Why do I need health insurance?

LG1234

I'm 33 going 34 soon so I know I'll be hit with a penalty if I don't take out health insurance next year. But I don't see why I should and I'm hoping someone can fill me in.

The way I see is if I get real sick the public system will look after me. If I'm not really sick and need to see a consultant I can pay the 400-500 quid private fee if needed.

Why would I fork out over 1000 a year for insurance?

coylemj

LG1234 wrote: »

The way I see is if I get real sick the public system will look after me. If I'm not really sick and need to see a consultant I can pay the 400-500 quid private fee if needed.

It's the stuff in-between which requires surgery and/or ongoing treatment that will catch you out if you don't have medical insurance. Say you develop a problem with your hip or one or both of your knees - that would be considered not urgent enough for A&E and if you go to a consultant, you will be told you need a procedure that will probably cost several thousand euros. In the public system you will be on a waiting list for years so to go private and get it fixed in a reasonable time-frame, you will have to dig deep and pay out of your own pocket.

If people in your age bracket don't pay medical insurance, the penalty for late entry will only keep rising and it will be unaffordable when you get into your 50s and 60s which is when you will start to really need it.

Zaph

I'm currently recovering from major orthopaedic surgery. Total cost for the surgery and several days in a private hospital was over €16k. Total cost to me thanks to VHI - zero, and I was able to schedule the surgery for a time that suited me work-wise. I also posted this elsewhere a couple of years ago as another demonstration of the benefits of private health insurance:

A number of years ago I had a sudden unforeseen complication following knee surgery that left me in absolute agony and unable to walk. Not knowing what was wrong, I went to A&E where an x-ray quickly showed what the problem was. It was clear that another operation was required, so I expected to be told I'd have one within a few days. I was stunned when they told me that I should go home and that they'd be in touch with me in "about 6 weeks" to discuss scheduling the operation. Not that the operation would be in 6 weeks, just that they'd give me a date for it at that stage. When I said that was ridiculous because I couldn't walk due to the extreme pain (far worse than the pain of the original complaint) and would have to go on sick leave, I was told that because it wasn't life-threatening I was a non-urgent case. It then dawned on me that because I was in A&E I was probably being put on the public waiting list, so I asked if my VHI meant I could have the operation sooner. The reaction I got clearly demonstrated the divide in the public and private healthcare systems in this country, it was pretty much "You have VHI? Well why didn't you say so? Take a seat and we'll see what we can do for you". I had the operation a week later.

That's the nature of insurance, you pay for it in the hope that you'll never need it, but are glad of it when you do.

CiniO

LG1234 wrote: »

I'm 33 going 34 soon so I know I'll be hit with a penalty if I don't take out health insurance next year. But I don't see why I should and I'm hoping someone can fill me in.

The way I see is if I get real sick the public system will look after me. If I'm not really sick and need to see a consultant I can pay the 400-500 quid private fee if needed.

Why would I fork out over 1000 a year for insurance?

My thinking is the same as yours.

If it's something serious, public health system will have to take care of that.
Anything smaller than that can be paid directly (scans/consultant fees), and if something more expensive needed urgently, it can always be done abroad in country where things like that are cheaper.

I can't see any reason to pay health insurance.

nobbin

My husband got diagnosed with cancer aged 42. Having private health insurance meant he started treatment immediately and quite frankly was in much nicer surroundings for the full day every 2 weeks he spent getting chemo. The difference between the two systems is just so unjust but when it's you or one's you love affected you are just thankful you have it.

ash23

I'm 34 and got health insurance when I had to wait almost 3 years for an appointment to sort out an ingrown toenail.

Then I got MS and I'm seen as a public patient. However I use my health insurance for my annual MRI. The MRI is over 500 euro to pay for it as it's a brain and full spine so takes an hour and a half and is charged in line with that.

If I was public I'd be getting one every three years or so.

If you would actually save the 1000 per year, maybe it'd be sufficient if something cropped up. But there are plenty of painful, debilitating illnesses​ that are not life threatening and therefore you can be left for years languishing on a public waiting list.
It's not right or fair but it's true.

coylemj

ash23 wrote: »

It's not right or fair but it's true.

What most people forget (or choose to ignore) is that if those of us who pay for medical insurance did not do so, the waiting lists for public treatment would be even longer.

The usual answer to this is that medical facilities should be available to all regardless of ability to pay but if the NHS is the model for that, why is there a company called BUPA in the UK running private hospitals and clinics all over the place?

Sue Pa Key Pa

LG1234 wrote: »

I'm 33 going 34 soon so I know I'll be hit with a penalty if I don't take out health insurance next year. But I don't see why I should and I'm hoping someone can fill me in.

The way I see is if I get real sick the public system will look after me. If I'm not really sick and need to see a consultant I can pay the 400-500 quid private fee if needed.

Why would I fork out over 1000 a year for insurance?

Because, although you can pay you 400-500 to see the consultant, you won't get his services without health insurance or paying for the treatment privately. It certainly won't boost you up the public waiting list

billbond4

I think there was an insurance expert on matt Cooper a few years ago and he was basically saying, throw the money you would be paying for health insurance in your twenties into a savings account, as if anything happens you should be able to afford it.
Then in your 30s get health insurance

coylemj

billbond4 wrote: »

I think there was an insurance expert on matt Cooper a few years ago and he was basically saying, throw the money you would be paying for health insurance in your twenties into a savings account, as if anything happens you should be able to afford it.

The likelihood of someone in their 20s resisting the temptation to use that money towards buying a house or car or holiday is zero.

If you have the attitude that you don't need to pay for medical insurance because a few hundred euros in the bank will cover any potential treatment, you're a fool.

professore

I developed a painful cyst on my arse that required surgery, and it was actually making me sick and feeling crap. The public waiting list for that would have been 2 years at least. Privately I got it done in 2 weeks. I have an office job, and it was really affecting my ability to work.

Toots

Health insurance is one of those things where it's better to have it and not need it than need it and not have it.

Just a couple of weeks ago, my little boy needed an operation. He'd been very unwell and had been referred to a consultant on the public system. The wait time was around 8 months, and god knows how much pain he'd be in during that time, and also missing a lot of school. We went private, saw a consultant in the Beacon within a week, and surgery was scheduled for 6 days later. Insurance covered all of the inpatient stuff, and we paid for the consultant appointments, however on our plan we can claim some of those back, so all in all it's cost us less than €50.

One of my friends (aged 30) has had chronic tonsil problems for years and was scheduled for surgery on the public system. She was waiting for over a year, and the operation was eventually done under the National Treatment Purchase Fund. However, in the intervening time, one of her cousins also needed the same operation. She had health insurance, went private, and had met with the consultant and had the surgery in the space of a few weeks.

To be honest, the outpatient costs associated with going private are the least of your worries. I remember having my son and my insurance covered a private room in Holles St. There was a big sign on the wall saying to make sure that your insurance definitely covered the room, because the nightly rate was something like €1100. So that's just literally the room, that doesn't include any medication, procedures, etc.

Pkiernan

ash23 wrote: »

It's not right or fair but it's true.

What is not fair about getting something extra by paying extra for it?

Peregrinus

In addition to speed of access, which others have mentioned, a significant factor is that if you develop a chronic, but not life-threatening, condition, you'll be very, very glad you had insurance.

It's one thing to pay out of pocket for private provision of a consultation or two, plus a single round of treatment. But if you have a condition that requires regular monitoring, treatment and review, for years and years - and there are many such conditions - you really don't want to be doing that in the public system if you can avoid it. If you only take out health insurance after you have developed the chronic condition, they won't provide any cover in relation to the pre-existing chronic condition until the expiry of a waiting period of between 5 and 10 years, and it's unlikely you'll be able to pay for private treatment for that length of time.

uck51js9zml2yt

My son has an ear condition that was picked up because we could go private. Surgeon said an infection would have hit his brain within weeks. If we relied on the public system he would probably not be alive today....Or at least seriously debilitated.

ash23

Pkiernan wrote: »

What is not fair about getting something extra by paying extra for it?

Most people pay for their health care via taxes. To have a split system where the wealthy get treated more quickly doesn't sit quite right with me to be honest.
I don't think someone should be left suffering because they can't afford to pay insurance.

Utopian ideals but yes, I do wish there was a way everyone could be treated quickly and fairly without being able to afford it being the crux of the speed of your treatment.

I've no problems with people choosing to pay for a nice room or a private hospital, just the waiting list issue.

LG1234

Im still not totally convinced i need this. I dont need a fancier room, if its urgent I have some savings I can tap into (which i will continue to add to if i dont have to pay insurance) if I go on a waiting list i can look at going abroad to get a procedure done etc.

But lets say I pick a plan thats 60 a month and I pay tax at the higher rate, does that mean I effectivly only pay 30 a month?

Pkiernan

LG1234 wrote: »

Im still not totally convinced i need this. I dont need a fancier room, if its urgent I have some savings I can tap into (which i will continue to add to if i dont have to pay insurance) if I go on a waiting list i can look at going abroad to get a procedure done etc.

But lets say I pick a plan thats 60 a month and I pay tax at the higher rate, does that mean I effectivly only pay 30 a month?

Health cost tax relief is assessed at the lowest rate (20%), not your marginal rate.

Pkiernan

ash23 wrote: »

Most people pay for their health care via taxes. To have a split system where the wealthy get treated more quickly doesn't sit quite right with me to be honest.
I don't think someone should be left suffering because they can't afford to pay insurance.

Utopian ideals but yes, I do wish there was a way everyone could be treated quickly and fairly without being able to afford it being the crux of the speed of your treatment.

I've no problems with people choosing to pay for a nice room or a private hospital, just the waiting list issue.

The wealthy are paying far more, both in taxes and in private fees.

Dravokivich

I find it a bit unfair that this penalty has been introduced. I don't have it because I can't afford insurance. This incremental penalty means it'll be harder for me to be able to afford it in future. Regardless of whatever economists may suggest you should do with your money.

Eire Go Brach

just to give you the other side.

All the money you save will pay for when your sick if you are sick.
Cancer is probably the best thing to get as public System is not so bad with that. But it's a gamble after all. I have it through my GFs job. She does pay BIC on it. But would not pay it myself. I'm 40 now, never been seriously ill. Been the doc twice in 4 years. Last time got my antibiotic. First one since I was 13. I got €40 back for each doc visit.

Just to add. It's been a benefit for her. She has a peanut allergy plus others.

Sue Pa Key Pa

The whole system is unfair, unjust and as a result of wastage of the resources given to the HSE (not nurses & doctors etc.). However, when it's the only game in town, we each have to make our own choices as to whether we take cover or not.

I would be very interested to hear from anyone without health insurance who opted to go private for a serious procedure out of their own funds. Did the hospital and consultant insist on some form of guarantee before agreeing to the procedure?

byhookorbycrook

Like Ash, I developed MS in my 30s.Previous to that I was NEVER ill, bar the odd cold or stomach bug. There was a 2 year waiting list to see a neuro publicly at the time. The treatment I am now on costs €2,500 a month, VHI covers it. The numbers of public patients who get it is quite limited. One of my other meds takes so much paperwork to get it , that many in the public system simply won't get it at all. It's been proven now , with MS that you need early diagnosis and aggressive treatment from the start.The delays in the public system can mean far worse prognosis.

km79

So weird .........I've been thinking about this a lot today and now find this thread !
Family of 4 (40 , 37 , 16 , 6) and all in good health touch wood .
Had health insurance for 5 years or so up until 4 years ago
Could only afford the basic package which basically covered nothing so decided to get rid of it
May now be in a position to get a middling package but i don't even know where to start tbh

LG1234

byhookorbycrook wrote: »

Like Ash, I developed MS in my 30s.Previous to that I was NEVER ill, bar the odd cold or stomach bug. There was a 2 year waiting list to see a neuro publicly at the time. The treatment I am now on costs €2,500 a month, VHI covers it. The numbers of public patients who get it is quite limited. One of my other meds takes so much paperwork to get it , that many in the public system simply won't get it at all. It's been proven now , with MS that you need early diagnosis and aggressive treatment from the start.The delays in the public system can mean far worse prognosis.

But if I didnt have insurance i could pay for the consulatations with the neuro and even though the drugs cost €2500 per month, you'd still only have to pay €144 per month because of the drugs payment scheme. And you'll be able to claim 20% back on each €144 in tax relief at the end of the year.

Ive had a look at a few plans and unless youre going all out and getting the best plan they seem to cover very little...

byhookorbycrook

The treatment is given in a hospital setting and is not under the DPS . I get it once a month , our Neuro is at every infusion . Many public patients see the Neuro once a year at most . The other drug was not under the DPS and after much campaigning we got it funded . It was costing up to €500 a month . It has been funded for " responders " who must be assessed by the Neuro to show it is working and the volume of paperwork for it is staggering .

My main treatment is associated with a possibly fatal side effect so I get an MRI at a minimum every six months . I know public patients who haven't had one in years.

madmaggie

Like previous posters, I'm very glad I have insurance. A couple of years ago I had a potentially dangerous health problem. Two weeks to see the consultant, then two weeks to surgery. Under the public system it would have been almost a year to get an outpatient appointment, and who knows how long until surgery. In an ideal world the public system would be as good, and insurance would only be for upgraded accommodation, but that's not the health system that we have.

CiniO

I have no health insurance.
Last year, I developed some abdominal pains with rectal bleeding, and on top of that chest pains.
Went to A&E (€100), they did ECG and chest xray and confirmed nothing wrong there, and said most likely chest pain due to fear of other symptoms. They gave me letter for my GP, so she could give me referral for abdominal ultrasound.
Knowing it's going to take long time. instead of that, I booked my flight to Poland for next day, got consultant visit with abdominal ultrasound (€30), Colonoscopy few days later (€100), gastrologist consultant visit (€25) and cardiologist consultant visit (€40).


Together with flights, driving to Dublin, airport parking, etc, it cost me less than €500 (including this A&E visit) and took me about 1 week.

Would health insurance help me obtain the same service here in Ireland - probably yes, but at much bigger cost, and I would need to travel anyway probably to Dublin or Galway in best case.

2forjoy

madmaggie wrote: »

Like previous posters, I'm very glad I have insurance. A couple of years ago I had a potentially dangerous health problem. Two weeks to see the consultant, then two weeks to surgery. Under the public system it would have been almost a year to get an outpatient appointment, and who knows how long until surgery. In an ideal world the public system would be as good, and insurance would only be for upgraded accommodation, but that's not the health system that we have.

I was opposite to above post . A couple of years ago I had a potential dangerous health problem . I paid consultant €160 and got appointment in two weeks .
Then I was sent for x-rays and tests under the public system . and a month later went back for final visit to consultant , another €120 and he put me on correct medication for life .

dev100

LG1234 wrote:

I'm 33 going 34 soon so I know I'll be hit with a penalty if I don't take out health insurance next year. But I don't see why I should and I'm hoping someone can fill me in.The way I see is if I get real sick the public system will look after me. If I'm not really sick and need to see a consultant I can pay the 400-500 quid private fee if needed.]Why would I fork out over 1000 a year for insurance?[/quote

It's a luxury to have and to be honest I was like you but I get it thru work but I top up and have a better plan .

I've seen work mates having had operations having cost thousands and it was all paid for by private health care and having it done quickly and I've seen mates who are on public system waiting an extreme length of time for an appointment for a consultant or a procedure . There's no comparison it's only when you need it you realise its fantastic.

The 500 you talk about is pocket change when it comes to anything complicated if you have to go private and don't have private health care.

Simple fact it's a luxury if you can afford it if not don't worry about it .

okiss

LG1234 - I would advise you to take out a health insurance policy that gives you cover in a semi private room in a private hospital and be willing to pay a high access if you go to hospital.
If you need medical treatement and don't have health insurance you will be put on a public list. You could wait a year to see a consultant and wait as long again before you get treatment. You could be in pain for 2 years with no end in sight.

Also if you develope a long term condition you can get seen qicker and get access to treatment that could be better for you long term.

For each year that you put off getting health insurance you will be charged a loading and this will put the cost of you insurance up by a certain % each year.
A few years ago I was in your position. I realised that unless I took out health insurance then that long term I would not be in a position to afford it. Since then I saw one of my friends wait for over 12 months for surgery in pain. I know if the same thing was wrong with me I would have surgery within a month.

Pat 36059

if later in life you develop an illness ,you won't be covered for that illness unless your in private insurance. Your Prsi covers very little apart from, you'll be on a list, and if you get iIll health you might just end up not getting attended to. Take out a medium plan , See how it goes .

Pelvis

Cancelled my health insurance a couple of years ago as I couldn't afford it at the time. Had been meaning to take it up again but hadn't got around to it, until last night, having read this thread!!

76544567

LG1234 wrote: »

I'm 33 going 34 soon so I know I'll be hit with a penalty if I don't take out health insurance next year. But I don't see why I should and I'm hoping someone can fill me in.

The way I see is if I get real sick the public system will look after me. If I'm not really sick and need to see a consultant I can pay the 400-500 quid private fee if needed.

Why would I fork out over 1000 a year for insurance?

When you get sick all will become more clear.
You will be able to look back and see if you made the right decision then.
Do you want to find out only then?

Geuze

Pat 36059 wrote: »

if later in life you develop an illness ,you won't be covered for that illness unless your in private insurance. Your Prsi covers very little apart from, you'll be on a list, and if you get iIll health you might just end up not getting attended to. Take out a medium plan , See how it goes .

Please note that PRSI is nothing to do with healthcare.

Please don't spread this myth.

Since the 1970 Health Act, every resident of Ireland is entitled to public healthcare, nothing to do with PRSI.


[Exception: optical and dental benefit]

daheff

coylemj wrote: »

What most people forget (or choose to ignore) is that if those of us who pay for medical insurance did not do so, the waiting lists for public treatment would be even longer.

The usual answer to this is that medical facilities should be available to all regardless of ability to pay but if the NHS is the model for that, why is there a company called BUPA in the UK running private hospitals and clinics all over the place?

What if all the private health care payments were made to the government and they administered the health system? More patients could be seen & we'd have shorted waiting lists. And more money would be available. why? Private health care is a for profit situation. For every euro you pay a percentage goes to line somebody elses pockets. If that money was reinvested into the health service we all benefit...and at a lower overall cost.

Sure even the HSE are in on the act...they sell capacity to private care providers at extremely high costs...and fluff the invoices (private providers are checking & disputing invoices from HSE for unexpected/unwarranted costs now).

Consultants are working for hospitals (public) and themselves (private).

Our health system is a farce. Govt have tried to outsource it to other people and ended up making a balls of it.

Merowig

Giving more money to the public health service does not mean automatically that this service will become more efficient.

Sue Pa Key Pa

daheff wrote: »

What if all the private health care payments were made to the government and they administered the health system? More patients could be seen & we'd have shorted waiting lists. .

So you're suggesting that I continue making the payments I give my health insurer to the Government, to assist those that aren't making any payments. I see a flaw there......................

And if you seriously think that the HSE will administer that cheaper than the profit taken by the private health insurers, you're more deluded than I think you are

Peregrinus

Merowig wrote: »

Giving more money to the public health service does not mean automatically that this service will become more efficient.

No. But it will be better-resourced. Unless it actually becomes less efficient, that should result in a higher level of service.

I don't think we can pontificate dogmatically, one way or the other, over whether privately-run or publicly-run health services are more or less efficient. It's easy to find examples of both. US health services, largely privately run and financed, are massively inefficiently administered; I think this is universally recognised. The UK NHS, by contrast, has an extremely low ratio of administrative expenses to overall budget. So ideologically-driven convictions that public services are always inefficient, or always efficient, are really no help here.

Merowig

The efficieny of the NHS seems to be a "myth"
https://www.adamsmith.org/blog/healthcare/myth-busting-nhs-not-efficient-after-all/

If the public health service has to be better ressourced, the Irish people have to vote for a party which raises additional taxes which contribute then to the health sector or increase the health sectors budget by cutting the budget from other sectors.
As it seems unlikely that this is going to happen any time soon the system stays as it is for now.

That means people who have chances of serious illnesses or are in their mid-30s are advised / incentivsed to take on health insurance.
If not there is the public service with its waiting lists or one can pay from ones pocket for private treatment in Ireland or abroad.

Peregrinus

It depends on what you mean by "efficiency".

One measure of efficiency is the ratio of administrative overhead to total budget. The more of your budget you spend on administrative overheads, the less you spend on actually delivering healthcare. The US scores very badly on this measure; the UK scores very well. (Ireland is in between.)

The OECD report that the Adam Smith blog refers to is measuring something else. It looks at the country that gets the best health outcomes per dollar spent on healthcare and treats that as the most efficient country. It then calculates the improved health outcomes other countries would get if they could spend their health dollars as "efficiently" as that best performer.

The problem with this analysis is that it isn't necessarily the case that the good outcomes achieved by the best performers are entirely, or even largely, the result of wise choices in spending health dollars - they may have more to do with genetics, diet, lifestyle, etc.

Sue Pa Key Pa

Inefficiency = System not working properly

HSE = Inefficient

Dardania

It's a Darwinian system: the wealthy (basically, the workers who can afford health insurance) get better, faster.
And the poor that can't spend or don't spend their money on healthcare, don't get better, or if they do, it's not fast

Merowig

Though many of the so called poor can still afford drinks and smokes... (which don't help with health either...).
Not to forget that there are still medical cards around for the poor.

Health insurance is available from around ~37 Euro a month... you do not need to be wealthy to afford this.

I find it normal that people who can afford it can get better/faster treatment. I don't see a problem with that.

Peregrinus

Sue Pa Key Pa wrote: »

Inefficiency = System not working properly

HSE = Inefficient

Um, no. A system might be not working properly for a variety of reasons besides inefficiency. It could be under-resourced. It could be poorly designed. It could be targetting different outcomes than the outcomes that the people who say it isn't working think it should be targetting.

After all, we do have the word of The Donald that healthcare is "so complicated".

Sue Pa Key Pa

Peregrinus wrote: »

Um, no. A system might be not working properly for a variety of reasons besides inefficiency.

There could be a 1,000 reasons why it is not working properly. The point is that it is inefficient.

daheff

Sue Pa Key Pa wrote: »

There could be a 1,000 reasons why it is not working properly. The point is that it is inefficient.

Its inefficient in its treatment of people by your, my and most peoples expectations.

It may be that they are super efficient based on what they (HSE & Staff) are motivated to achieve...but that may not be what we expect of them.

That said, I do think that the health service could do a lot better.


My earlier point of giving the money spent on health insurance to the health system rather than to for profit companies is that when you give money to for profit companies there is a significant amount of leakage from the money put into the system.

IF (and I know its a rather big IF) this money could be used efficiently then we'd all win. But given that this money is used to buy the time of the same staff that work in the inefficient state run service, I don't think theses staff suddenly become super efficient because they then have their private patient hats on. Thus there is still this leakage of funds.


Personally I don't agree with the notion that people should only get healthcare because they can afford it. What if you were sick and couldn't afford it, but if well could afford to pay tax to fund that healthcare? Should this person not be treated because they cant afford healthcare at this point ??(forgetting about savings/insurance etc).

And we should be looking after those less well off in society (but not the scumbags who don't care -and drink/smoke/take drugs to excess and cause havoc to the health system)

Merowig

Ireland has already a medical card system in place, public services are as well available which are tax funded and cheap health insurances are available.
That is more than enough


If you abolish health insurance / remove the incentives for taking health insurance (no better and faster treatment)/ abolish the private health system - people would automatically stop paying for that. I am not paying for something without getting a return. No one would.
So there would not be more money for the state system available - only more people who would depend on it...


I would travel then to Germany, the Netherlands, Israel, the UK or Romania to get a better/faster treatment if necessary and would most likely get some kind of health insurance for abroad as well.
Simple as that. Bad luck then only for the people who do not want to or cannot travel abroad for treatment...

Sue Pa Key Pa

daheff wrote: »

My earlier point of giving the money spent on health insurance to the health system rather than to for profit companies is that when you give money to for profit companies there is a significant amount of leakage from the money put into the system.

You still think I should pay my health insurance premiums in to the health service for the good of those that don't pay? Not happening

I already do that with taxation on my gross salary, I'm certainly not doing that with my net.

enfant terrible

Would health insurance or income protection for illness be a wiser investment.

If one could only afford one of the above?

Peregrinus

enfant terrible wrote: »

Would health insurance or income protection for illness be a wiser investment.

If one could only afford one of the above?

Tough one. They insure against different risks. So the answer has to depend on which risk worries you the more. Getting sick, and having to rely on the public health service? Or being unable to earn, and having to rely on disability benefit?

You need to factor in not only just how bad each of these would be, if it were to happen to you, but also how likely it is to happen to you.