How does ireland not have free healthcare?

BrokenArrows

When i say Free i mean you dont pay per visit, it comes out of taxes.

Ive been living in London for the past 6 years and I have to say having "free" healthcare is great. If there is something wrong with you, then you call the GP and arrange a visit. Might be a few days or more wait to get an appointment if its not an emergency. You get checked out. No charge at all. Need surgery then no charge at all.
Broken bones, no charge.
Medicine is cheap. A week of antibiotics cost me 7 Pound (€10)

The UK's budget to offer this free service is 96 Billion Pounds for a population that 14 times the size of ireland.

Irelands budget to offer this non free service is 10 Billion Pounds (13Billion Euro).

You pay €60 euro to see a doctor who does nothing but writes a prescription, and you pay a bunch more for the medicine. €100 euro if you need to go to the emergency room and around €275 if you break a bone.

So how can ireland not have a free service when they are paying significantly more per person to run the hospital system. If you were to scale down the UK budget then it should be 6.8 billion pounds (8.7 Billion Euro).

So irelands paying 33% more to run the non free health system than the UK spends to run a free system. Granted that their are economies of scale to take into consideration but FFS!

And then to top it all off i worked out how much more i would pay in tax in ireland and if i take my salary here and convert it to Euro then i would pay 8% more tax in Ireland.

And the Irish government wonders why people dont want to move "home"!!!

** And when i say TAX i mean all mandatory deductions from my pay packet.

NIMAN

You pay for the NHS in the UK.
To say its free is nonsense.

Kev_2012

I'd happily pay a little more tax to have unlimited free healthcare

smash

NIMAN wrote: »

You pay for the NHS in the UK.
To say its free is nonsense.

OP also states "And then to top it all off i worked out how much more i would pay in tax in ireland and if i take my salary here and convert it to Euro then i would pay 8% more tax in Ireland. "

We also pay a health levy through USC. Remember?

12Phase

Political choices largely.
Ireland never had the structural reforms the UK did after WWII.

Our healthcare structure still looks like theirs pre NHS.

Our per capita spend on health is higher than the UK. That's fact.

Allinall

Having to pay keeps the hypochondriacs at large, which can only be a good thing.

Aongus Von Heisenberg

The primary purpose of the health system is to benefit those working in it and those who own the private parts of it.
Healthcare provision is very much a secondary priority, value for money for the taxpayer is hardly on the list of priorities at all.

Government "reforms" for a long time have been more about privatising more of it by pushing people into health insurance than about improving healthcare provision.

BrokenArrows

NIMAN wrote: »

You pay for the NHS in the UK.
To say its free is nonsense.

Read the very first line of my post.

smash

Allinall wrote: »

Having to pay keeps the hypochondriacs at large, which can only be a good thing.

Not when a huge chunk of the population are on medical cards.

Lurkio

BrokenArrows wrote: »

When i say Free i mean (...............) dont want to move "home"!!!

Failure to take on unions, the way the merger of health boards was handled, lack of imagination, sheer feckin stupidity, political football matches...........as long as it more or less keeps ticking over I can't imagine things changing.

12Phase

If you want to see how strung up it is with vested interests, just look at the disgraceful mess that went on about picking a site for the national children's hospital.

35.5 million of funds literally flushed down the toilet due to inexplicable bickering yet there has been nobody held to account for it.

...And Justice

Kev_2012 wrote: »

I'd happily pay a little more tax to have unlimited free healthcare

Add your reply here.
You'll never get that here while the pharmaceutical industry manufactures most of the world's medicine here, that's why we pay so much for it too.

...And Justice

...And Justice wrote: »

Kev_2012 wrote: »

I'd happily pay a little more tax to have unlimited free healthcare

You'll never get that here while the pharmaceutical industry manufactures most of the world's medicine here, that's why we pay so much for it too.

Add your reply here.

uck51js9zml2yt

We can't have a low direct taxation system and better services.
The problem is we want both and no one has the cop on to say it can't be done.

Compatinging ourselvescto Scandinavian countries is ridiculous. They pay more tax and have the money to spend on the services.

thebeerbaron

Here's why, there are over 100,000 staff in the HSE, about 10,000 are medically trained to treat patients.
So have enough staff but we dont have enough of the RIGHT staff

Former head of the HSE (before tony o'brien) said that when it was created they had too many HR staff but that he cant get rid of them.
Unions would strike

Basically most of the money is not spent on services but on staff pay and pensions.
This is a hangover of the FF expansion during the 00s. Most of the money was not spent on services but on pay and pensions so the unions would vote for them

BrokenArrows

Cullen Ashy Skateboard wrote: »

We can't have a low direct taxation system and better services.
The problem is we want both and no one has the cop on to say it can't be done.

Compatinging ourselvescto Scandinavian countries is ridiculous. They pay more tax and have the money to spend on the services.

Whose comparing ireland to Scandinavian countries?

Eugene Norman

Kev_2012 wrote: »

I'd happily pay a little more tax to have unlimited free healthcare

It wouldn't be a little more tax.

thebeerbaron

anyone who says we need to raise more tax for our health system is wrong
http://www.finfacts.ie/Irish_finance_news/articleDetail.php?Ireland-second-highest-OECD-health-spending-poorest-outcomes-506

we need to reform the current system with changes in staff and procedures
the money is there, its how its spent that is the problem

K-9

Cost, but we kind of are used to paying for it.

Take the Mother and Child Scheme in 1950, the Catholic Church opposed free maternity care for women, FG suported them.

FF brought it in in everything but name a few years later.

We've a culture of paying health insurance here, Britain doesn't when they could easily do with it.

Eugene Norman

Cullen Ashy Skateboard wrote: »

We can't have a low direct taxation system and better services.
The problem is we want both and no one has the cop on to say it can't be done.

Compatinging ourselvescto Scandinavian countries is ridiculous. They pay more tax and have the money to spend on the services.

We have very high taxes on labour. Now if we could extend the tax base via taxes on wealth (property or land), increase corporation taxes without the corporations fleeing and get people to pay for water then maybe we could fund a free health service.

OldMrBrennan83

This post has been deleted.

The Backwards Man

People in Ireland want to have everything and they want to pay for nothing. Services are bad because no one wants to pay the cost of financing them. That's the way it's always been, and it looks like it's the way it will be for a long time to come

Zillah

The Backwards Man wrote: »

People in Ireland want to have everything and they want to pay for nothing. Services are bad because no one wants to pay the cost of financing them. That's the way it's always been, and it looks like it's the way it will be for a long time to come

But if you look at the math in the OP we are paying more for healthcare per head than the UK is. Obviously we're doing something fundamentally wrong.

thebeerbaron

we already pay enough, there is no need to increase any taxes, see my above post

tommyhayes1989

Medicine is so expensive because we do not have anyone to lobby the Pharma companies to use Generic drugs. Can't quite remember the name of the set up but that's about right.
As for healthcare, the HSE and the "healthcare system" in this country is quite literally the most ineffective, inefficient and useless organisation. Year after year we pump our own money into it, budget add ons after add ons, and it always runs over budget. There is a serious mismanagement of resources, both physical and labour. Which makes me feel somewhat sympathetic for the nurses and co.

Eugene Norman

The Backwards Man wrote: »

People in Ireland want to have everything and they want to pay for nothing. Services are bad because no one wants to pay the cost of financing them. That's the way it's always been, and it looks like it's the way it will be for a long time to come

Again. One of the highest taxes on labour in the world.

FizzleSticks

This post has been deleted.

Amfyoyo

Four other factors are
The alleged 'government' in it's frantic efforts to be seen to produce 'jobs' agrees with pharmaceutical Companies that a Company will employ 100 new 'employees' a year ,for 4 years,paying them €40,000 a year salary...the 'deal' is "We'll employ Ur people provided Ur 'Health Service' exclusively use our Branded medications, not Generics"...the actual cost of each 'job' is actually €300,000 +

Unlike most civilized Countries who have a prescription for life once a condition is diagnosed, in Ireland, U've to go back to Ur GP every 3 months, who hits the 'print ' button on their PC for Ur repeat prescription...even at €30 for repeats, do the sums...10,000 GP's with 100 patients on repeats per month .....
10,000 x 100 patients x 12 months x €30 .... €360,000,000...and that's just for repeats

The Ratio of Admin to Medical staff is 2.7:1 For every ONE Medical Person who can 'make U better', ie Doctor/ Consultant / Nurse,there are 2.7 in admin...secretaries,porters and of course, management,'management consultant' and other well paid hangers on..who seem to be incapable of doing their job unless told exactly WHAT to do by KPMG/PWGC in a 'report',costing €millions

A Minister for health who underfunds the Hospitals yet gives them 'unrealistic' targets to achieve....when they fail to hit these 'targets' ,they are fined, meaning they have to pay money from their reduced Budget to pay the fine, effectively reducing next years budget , and ensuring that target wont be ;hit' either....and this from a man who was caught stealing €2,000 from his expenses last October by the Sunday Times and forced to return the money.....

Tubbs

BrokenArrows

FizzleSticks wrote: »

This post has been deleted.

Im still able to go to the doctor without it costing me anything extra than what i pay from my salary.

Icemancometh

BrokenArrows wrote: »

When i say Free i mean you dont pay per visit, it comes out of taxes.

Ive been living in London for the past 6 years and I have to say having "free" healthcare is great. If there is something wrong with you, then you call the GP and arrange a visit. Might be a few days or more wait to get an appointment if its not an emergency. You get checked out. No charge at all. Need surgery then no charge at all.
Broken bones, no charge.
Medicine is cheap. A week of antibiotics cost me 7 Pound (€10)

The UK's budget to offer this free service is 96 Billion Pounds for a population that 14 times the size of ireland.

Irelands budget to offer this non free service is 10 Billion Pounds (13Billion Euro).

You pay €60 euro to see a doctor who does nothing but writes a prescription, and you pay a bunch more for the medicine. €100 euro if you need to go to the emergency room and around €275 if you break a bone.

So how can ireland not have a free service when they are paying significantly more per person to run the hospital system. If you were to scale down the UK budget then it should be 6.8 billion pounds (8.7 Billion Euro).

So irelands paying 33% more to run the non free health system than the UK spends to run a free system. Granted that their are economies of scale to take into consideration but FFS!

And then to top it all off i worked out how much more i would pay in tax in ireland and if i take my salary here and convert it to Euro then i would pay 8% more tax in Ireland.

And the Irish government wonders why people dont want to move "home"!!!

** And when i say TAX i mean all mandatory deductions from my pay packet.

Hang on, I had to stop you here. All a doctor does is write a prescription?

Ragnar Lothbrok

Patww79 wrote: »

This post has been deleted.

The waiting lists are terrible here too. Not to mention trollies in corridors etc - how is that better service than the NHS provides?

I spent 12 months in England recently and as a diabetic I was entitled to free feet examinations every 8 weeks (it costs at least €60 here so I get them looked at every six months now), free prescription drugs, free GP visits, etc, etc.

My father, who lives in England, underwent major surgery (triple heart by-pass) and the service he received prior to, during and after the operation was unbelievably good.

The NHS has many detractors in the UK, but when I explained how our medical services work over here, most of them were amazed and admitted that they do tend to take the NHS for granted and don't recognise how great it is compared to systems almost everywhere else on the planet.

Corruptedmorals

Yes I wouldn't be cheering our waiting lists any time soon.

Orthopaedics - 3 years
ENT- 18 months- 2 years
Opthalmology - 1 year
Paeds rheumatology - 2-3 years
Paeds ENT 3 years
Paeds Orthopaedics 18 months
Paeds cardiology 18 months

They're so bad that some of the private waiting lists are bad too, 3 paeds specialities that I know of are 8 months each in Crumlin. The HSE have had to introduce a scheme to have people waiting the longest seen as public patients in private rooms out of hours.

questionmark?

I ain't defending the mess that is the HSE but to say the NHS is free is utter nonsense.

Once you earn over £155 per week you pay 12 pence out of every pound you earn for national insurance that goes towards funding the 'free' NHS and the benefits system. You pay wheter you use it or not. Would people in Ireland be happy to pay extra tax for the doctor out of their wages. Ya right.
The NHS is also in disarray in many of the Trusts that run each district just not at the same level of ****eness as the HSE.

YFlyer

Unhealthy people love free health care.

Deise Vu

Just to clarify something OP said in the opening post. If it is not an emergency you make an appointment with you GP under the NHS and then he sees you for free. Flu, viruses, a funny lump under your armpit is not an emergency. I have heard if you ring your GP on a Wednesday you would be lucky to see him by the following Tuesday by which time your virus is probably long gone and you spent a week suffering or worrying.

Sometimes paying for a GP who will see you in an hour or two is not too bad. It certainly isn't the part of the health system that I would have most complaint about.

thebeerbaron

questionmark? wrote: »

I ain't defending the mess that is the HSE but to say the NHS is free is utter nonsense.

Once you earn over £155 per week you pay 12 pence out of every pound you earn for national insurance that goes towards funding the 'free' NHS and the benefits system. You pay wheter you use it or not. Would people in Ireland be happy to pay extra tax for the doctor out of their wages. Ya right.
The NHS is also in disarray in many of the Trusts that run each district just not at the same level of ****eness as the HSE.

We dont need new taxes, we currently spend 2nd highest in OECD!!!!!

suicide_circus

We don't pay enough tax basically.

And the "Ara sure its grand!" attitude means that very few things get done properly.

thebeerbaron

suicide_circus wrote: »

We don't pay enough tax basically.

And the "Ara sure its grand!" attitude means that very few things get done properly.

Weather we pay enough is a matter for debate.
But in terms of health spending Ireland spends the 2nd most in the OECD.
This means that we have the money for a better service but how it is used is the problem.
Anyone who says we need to raise taxes is wrong.

questionmark?

thebeerbaron wrote: »

We dont need new taxes, we currently spend 2nd highest in OECD!!!!!

The whole point was that the NHS is not free like the OP suggested.

Eugene Norman

suicide_circus wrote: »

We don't pay enough tax basically.

And the "Ara sure its grand!" attitude means that very few things get done properly.

god the not enough tax argument will never die..

personally i believe that fully state run health services tend to be cheaper if properly run...

screamer

Ah maybe because last time I checked, we're pretty broke as a country without adding the cost of payment free healthcare onto our backs. Besides, look at the under 6 free GP scheme, clinics chockers with kids who are being dragged to the doctor for everything and anything because it's free of charge. Ridiculous. (also in at my local GPs the ones with medical cards are always there, different story if they had to cough up 60 euro every time). That sort of use it and abuse it behaviour would only make the costs sky rocket and the services even more diabolical than they are already.

L1011

The Church sat on all attempts to introduce a proper system, blaming "socialism" but really fearing loss of control of maternity services, children's homes, laundries etc. By the time their influence wained it was too entrenched

jam_mac_jam

I don't think we should have free GP care, its too expensive and why shouldn't people who afford it pay for it. There are much bigger issues in the health care system such as waiting lists and granniess on trolleys. A lot of people have medical cards already so they have free visits. I would rather pay the 60 quid rather then have to wait a week to see a doctor.

K-9

screamer wrote: »

Ah maybe because last time I checked, we're pretty broke as a country without adding the cost of payment free healthcare onto our backs. Besides, look at the under 6 free GP scheme, clinics chockers with kids who are being dragged to the doctor for everything and anything because it's free of charge. Ridiculous. (also in at my local GPs the ones with medical cards are always there, different story if they had to cough up 60 euro every time). That sort of use it and abuse it behaviour would only make the costs sky rocket and the services even more diabolical than they are already.

Halving to pay €60 to see a doctor isn't a good thing either!

NIMAN

The NHS is in crisis. Its not as great as people think it is.

thebeerbaron

K-9 wrote: »

PRSI is very low.

On minimum wage here you pay zero PRSI, in England about £15 a week.

We do pay USC which seems to go into a black hole, not the National Insurance system anyway.

USC should be made a PRSI payment, forget about cutting it.

why increase PRSI or make any changes to USC when we are 2nd highest in funding for the health service in the OECD?
You are missing the point entirely. If we keep discussing taxes we will not discuss why the money we already pay is not delivering a better service.

There is no funding problem, there is no taxes changes needed. It is management and staff reform that is needed.

K-9

thebeerbaron wrote: »

why increase PRSI or make any changes to USC when we are 2nd highest in funding for the health service in the OECD?
You are missing the point entirely. If we keep discussing taxes we will not discuss why the money we already pay is not delivering a better service.

There is no funding problem, there is no taxes changes needed. It is management and staff reform that is needed.

PRSI doesn't just fund Health, it funds SW including pensions as well.

20% of our taxes now service debt, something we didn't have to do in 06/07.

K-9

K-9 wrote: »

Take the Mother and Child Scheme in 1950, the Catholic Church opposed free maternity care for women, FG suported them.

In fact, it was the doctors in the form of the Irish Medical Association who first opposed the Mother and Child Scheme (starting with its precursor, the Fianna Fáil-introduced Health Bill of 1947), claiming they were opposed to the "socialisation of medicine". As always it was the financial interest of a powerful group which called the shots; the "moral" element was the dressing. It was they who lobbied the RCC and Fine Gael ministers to support them, which they wholeheartedly did.

Nowadays, this self-serving action of the medical profession is forgotten and the fashion is for all blame to be heaped on the RCC.

K-9

Fair point, still a powerful lobby group these days.

George Michael

the price of prescription is really just astronomical

ectoraige

Poor systems management. Here's just one example. Basically a situation where elective surgeries are being cancelled because the ED is full, in order to free up beds for emergency cases. However, the beds on the orthopaedic recovery ward can't be used to do infection risks, so the beds lie empty. Meanwhile, the patients who were due for surgery are told not to come in, and put back on the waiting list. The staff employed to work that day have no work to do, but get paid anyway. They can't be transferred to work in other parts of the hospital on that day due to the nature of their contracts. Money being spent, with zero productivity.

That's just one example, but it's systematic waste due to poor management.