml2yt

My son needs an ear operation after seeing a consultant privately and having an investigation of the ear done privately. It was an 18 month wait to get an initial visit publicly by which time he could loose his hearing.
So yes ..it's needed.

socco

as a follow up question linked to this: do people consider income continuance payment plan important?

The reason I raise it is because i see the two as very important and I mean both of them. Having health insurance will ensure that you're medical bills are covered but if you don't have any income coming in you're going to run into trouble anyway.

Cristiano Zealous Slavery

Cristiano Zealous Slavery wrote: »

My son needs an ear operation after seeing a consultant privately and having an investigation of the ear done privately. It was an 18 month wait to get an initial visit publicly by which time he could loose his hearing.
So yes ..it's needed.

Its the same consultants doing the same work. In reality you're not paying to have the job done; you're paying to jump the waiting list. It would be more honest to arrive with a little brown envelope as in some ex soviet countries.

Consultants should be either totally public or totally private, and if they are private the should be using private hospitals and support services. Private consultant numbers should not be restricted.

Diairist

It is always nice to be able to afford both income protection & health insurance. If circumstances allow, income protection is fantastic if you're self - employed. Imagine a self employed guy whose office is above a pub. Imagine the pub is raided and a bullet goes through the ceiling & hits him? Imagine the pub goes on fire and his equipment / records are burnt ?

uck51js9zml2yt

DrDonkey wrote: »

Its the same consultants doing the same work. In reality you're not paying to have the job done; you're paying to jump the waiting list. It would be more honest to arrive with a little brown envelope as in some ex soviet countries.
.

my guy works privately.

As for ex soviet countries.
I broke my collar bone in one last year.
Went to see a consultant publicly without issue on my first visit.
when I had to go back there was a 2 hour wait so I went private, paid my 6€ and skipped the que of people sitting there.

Cristiano Zealous Slavery

Cristiano Zealous Slavery wrote: »

when I had to go back there was a 2 hour wait so I went private, paid my 6€ and skipped the que of people sitting there.

Exactly. Same system, just more transparent.

Gael23

lonestargirl wrote: »

I disagree - if you are diagnosed with cancer you will be very well taken care of in a timely fashion in the public system. The issues are more with 'elective' procedures, some of which may be causing significant impact on a person's quality of life.

I posted earlier about that and it's unfortunately not strictly the case. Yes if you have cancer or something serious wrong with you, you will get treatment but its sometimes too late by the time you get a diagnosis in the public system

JohnMc1

ryanf1 wrote: »

I posted earlier about that and it's unfortunately not strictly the case. Yes if you have cancer or something serious wrong with you, you will get treatment but its sometimes too late by the time you get a diagnosis in the public system

Agreed. Sadly my Cancer relapsed [Lymphoma] in Feb and I've been waiting for a biopsy ever since. Its ridiculous trying to get it done on a Medical Card. And I could have sworn our Minister of Health and the HSE say that there would be no feet dragging when it came to Cancer.

phoenix999

My father had radiotherapy for prostate cancer as a public patient. They wouldn't operate due to his age. He received the best of treatment. His cancer didn't spread and he is still healthy two years later. My uncle, also a public patient, had chest problems and was told he would have to wait six months for a scan. So he decided two days later to admit himself to A&E after getting chest pains. He had the scan just two days later which found a malignant tumour on his lung. So public patients shouldn't feel condemned to waiting silently on waiting lists.

micosoft

It's a good question. I've been treated by several consultants over the past five years for everything from Liver to Thyroid. All publically. And all of it was excellent.
I have to say the public system works when you are in a well run hospital like vincents. It's all the crappy small hospitals around the country where the horror stories arise (lady of lourdes is one I'll be skipping).

The big issue here is the dysfunctional nature of the health insurance market, the most criminal part being "community rating" where somebody can wait till their fifties to join and pay the same rates as someone who joined in there twenties.

What should be in place is mandatory health insurance. You can pick your company but you must contribute to a scheme if you earn an income. If you want a nicer room etc you can pay extra. GP's should be included.

We should also eliminate completely free medical care. The prescription charges for medical card were a step in the right direction (50c is nothing and eliminated a huge amount of abuse there). A small fee - say €5 per doctors visit.

JohnMc1

lonestargirl wrote: »

I disagree - if you are diagnosed with cancer you will be very well taken care of in a timely fashion in the public system. The issues are more with 'elective' procedures, some of which may be causing significant impact on a person's quality of life.

I wish I could agree. I went to my hematologist in Feb for a swelling on the right side on my neck [I previously had Lymphoma] I had a CT scan that week. She referred me to a doctor for a biopsy and I've been waiting ever since. I saw him for a consultation a couple of weeks ago and he said I could have it this coming week. Considering his office was closed last week and I never received a letter or a phone [He was supposed to call me a couple of days after the consultation] I have a feeling that was just lip service and I'm nowhere near having a biopsy done.

JohnMc1

micosoft wrote: »

.
I have to say the public system works when you are in a well run hospital like vincents. It's all the crappy small hospitals around the country where the horror stories arise (lady of lourdes is one I'll be skipping).
.

The Feet dragging for me is happening in Waterford regional. So the blame can't be placed solely on the small hospitals.

Gael23

JohnMc1 wrote: »

Agreed. Sadly my Cancer relapsed [Lymphoma] in Feb and I've been waiting for a biopsy ever since. Its ridiculous trying to get it done on a Medical Card. And I could have sworn our Minister of Health and the HSE say that there would be no feet dragging when it came to Cancer.

Another story since I last posted. A neighbour of ours went into a&e feeling unwell last Friday. Symptoms persisted so she returned to her GP on Monday and was sent to a private hospital to have tests repeated. On Thursday she had a brain tumour removed.

JohnMc1

ryanf1 wrote: »

Another story since I last posted. A neighbour of ours went into a&e feeling unwell last Friday. Symptoms persisted so she returned to her GP on Monday and was sent to a private hospital to have tests repeated. On Thursday she had a brain tumour removed.

I'm glad that there are some good stories about Public Healthcare here. Its just very hard to see the good when you feel like one of the few who is left to rot.

smallbrowncat

An update from the original poster here, a few years on. We're still in Ireland, but we have a baby now. We still don't have health insurance. I consider it every 6 months or so, then I get so disgusted by the cost and the confusing nature of it I decide not to. We won't be here more than 2-3 years longer so I still don't know whether it's worth getting it.

The public maternity care was great in some respects (wonderful Domino care), and really dire in others (postnatal ward, lack of staff, essentially abandoned for 6 hours after birth) but it's not much worse than what friends have described they got through semi-private or private.

I still don't know whether to get health insurance. My first option if my son was seriously sick (and didn't need immediate hospitalisation) would be to take him home to New Zealand.

Is it worth getting health insurance for just 2-3 years? My gut says no. But I'd be really interested in hearing what other parents have to say!

uck51js9zml2yt

smallbrowncat wrote: »

An update from the original poster here, a few years on. We're still in Ireland, but we have a baby now. We still don't have health insurance. I consider it every 6 months or so, then I get so disgusted by the cost and the confusing nature of it I decide not to. We won't be here more than 2-3 years longer so I still don't know whether it's worth getting it.

The public maternity care was great in some respects (wonderful Domino care), and really dire in others (postnatal ward, lack of staff, essentially abandoned for 6 hours after birth) but it's not much worse than what friends have described they got through semi-private or private.

I still don't know whether to get health insurance. My first option if my son was seriously sick (and didn't need immediate hospitalisation) would be to take him home to New Zealand.

Is it worth getting health insurance for just 2-3 years? My gut says no. But I'd be really interested in hearing what other parents have to say!

if we didn't have insurance my son would likely be dead. had infection in his ear. public wait for a consultant is 18 months. we went private to be told his ear drum was growing into his ear. he had surgery in a matter of weeks and we were told short term the infection would hit his brain.
we now get to see the surgeon for follow up in his public clinic every few months and apart for a slight loss of hearing he's doing great. surgery cost 6k. the insurance for us all was 2000.

smallbrowncat

Yes but what if you just paid to see the consultant privately (with no insurance)? So, pay the €400 or whatever it might be to see him. Surely, seeing the serious nature of your son's condition and getting a diagnosis from the consultant you would automatically get seen quickly under the public system anyway?

There is a huge lack of clarity as to what the real benefit of health insurance is. If you pay privately to see a consultant, can you then not use the public system at all??? Ie would you HAVE to pay out of your own pocket for private surgery once you've paid privately to see the consultant? Or can you not see a consultant privately at all unless you have insurance?

I can afford to pay whatever it is to see a consultant (to avoid the waiting times) and yes I could afford the 6k to pay for surgery (I've saved that by not spending money on health insurance in the past few years).

It's like that VHI advert where the mum describes having her twins born early. She said there was nothing to worry about, she just signed a form. But under the public system, if her twins were born early it's not like she wouldn't have been looked after anyway, as it was an emergency situation IYSWIM?

I am really struggling to work out the exact situations where private health insurance is a benefit, or in other words, you'd be screwed by not having it. I can afford to pay to see a consultant, and I can afford most types of day surgery. Do I still need health insurance?

The system is really opaque and I've spent 3 years trying to work it out and I'm still no bloody closer to an answer. If anyone could help clarify these points I would be really appreciative!

smallbrowncat

BTW I am very glad your son is doing ok now tatranska!

adamski8

smallbrowncat wrote: »

Yes but what if you just paid to see the consultant privately (with no insurance)? So, pay the €400 or whatever it might be to see him. Surely, seeing the serious nature of your son's condition and getting a diagnosis from the consultant you would automatically get seen quickly under the public system anyway?

There is a huge lack of clarity as to what the real benefit of health insurance is. If you pay privately to see a consultant, can you then not use the public system at all??? Ie would you HAVE to pay out of your own pocket for private surgery once you've paid privately to see the consultant? Or can you not see a consultant privately at all unless you have insurance?

I can afford to pay whatever it is to see a consultant (to avoid the waiting times) and yes I could afford the 6k to pay for surgery (I've saved that by not spending money on health insurance in the past few years).

It's like that VHI advert where the mum describes having her twins born early. She said there was nothing to worry about, she just signed a form. But under the public system, if her twins were born early it's not like she wouldn't have been looked after anyway, as it was an emergency situation IYSWIM?

I am really struggling to work out the exact situations where private health insurance is a benefit, or in other words, you'd be screwed by not having it. I can afford to pay to see a consultant, and I can afford most types of day surgery. Do I still need health insurance?

The system is really opaque and I've spent 3 years trying to work it out and I'm still no bloody closer to an answer. If anyone could help clarify these points I would be really appreciative!

sorry to drag this up but ive been searching the subject all day and these questions are exactly what i want answers to. I really cant see the benefit if you can afford to pay for the elective surgeries!

Gael23

adamski8 wrote: »

sorry to drag this up but ive been searching the subject all day and these questions are exactly what i want answers to. I really cant see the benefit if you can afford to pay for the elective surgeries!

Well a hospital bed is around €1000 per night so if you have that sort of money lying around then well and good but very few people good.
Since posting here last, I have downgraded mine to only cover hospital stays but will never give it up