Government and Health Insurance Companies

Bullseye1

"We are aware of the difficulties our members face in the current economic climate and have aimed to keep your premium as low as possible. However, despite our voiced concerns, Government policy continue to drive our prices upwards. This along with rising costs within the health industry, including a significant increase to the government levey, we have unfortunately had to increase our premiums. But we continue to be very conscious of our pricing and our promise to provide excellent value to our members.

- Laya Healthcare 16th September 2013.

Got my insurance renewal and was shocked at the quote given me. Its gone up €150 since last year. I've had the policy 10+ years and made no claims. It appears the government policy is driving people away from private health insurance. What exactly is their end game? To put these companies out of business and have everyone on the public health system which is already dis-functional.

With the wife due to receive her quote shortly the government has succeeded to removing two more people from having private health insurance.:(

Banjo String

Bullseye1 wrote: »

- Laya Healthcare 16th September 2013.

Got my insurance renewal and was shocked at the quote given me. Its gone up €150 since last year. I've had the policy 10+ years and made no claims. It appears the government policy is driving people away from private health insurance. What exactly is their end game? To put these companies out of business and have everyone on the public health system which is already dis-functional.

With the wife due to receive her quote shortly the government has succeeded to removing two more people from having private health insurance.:(

We've decided not to renew ours either bullseye, it's just getting too expensive.

I know the old cliche is your health is your wealth, but with less disposable income, my wealth isn't stretching to cover my health.

If any of the 4 in our family get sick after Oct, it will be the public health care system for us.

COYW

My policy is up for renewal in January and I am worried on reading the posts above. I switched from Aviva to Laya last year, as my Aviva quote was well over €1,200 for me as an individual, and that policy did not include GP cover. I never claimed on the policy.

Laya quoted me just under €900 for the same level of cover. Dreading to think what they will charge this year. I queried the increase in my policy with Aviva last year and they told me that it related to the lack of availability of hospital beds and the increase in policy cancellations.

The government is moving towards universal health. It will lead to these companies going to the wall. Nobody in their right mind is going to pay for private cover, if the level of service is the exact same as someone on the public system. It will be interesting to see how that system will be funded. I suspect that the working men and women will have to pay a whopper of a health tax to cover it. The health system is creaking at the seams and turning over a massive loss as it is.

Gloomtastic!

Little tip here:

If you don't have health insurance and have kids in primary school (maybe secondary as well, I don't know)

If your school charges €5 per child insurance which covers your kid for hospital bills if it gets injured during school hours. For €2 or €3 extra you can extend this to 24/7. Talk to your school.....

micosoft

It seems to come down to the following ideology which seems mainly Labour but has infected Fine Gael too. They same odd ideology applies to private schools - it's as if you decide you want to spend extra for a better school or room in a hospital that all your tax contributions disappear.

Basically we leading to a situation that if you go Private you must pay for the entire service privately. That means your PRSI, PAYE and Duty Taxes (looking at you alcohol and Ciggies) mean NOTHING and don't contribute to the service. Hence your health insurance is going up to cover items that should be covered by your tax contribution.

On the other hand if you are treated publically you get fully covered regardless of any contribution you might make.

Throw into the mix the criminal community ratings scheme which penalises people who join private health care young and encourages people to join late in their lives when they are likely to get sick more frequently. It's like joining a pension fund at 55 and getting the same return as a 25 year old.

It's a really odd system that is the worst of every world and designed specifically to punish those that want to pay for their health care. Either which way this is simply going to create an even bigger crisis in the health care system as people like the OP and myself stop paying in.

Finally just so I don't sound like a moaner -

People should be forced to pay health insurance (essentially the USC) but going to an insurance provider instead of Revenue. You can get the basic health insurance which is the % for USC or top that up with an additional fixed fee to get say a private room. It means everybody in the tax system contributes to the health care.

Health care inflation is running at roughly 10% (driven by new technologies and interventions and life expectancy - not a bad thing) so we have to overhaul the system. But the populist labour inspired system that we all use public or get crucified is not fair and not realistic. Tell your TD that!

View

Bullseye1 wrote: »

- Laya Healthcare 16th September 2013.

Got my insurance renewal and was shocked at the quote given me. Its gone up €150 since last year. I've had the policy 10+ years and made no claims. It appears the government policy is driving people away from private health insurance. What exactly is their end game? To put these companies out of business and have everyone on the public health system which is already dis-functional.

With the wife due to receive her quote shortly the government has succeeded to removing two more people from having private health insurance.:(

It isn't an obligation of government to subsidise private health care although it has done so for years out of the public health budget. It is now rectifying that mistake by charging real - not subsidised - prices to those companies for their "private" beds in public hospitals - hospitals which only operate as a result of public money being poured into them.

And if it is so "awful" for those companies they are free to set up exclusively private hospitals which if you note they by and large don't. Not many "private" consultants solely operate privately, that work is supposed to a sideline from their work as public consultants, not the other way round.

Bullseye1

View wrote: »

It isn't an obligation of government to subsidise private health care although it has done so for years out of the public health budget. It is now rectifying that mistake by charging real - not subsidised - prices to those companies for their "private" beds in public hospitals - hospitals which only operate as a result of public money being poured into them.

And if it is so "awful" for those companies they are free to set up exclusively private hospitals which if you note they by and large don't. Not many "private" consultants solely operate privately, that work is supposed to a sideline from their work as public consultants, not the other way round.

It was interesting to hear on the PKenny show that hospitals were charging insurance companies for beds when the patient did not check in for overnight stays. It looks like the hospitals have been fleecing the insurance companies for years with patients not questioning the charges.

micosoft

View wrote: »

It isn't an obligation of government to subsidise private health care although it has done so for years out of the public health budget. It is now rectifying that mistake by charging real - not subsidised - prices to those companies for their "private" beds in public hospitals - hospitals which only operate as a result of public money being poured into them.

And if it is so "awful" for those companies they are free to set up exclusively private hospitals which if you note they by and large don't. Not many "private" consultants solely operate privately, that work is supposed to a sideline from their work as public consultants, not the other way round.

But is it a subsidy? Surely the taxpayer is entitled to return on the taxes spent?
It would be a subsidy if Public Health were restricted to those who cannot afford any healthcare like in the US but our system taxes on the provision that this level of treatment is available to all.

You could make the counterargument that private patients subsidise the public system by paying their tax to cover medical treatment but directly paying for accommodation instead of the public accommodation.

Don't get me wrong - I think the whole system is broken. But forcing private patients to pay taxes for treatment and pay on the double through private insurance will only result in collapsing the private healthcare system creating an even bigger crisis in Irish Healthcare.

View

Bullseye1 wrote: »

It was interesting to hear on the PKenny show that hospitals were charging insurance companies for beds when the patient did not check in for overnight stays. It looks like the hospitals have been fleecing the insurance companies for years with patients not questioning the charges.

If the bed is booked, then it isn't free for other patients. No one does a "last minute" discount surgery system, so charging "No shows" is fair enough. Many hotels do the same.

View

micosoft wrote: »

But is it a subsidy? Surely the taxpayer is entitled to return on the taxes spent?

Yes it is. The taxpayer is entitled to public cover for their public taxes. Nothing more.

The point is the costs for private care are NOT being reflected in the price charged for it. Hence the price rises.

Bullseye1

View wrote: »

If the bed is booked, then it isn't free for other patients. No one does a "last minute" discount surgery system, so charging "No shows" is fair enough. Many hotels do the same.

The patient never intended staying in over night and confirmed before attending. The hospital still sent the bill to the insurance company who wrote to their customer that the bill had been paid. He in turn rang them to tell them he had not stayed over night and then an argument ensued.

Bullseye1

View wrote: »

Yes it is. The taxpayer is entitled to public cover for their public taxes. Nothing more.

The point is the costs for private care are NOT being reflected in the price charged for it. Hence the price rises.

It still does not solve the issue of 10,000s of thousands of people giving up health insurance and overloading the already disfunctional public health care system. Yet the government is claiming they will introduce universal health care insurance in its lifetime. It seems they are trying to remove private health care and introduce public health care instead and therefore make it compulsory to take out insurance. Something those relying on the public system don't currently have to worry about.

View

Bullseye1 wrote: »

The patient never intended staying in over night and confirmed before attending. The hospital still sent the bill to the insurance company who wrote to their customer that the bill had been paid. He in turn rang them to tell them he had not stayed over night and then an argument ensued.

Errors (and/or fraud) occur in any system. It maybe a case of that, then again there maybe no option available for the patient to "un-bundle" the services the hospital provides. They don't allow you a deduction if you don't like the hospital's food!!!

View

Bullseye1 wrote: »

It still does not solve the issue of 10,000s of thousands of people giving up health insurance and overloading the already disfunctional public health care system.

It isn't intended to. The state hasn't the money to provide public healthcare. Providing subsidies to private healthcare so it is "affordable" isn't therefore an issue for it.

The question for the state is how to fund the local A&E, not whether an expensive service becomes "unaffordable" once a subsidy is removed and its true cost is revealed.

micosoft

View wrote: »

Yes it is. The taxpayer is entitled to public cover for their public taxes. Nothing more.

The point is the costs for private care are NOT being reflected in the price charged for it. Hence the price rises.

I'm not sure you are getting my point. I know full well that the full cost of treatment is not covered by private health insurance. What is different is our (excuse the pun) view of it.

I see us all paying for basic healthcare in this country.
Then those that can afford it top up that basic healthcare with a private insurance plan that gets them a nicer room. More flexibility on dates for elective emissions. Choice of consultant. And yes (wrongly IMHO) quicker up the list. It's on top of and not replacing the public system.

I don't accept that if you want these extras you should suddenly lose your basic health benefits and have to pay on the double for this - once through the tax system and again through your private health insurance. The alternative is the US system where you must pay unless you have no job or assets and only then get publically treated. Not a system I support BTW.

Now whether or not the current Irish system is a good or effective system is another question. I don't think it is and think mandatory insurance is the future.

Secondly - the effect of forcing people to pay twice will make people choose not to pay for private health insurance. Private health insurance even under the current system provides an element of subsidy in that it does take some costs and demands out of the public system - you cannot deny that.
What you are positing is that those that pay for private health insurance will just sit back and take it. That's irrational. They won't and we will all be worse off for it.

View

micosoft wrote: »

I'm not sure you are getting my point. I know full well that the full cost of treatment is not covered by private health insurance. What is different is our (excuse the pun) view of it.

I see us all paying for basic healthcare in this country.
Then those that can afford it top up that basic healthcare with a private insurance plan that gets them a nicer room. More flexibility on dates for elective emissions. Choice of consultant. And yes (wrongly IMHO) quicker up the list. It's on top of and not replacing the public system.

I don't accept that if you want these extras you should suddenly lose your basic health benefits and have to pay on the double for this - once through the tax system and again through your private health insurance.

No one is saying you lose your public healthcare. If you choose to forego it fair enough.

Then you are in the private system and get to pay the cost of that private service, not a private service which is heavily subsidised by tax-payers who in some cases can't afford that private care which you are using.

oscarBravo

View wrote: »

The question for the state is how to fund the local A&E, not whether an expensive service becomes "unaffordable" once a subsidy is removed and its true cost is revealed.

The broader question for the state is whether it will be able to fund the local A&E if people stop paying for private healthcare and increase the demand for public healthcare.

View

oscarBravo wrote: »

The broader question for the state is whether it will be able to fund the local A&E if people stop paying for private healthcare and increase the demand for public healthcare.

Agreed. But the cost of providing public healthcare per patient is cheaper to the state than providing a subsidised private healthcare per patient.

oscarBravo

View wrote: »

Agreed. But the cost of providing public healthcare per patient is cheaper to the state than providing a subsidised private healthcare per patient.

Does that calculus hold indefinitely? In other words, if every private healthcare provider departed the country in the morning, would the savings in subsidies outweigh the increase in costs?

View

oscarBravo wrote: »

Does that calculus hold indefinitely? In other words, if every private healthcare provider departed the country in the morning, would the savings in subsidies outweigh the increase in costs?

Hard to say. In most hospitals it is a mixture of public and private so the answer is presumably yes for them.

There are of course others such as the Blackrock Clinic which are private only (I think). Presumably the issue of the state subsidising them doesn't arise if the are "pure" private.

ressem

View wrote: »

Agreed. But the cost of providing public healthcare per patient is cheaper to the state than providing a subsidised private healthcare per patient.

The government's push for universal insurance and paying for public patients to receive treatment in private hospitals here and abroad would suggest the opposite.

The Pat Kenny discussion suggests that there appear to be examples where the private insurance companies are charged through the nose subsidising the hospital and it's other patients.

A colleague has been having a pint of blood drawn every few months to reduce his elevated iron levels, and the insurance company has been billed a full day's bed for a one hour procedure (little different to that undergone by anyone with an IBTS card). In the high hundreds of euro.

The HSE this year green-lighted his GP to draw and dispose of the blood instead. And there is a pilot in Dublin allowing many with this common haemochromatosis condition to simply donate at the IBTS clinic.
This small change will save the insurance company 2 thousand per year for this one patient. There are 40,000 Irish people with the condition.

I'd be skeptical that the added 1 hour workload of these scheduled straightforward treatments created 700 euro of additional overhead for the hospital.

micosoft

View wrote: »

No one is saying you lose your public healthcare. If you choose to forego it fair enough.

Then you are in the private system and get to pay the cost of that private service, not a private service which is heavily subsidised by tax-payers who in some cases can't afford that private care which you are using.

But the fundamental flaw in your argument is that users of private health care are ALSO tax payers and are entitled to receive the public contribution to their treatment. There is no subsidy. They are paying for that treatment through tax as well as paying privately for the accommodation.

Your argument would be true if you got a refund on your public health contributions if you went private. Or you believe that those availing of private health care pay no tax contribution towards the health service which is exactly the opposite of what occurs i.e. those that pay for private health insurance are also likely in the higher tax bracket any pay more to contribute in the first place.

In any case - even if one were to agree with your view, you still have not addressed the fact that nobody except the ultra wealthy will pay for private health insurance in this scenario making the situation worse all round by increasing the demand on public beds etc. while denying people the opportunity to spend more on their health care to have increased choice. It's a lose lose situation.

spank_inferno

Like America, why dont the insurance companies build & run their own facilities?

Then they can charge themselves as much or little as they please.

View

micosoft wrote: »

But the fundamental flaw in your argument is that users of private health care are ALSO tax payers and are entitled to receive the public contribution to their treatment.

There is no entitlement for them to receive this contribution if they opt for private treatment instead of public treatment. The state may be generous and allow them to and equally it may not.

"micosoft wrote: »

There is no subsidy. They are paying for that treatment through tax as well as paying privately for the accommodation.

The cost they are paying for their private treatment does not cover the cost of it being provided to them in a public hospital using publicly paid for staff and publically paid for labs etc

"micosoft wrote: »

Your argument would be true if you got a refund on your public health contributions if you went private. Or you believe that those availing of private health care pay no tax contribution towards the health service which is exactly the opposite of what occurs i.e. those that pay for private health insurance are also likely in the higher tax bracket any pay more to contribute in the first place.

Out of curiosity, do you belive you have a right to have your private taxi journey subsidised by the tax-paper if you opt to use one rather than the slower tax-payer provided public bus service?

"micosoft wrote: »

In any case - even if one were to agree with your view, you still have not addressed the fact that nobody except the ultra wealthy will pay for private health insurance in this scenario making the situation worse all round by increasing the demand on public beds etc. while denying people the opportunity to spend more on their health care to have increased choice. It's a lose lose situation.

Private health insurance as can be seen in other countries is an extremely expensive service. The only reason it is "affordable" here is because the true cost of it has been hidden and subsidised by the public service. Now that is changing and it is suddenly unaffordable to some.

That is not the state's problem. The problem for the state is providing the public service. Tying up beds to provide a private service for some in public hospitals where there are shortages of public beds is just bonkers.

View

ressem wrote: »

A colleague has been having a pint of blood drawn every few months to reduce his elevated iron levels, and the insurance company has been billed a full day's bed for a one hour procedure (little different to that undergone by anyone with an IBTS card). In the high hundreds of euro.

As spark_inferno pointed out there is nothing stopping the insurance company from organising this on their own if they reckon they can do it cheaper.

You think they can't figure out which option is cheaper for them?

micosoft

View wrote: »

There is no entitlement for them to receive this contribution if they opt for private treatment instead of public treatment. The state may be generous and allow them to and equally it may not.

Fair enough - thats a valid opinion to have. My opinion is that there is an entitlement to expect a return on your taxes that go into health care.

View wrote: »

The cost they are paying for their private treatment does not cover the cost of it being provided to them in a public hospital using publicly paid for staff and publically paid for labs etc

We've already agreed that. Do you not agree that they have paid for this through their taxes or do those not on private health insurance not pay tax?

View wrote: »

Out of curiosity, do you believe you have a right to have your private taxi journey subsidised by the tax-paper if you opt to use one rather than the slower tax-payer provided public bus service?

Well no.... Public transport receives a subsidy because the state wants people to partake of public transport to reduce the social cost of private transport. The state makes a simple calculation that the reduction in overall cost by subsidising public transport makes a return in reduced traffic, roads, pollution etc and that actually benefits private transport including your taxi driving in an uncongested bus lane. On the other hand car owners (and by extension taxi's) are actively "fined" by the state for their social cost.

Private health care makes no such social cost on society. And Public Health care is not subsidised - it's straight out paid for. What you are proposing is that private health holders are punished for some unspecified reason....

If you want to get silly about it you can pay for first class on IE. Should you pay unsubsidised rate for that too?

View wrote: »

Private health insurance as can be seen in other countries is an extremely expensive service. The only reason it is "affordable" here is because the true cost of it has been hidden and subsidised by the public service. Now that is changing and it is suddenly unaffordable to some.

Some countries with low general taxation and privitised healthcare such as the USA. In most countries such as the UK with public health care, private health care is relatively cheap. You can't have it both ways by making those on private health insurance pay on the double. Either we fully privatise and let the state cover those that can't pay or we have a public health system where people can top up their cover.

View wrote: »

That is not the state's problem. The problem for the state is providing the public service. Tying up beds to provide a private service for some in public hospitals where there are shortages of public beds is just bonkers.

But it will be the states problem. Under your approach there will be a flood of ex private patients into the public system tying up beds but with no private money. Regardless of your opinion about private health insurance you simply have not thought through the impact of essentially destroying the private health insurance market in Ireland. You have a bizarre belief that consumers will not change their behaviour if their health insurance quadruples.

micosoft

View wrote: »

No one is saying you lose your public healthcare. If you choose to forego it fair enough.

Then you are in the private system and get to pay the cost of that private service, not a private service which is heavily subsidised by tax-payers who in some cases can't afford that private care which you are using.

If they can have public treatment or private treatment why can't they have both? Unless your view is ideological. Choose private and you must be punished?

View

micosoft wrote: »

Unless your view is ideological. Choose private and you must be punished?

You are the one arguing people should be punished - those people who avail of the public service that is (which presumably doesn't include you).

Tax-payers money IS being diverted from public healthcare to provide a subsidised private health care system for some - subsidised as those some are NOT paying the full cost of the treatment they are receiving via their private healthcare. They are paying a fraction thereof.

The state is now reducing that subsidy hence the howls of anguish about premia going up.

It is deeply ideological to want the state to continue a system where people who could NEVER afford private health care are short-changed while money is instead spent to cover a good chunk of the cost of private healthcare for others.

ressem

View wrote: »

You are the one arguing people should be punished - those people who avail of the public service that is (which presumably doesn't include you).

Tax-payers money IS being diverted from public healthcare to provide a subsidised private health care system for some - subsidised as those some are NOT paying the full cost of the treatment they are receiving via their private healthcare. They are paying a fraction thereof.

The state is now reducing that subsidy hence the howls of anguish about premia going up.

It is deeply ideological to want the state to continue a system where people who could NEVER afford private health care are short-changed while money is instead spent to cover a good chunk of the cost of private healthcare for others.

You are the one arguing people should be punished - those people who avail of the public service that is (which presumably doesn't include you).

This assumes that when this percentage of the health budget stops being paid to private hospitals, that it will all flow back to the public service.
If you've heard the term "the money follows the patient" the public service will not get money from the taxpayer for treatments that it is not carrying out. Nor should it.

What are the scenarios if your ideal comes to pass?

• A large number of people pay ten thousand a year or more to private insurance companies.
  
• Two completely separate health services one wholly private and one wholly public are formed.
  
• The public health service starts falling foul of unfair competition rules if state payments are excessive and the government is compelled to purchase a greater amount of services from the private sector.

How does this remove the punishment for public patients? It'll be a very mixed bag of more people going through the hospital, which might increase efficiencies in one area, while making bottlenecks worse in others.
The private hospitals might close their daytime A&Es for example.

But you seem to have more faith in the HSE to efficiently optimise the hospitals for increased demand than I do.

The reason that 2 million irish citizens are covered by private insurance, is seeing multi-year waiting lists in the public health system. They've greatly improved cancer services, but so many other areas appear gridlocked.

And if you insist on personalising it, instead of making your case, I no longer have private health insurance.

micosoft

View wrote: »

You are the one arguing people should be punished - those people who avail of the public service that is (which presumably doesn't include you).

Tax-payers money IS being diverted from public healthcare to provide a subsidised private health care system for some - subsidised as those some are NOT paying the full cost of the treatment they are receiving via their private healthcare. They are paying a fraction thereof.

You are presuming that those that pay for private health insurance are not tax payers
OR
that you are not entitled to anything from your tax contributions even if they are marketed as such (Universal Social Charge).

The first is flat out factually wrong and nothing to do with ideology. Those that pay for private health insurance tend to be the highest tax payers. Therefore they are NOT being subsidised. They are paying for what you call a public subsidy through their tax contribution.

The second is a valid ideological position. I disagree but I can see how you could argue for it.

My "ideological" view is that you pay for a service you are entitled to a return on that. If you want to privately top it up that's your choice. You still get the basic service covered because you paid for it.

Mucco

micosoft wrote: »

Throw into the mix the criminal community ratings scheme which penalises people who join private health care young and encourages people to join late in their lives when they are likely to get sick more frequently. It's like joining a pension fund at 55 and getting the same return as a 25 year old.

Just to pick up on this. There really is no other choice but for risk equalisation. Even in the States, most insurance is through a workplace scheme, where the risks are shared. The alternative is everyone paying their actuarially fair rate, which will equal the cost of the healthcare + the admin for the insurance.

Of course, with optional insurance and risk equalisation, you get adverse selection (low risk opting out), therefore compulsory insurance is a solution, maybe through taxes! I don't know why young people opt for private insurance in Ireland.

oscarBravo

Mucco wrote: »

I don't know why young people opt for private insurance in Ireland.

I'm not exactly young (not exactly old, either) but I've needed a few medical treatments in the past few years, and I'm very, very glad I have health insurance.

micosoft

Mucco wrote: »

Just to pick up on this. There really is no other choice but for risk equalisation. Even in the States, most insurance is through a workplace scheme, where the risks are shared. The alternative is everyone paying their actuarially fair rate, which will equal the cost of the healthcare + the admin for the insurance.

Of course, with optional insurance and risk equalisation, you get adverse selection (low risk opting out), therefore compulsory insurance is a solution, maybe through taxes! I don't know why young people opt for private insurance in Ireland.

There are fair alternatives.... the older you decide to join Health Insurance the higher your rate. Same as if you delayed till your fifties for your pension.

That said mandatory health insurance is the way forward. It really is the only fair way.

shocko62

Health insurance is one of the most complex / complicated insurance to try and understand in Ireland. I worked in this insurance market and have a lot knowledge in this space. A lot of people on here has mentioned Community rating and risk equalisation. these are the two main factors which effects the cost of Health insurance in Ireland.

Community rating means that everybody pays he same amount for a particular level of cover regardless of their age. Essentially the younger members support the older members as they are less likely to use their cover.
Risk equalisation mean that regardless if you make a claim this year or not the cost of your cover the following year is the same. in other words, you're not penalised if you make a claim.

Seen as we in Ireland work in a community rating system, the insurance company have to protect themselves by introducing waiting periods. This means that you have to have cover for a period of time before you can make a claim. EG. if you're under 55 years old you have a waiting period of 5 years for a pre existing condition, 1 year for maternity cover and 26 weeks for anything new. the older you are the longer the waiting periods. So you can' just wait till you need an operation and take out insurance. that would be like having no insurance on your car, having an accident and calling an insurer to get cover.

Because VHI have been in the business working under these rules for 57 years (as a non profit company) they now have the majority of the older members. This also means that they have the majority of the claims. if the VHI are to continue to stay viable (cover the cost of the claims) the government had to introduce a system of age related tax.

This basically means that every insurer in the market has to pay a tax for ever adult and child they have on their books. this money goes into a fund / pot. Then for every adult over a certain age on the insurers book EG. over 65 years old the insurer get money out of the funds. As result of this because the VHI have the majority of the older members they end up getting the majority of the money out of the fund. All insurers use this system as an excuse to have to increase their prices. However this is a rubbish excuse. if this system was not there, the VHI would close up over night. Then the older members would move to the other 3 main providers and as a result their claims would increase and so they would still have to up the cost of their plans.

The alternative to this system is to go down the risk rated root. This means that if you're younger you pay less an the older population pay more for their cover. it also means that if you make a claim the insurer can apply a loading the following year. This is how car insurance works ( you make claim this year and the following year you're insurance premium increases.)

seen as health insurance is the one insurance that almost every person is going to use at some stage this I personally believe a risk rated system would not work. A person over 60 with a cardiac problem would be priced out of the market.

I believe you should review your cover every year to ensure you're getting the best value for money. A fantastic web site to use as a helpful source of research is www.hia.ie This site has every single coverset available on the market.

I would also suggest that you look at taking out a policy with a high excess if you're fit and healthy (not going / using private hospital on a regular bases) this means that you will have to pay the first X amount to the private hospital per claim. The higher amount of excess you take on the less your premium for cover will be. would suggest that you stay wll clear of plans with a percentage of cover in private hospitals. EG if you have 60% cover in a private hospital you'll have a shortfall of 40% per night. the cost of a bed in a private hospital can cost over €1000, you'll end up with a huge bill.

Day to day cover on plans are also only advisable to take out if you have a lot of day to day expenses. if you only have few GP visits per year you will not claim back enough from your policy to cover the cost of having this type of cover on your plan. day to day cover could cost you up to €200 per adult and €100 per child.

you should also look at splitting your cover. put children on a different plan to adults as they normally don't need as much cover. you can also put adults at different levels of cover, maybe dad needs better cardiac cover but mam wants better maternity cover. try and only pay for what you want / need.

I hope this help a little with the background to the costing of health insurance and also how to choose a plan.

micosoft

Thanks for the primer. Regardless of how we try to fix the current mess I think most would agree mandatory cover is the way forward. No matter what solution the cost of new medical treatments and life expectancy will create significant costs. The Americans spend 17.9% of GDP on healthcare which is astonishing if you think about it.... €6,375.69 per person. This in one of the less equal healthcare systems.

shocko62

I agree 100% with you. If we continue with our current system of health insurance it will only increase and increase. Seen as we have an increasing / aging population combined with a failing risk equalisation system and medical expenses soring due to modern medical advances (which is fantasic) the cost of heslth insurance can only increase.
The goverment are looking at a new universal health system. They're plan is lacking detail at the moment as they are still to release their white paper on it. But its understood that everybody will have to purchase health insurance. You'll have an option of who to be insured with and there will be a minimun level of cover. Those who cannot afford cover will be subsidised by the tax payer.
This system will also have a lot a faults. It'll be very hard to convince the general population they must have a minimum cover but even more so that they have to pay more tax for those who cannot afford it.
In Germany you could have up pay up to 15% of your income for health cover. And if you have an operation and its found that you have not paid enough tax you might be loaded with a levy. However you also get free nursing home treatment as part of this tax.
Some how i can't see people accepting this system either.

micosoft

Unfortunately yes. My Mother owned a Nursing Home and it was a real eye opener what some people thought was reasonable to spend on 24/7 nursing care (less then two nights in a B&B per week). Of course this usually was about the god given "entitlement" to their inheritance which they did not want touched to contribute. It bemuses me to see people demand €5000 treatments at the drop of a hat but balk at paying 50c under the free scheme.

Good quality Healthcare costs a lot of money and will cost more. We have to learn we can't keep making the next generation bail us out by loading them with debt for our healthcare and nursing care.

shocko62

Here here. Its like anything you purchase..... you get what you pay for. Somebody has to pay for good healthcare.
There's this saying used a lot "sure if i need an operation they wouldn't let me die" but who is going to pay for it. Consultants are on top money and rightly so for the job they do.... saving lives.
There is a sickening culture in Ireland that we deserve free health care and like you said they complain about paying 0.50c for their perscriptions.

COYW

Just got my renewal in the post. It has gone up over €300 to just under €1,200. Time to shop around again. No claims on the policy, ever, before anyone asks.

Zubeneschamali

COYW wrote: »

The government is moving towards universal health.

Yes, and at the rate they are going, my great-grandchildren may not need private health cover.

spank_inferno

COYW wrote: »

Just got my renewal in the post. It has gone up over €300 to just under €1,200. Time to shop around again. No claims on the policy, ever, before anyone asks.

if you dont mind me asking, how old are you?

If you have not made a claim..are you likely to incur €1200 in hospital & consultant costs in 2013/14?

If not... Why bother shopping around... Just dont pay.

Zubeneschamali

spank_inferno wrote: »

If you have not made a claim..are you likely to incur €1200 in hospital & consultant costs in 2013/14?

It's insurance - you don't just buy it if you are likely to need it. You buy it in case you might need it.

And if you need it in 2014 but don't have it, you could still be waiting to see a consultant in 2020.

oscarBravo

spank_inferno wrote: »

If you have not made a claim..are you likely to incur €1200 in hospital & consultant costs in 2013/14?

Three years ago, I was in the situation where I had never made a claim. If I had decided not to bother paying for health insurance, I would probably still be on a waiting list now to see a consultant ophthalmologist, and my eyesight would have deteriorated dramatically for want of the urgent surgery I underwent; and the kidney stone that was detected early would probably have become an emergency procedure several months later.

I'll go barefoot before I go without health insurance in this country.

COYW

spank_inferno wrote: »

if you dont mind me asking, how old are you?

If you have not made a claim..are you likely to incur €1200 in hospital & consultant costs in 2013/14?

If not... Why bother shopping around... Just dont pay.

I am in my 30s. As for my reasons for getting insurance, see oscarBravo's post. We never know when we'll need health cover.

Did a bit of shopping around and I can get the same level of cover for €800 if I increase my voluntary excess by €200. Will shop around tomorrow to see what else I get can for my money.

spank_inferno

I know insurance is a gamble...
However the assumption that not having it inhibits prompt healthcare access is incorrect.

18 months ago I (rather embarassingly) was befallen be Pilonidal sinus.... .

Dont have insurance & public wait was about 4 months.

As if was agony... I opted just to pay fof it.
Paid the consultant / surgeon / anasthetic guy in cash plus the €75 for a day in Naas general.

All in... 3 weeks from diagnosis €800 cost.

Job done.

As an otherwise healthy 30yr old its a 1k annual gamble I'm happy not to take.

Paying a-la-carte has its plusses.

oscarBravo

spank_inferno wrote: »

All in... 3 weeks from diagnosis €800 cost.

Hmm. Consultation, CT scan, followup consultation, general anaesthetic, surgery, overnight stay, stent insertion, another surgery under GA, another overnight stay, followup consults... and that was just the kidney op.

I saw the bill my insurance company paid.

I can live without shoes.

Zubeneschamali

spank_inferno wrote: »

All in... 3 weeks from diagnosis €800 cost.

That's like saying a fender-bender in traffic with some scratched paint is the worst that's happened to you, so you don't need car insurance.

The next accident could cost millions.

spank_inferno

Indeed... It is a risk.

I could get cancer tomorrow.

But as a healthy 31 yr old, costly health insurance is somethinb I dont regret going without.

Of course when I turn 50 and my joints turn to dust that opinion will change.

Then I'll be thankfull for the terrified young'uns subsidising my insurance costs!

Zubeneschamali

spank_inferno wrote: »

Of course when I turn 50 and my joints turn to dust that opinion will change.

This is why running healthcare as a private operation is stupid. No-one wants to pay until they need it, and then they can't afford it.

TwoShedsJackson

COYW wrote: »

Just got my renewal in the post. It has gone up over €300 to just under €1,200. Time to shop around again. No claims on the policy, ever, before anyone asks.

If this is for a personal policy, find out if your insurer has an equivalent corporate plan - if they do, get switched to it. They are obliged to do so, but are not obliged to tell you that an individual is perfectly entitled to sign up to a corporate plan.

I did this with Laya this time last year and my policy went from €1500 to €800 overnight, for a 2 minute phone call.

Mucco

In Ireland, health insurance is about paying for access. It is mostly the same treatment, by the same doctor in the same hospital, and sometimes in the same room as the public system.

The cost of the public system is capped at 750 per annum, which is less than the premia quoted here. The public system treats the vast majority of patients in Ireland very well, those of you saying you have been glad to have private healthcare do not know what treatment you would get under the public system, so you cannot say that private insurance is worth the money.