Why don't we have ACTUAL universal healthcare like the rest of Europe?

Jeremy Sproket

On paper we have "universal" healthcare. But the thing is ... we don't really.

You still have to pay €60 to see a GP (there are no public versions of GPs here, it is entirely privatised with medical cards for some).

Most dental care is private too.

There is a similar amount of money going into the HSE as there is going into the NHS (per capita), but the HSE is appalling in comparison.

Means testing is the most unfair part. People who need important care such as cancer treatment, surgery etc. are means tested. Those who bothered to save and put by during their lives have to pay to access healthcare and those who pissed all their money away don't.

If this new "Sláinte Care" is brought in, I wouldn't mind paying for it monthly from my salary. But knowing the way this country works, it'll probably be means tested. Those who are already paying excessive amounts from their salary for Sláinte will have to pay again at the point of service because they earn "too much".

Ubbquittious

Because the government is looking after VHI, Laya and the private hospitals.

landofthetree

You have to pay for GP visits in many European countries.

Eg Netherlands

https://www.expatica.com/nl/healthcare/healthcare-services/doctors-in-the-netherlands-1149910/#:~:text=Costs%20of%20doctors%20in%20the%20Netherlands%20are%20around%20%E2%82%AC30,pay%20the%20full%20costs%20yourself.

In Sweden they charge as well

Patient Fees in Sweden

"A doctor's appointment at a health centre costs between 100-300 SEK. An appointment with a gynaecologist or pediatrician costs between 200-350 SEK and a visit to the emergency room will cost you about 220-400 SEK. If you need to be hospitalised you will pay maximum 100 SEK a day."

In Belgium it's not free.

"The fixed fee for a visit to a general physician in Belgium in 2019 is €21.79 (€26.27 if accredited). "

It's only the evil Tory scum in the UK who hand out free GP care so you will be healthy for work.

Wanderer78

https://www.boards.ie/discussion/comment/118054454#Comment_118054454

yup, theres major wealth extraction occurring by using the insurance industry, but its a little unfair to ultimately blame them, theres an astonishing amount of waste occurring on the public side also, add these two together and you get our health system

You can be waiting 3/4 weeks for an appointment to see a GP in England, NHS isn't as great as.you think.

You pay to see a doctor in Finland also, cheaper then here but not free

silliussoddius

https://www.boards.ie/discussion/comment/118054455#Comment_118054455

There's no such thing as a free health care system.

Jeremy Sproket

https://www.boards.ie/discussion/comment/118054486#Comment_118054486

Of course. Never implied there was :P It's paid through taxation.

In most of Europe healthcare is free (at the point of use) or else very heavily subsidised. Here, the HSE receives similar revenue streams per capita to that of our European neighbours yet we are paying similar to what an American would have to pay for surgeries etc, even on the public system.

silliussoddius

https://www.boards.ie/discussion/comment/118054532#Comment_118054532

According to the link above the promised land of public services, Sweden, charges at the point of entry. Looks like Belgium and the Netherlands do also. Is there data on countries that don't.

Because Fine Gael and Fianna Fáil love looking after their boyos in the insurance industry.

Thankfully Pearse Doherty has become and pain in that particular arse.

https://www.boards.ie/discussion/comment/118054532#Comment_118054532

I know plenty of people who went to A&E and ended up staying in hospital for a week or more. They didn't pay anything more then 100 Euro for their treatment.

That's pretty alright and nowhere near American costs.

igCorcaigh

The electorate have been trained to reject tax rises, the established parties buy votes at each budget; yet public funds are wasted through mismanagement or paybacks to the old boys club.

Serious reform and transparency is needed, and many countries are in the same way.

The Boston vs Berlin debate (*) is still an unresolved question in this country though; who do we really want to be?

(*) My age showing there.

silliussoddius

https://www.boards.ie/discussion/comment/118054556#Comment_118054556

Boston taxes with Berlin services.

is_that_so

https://www.boards.ie/discussion/comment/118054454#Comment_118054454

It's more to do with people not wanting to pay the level of taxation necessary to support. Vested interests too play a big part including the various medical groups and unions. Slaintecare is supposed to take care of all of this but I don't blame anyone for looking at private insurance under our present set up.

https://www.boards.ie/discussion/comment/118054570#Comment_118054570

Nonsense tbh. We spend as much per capita for the HSE as the Brits do for the NHS. Considering the difference in cost, speed and quality there is plenty of room for improvement with what we're currently spending.

Timberrrrrrrr

https://www.boards.ie/discussion/comment/118054485#Comment_118054485

I have never waited to see my GP, I call in the morning and I have an appointment for that day, I dunno where people are living that they have to wait weeks to see a GP but I've never heard of it happening.

Geuze

https://www.boards.ie/discussion/2058214207/why-dont-we-have-actual-universal-healthcare-like-the-rest-of-europe

Yes, the provision of GPs is private, they are self-employed. I suspect that is the situation in many countries?

Does anybody want all GPs to be HSE employees? I don't think the GPs want that, do they?

Yes, access to the medical card is means-tested, yes, but your post seems to suggest that access to hosps is means-tested. It is not. Since the 1970 Health Act, there is universal access to hosps.

Slaintecare will not be means-tested, Slainetcare is an expansion of tax-financing of healthcare. People will pay more tax, but they can drop their health insurance. That's the idea, anyways.

XsApollo

You can’t reform the HSE because the People working in the HSE don’t want it.

the only solution for people working in it is to have more money pumped into it.

For the budget it receives it should be a hell of a lot better

igCorcaigh

https://www.boards.ie/discussion/comment/118054583#Comment_118054583

So where is the money going to? Why the difference? A rhetorical question I suppose; I don't know the answer, nor am I looking one from you.

Geuze

There are four possible fees for healthcare in Ireland:

(1) GP fees, zero if you have a GMS

(2) pharmacy prescriptions, very low if you have GMS, otherwise capped at 100 pm

(3) ED fee = 100, zero if you have a letter from GP, or GMS

(4) overnight fee in hosp = 80, again zero if you have GMS

Geuze

I think that some people seem to think that GP fees are zero everywhere else.

That is not the case.

In France, GP fee = 25.

Your compulsory public health insurance covers 70%, you pay 7.50.

the NHS is not “the rest of Europe”. Germany is part private part public like here, and you pay at point of use - if you can - like here. this applies to public patients as well, who are then reimbursed

The health charge is 15% of your wages, but you can opt out and go private which can be cheaper for the young. Stay in the private sector too long and you are stuck there and unlike here the private costs are not community rated. I know someone paying 1K a month approaching retirement.

https://www.boards.ie/discussion/comment/118054604#Comment_118054604

The NHS is also a basket case, but it’s impossible to criticise.

Medical cards held by 1/3rd the population add doctor visit cards and up to half the population have effectively free visits. A ten euro flat fee for every visit to a healtcare provider would do more for waiting times than any other initiative

Geuze

https://www.boards.ie/discussion/comment/118054604#Comment_118054604

The price of healthcare in Ireland is way higher than other countries, the volumes are not.

Example: payment to GP for vaccinations.

Ireland = 25 + 25 + 10 = 60

UK = GBP12.58 + 12.58

Another example: Irish GP charges 50+, French GP charges 25

https://www.boards.ie/discussion/comment/118054604#Comment_118054604

Plenty of people making plenty of money. People like to go on about the HSE clerical staff or w/e but let's be honest, there's people getting paid what they'd get paid in England while also working privately as well. Doctors, consultants and dentists can pretty much charge what they want and there's no oversight. And they're dead right to do it, but for some reason we have to let on like they're all benevolent heroes and selfless angels. They're looking to charge as much as they can in a marketplace with huge barriers to entry for new sellers.

A simple example for you. I needed a dental procedure done. All in it would have cost close enough to 2 grand here, assuming the final bill matched the estimate which never happens. Who would've imagined an X-ray might be (definitely) required but not included in their published price. Just over the border I've spent around 500 so far and might have to spend another 500. Funnily enough if you go a bit further from the border (which would mean a full day off work if travelling from the south) the price falls by another 20-30%. Rents in those places are the same yet for some reason the dentist who can generate more demand "needs" to charge a quarter more than a guy 20 miles away.

A quick Google says half of Irish people have health insurance. Which shows just how bad the public system is that even with half the population going private (plus people paying out of pocket) the public system is pretty much fucked. Someone will probably make a ham-fisted attempt to compare with the UK but over there it looks like 11% of people feel the need for private health insurance.

https://www.boards.ie/discussion/comment/118054583#Comment_118054583

Blaming the taxpayer is blaming the people on the trolley.

They wait for weeks for doctors appointments in leeds

https://www.boards.ie/discussion/comment/118054645#Comment_118054645

Wut? I'm not blaming the taxpayer. The taxpayer pays enough, as is obvious since we spend as much as the Brits on their NHS.

SuperBowserWorld

edit

https://www.boards.ie/discussion/comment/118054656#Comment_118054656

3 week wait for me to give my GP 60 quid. Took someone else I know a couple of weeks to get an appointment. Not to go to the appointment, just to get a date for an appointment because she was removed from her GPs books and none of the practices in town would take on new patients til she got a bit of luck.

Waiting a couple of weeks for an appointment that'll be free, with possibly free drugs if needed, free consultant if needed (might have to wait 6 months like it's the end of the world) and no worry about cost of any further treatment... vs couple of weeks to hand over 60 quid, maybe another 30 (let's lowball) for prescription, hope ya don't need a consultant or that's another 200.

Yeah, I think I know which is "better".

igCorcaigh

https://www.boards.ie/discussion/comment/118054656#Comment_118054656

Yeah, my brother who lives in Cardiff has to go to private GP (and other) services because of waiting lists. This is the UK NHS governed by the Tories.

Geuze

https://www.boards.ie/discussion/comment/118054619#Comment_118054619

@fvp4 ,

I know that public health insurance is 15% approx of wages in DE, split more or less 50/50 between ee and er.

If somebody has the normal public health insurance, how much is a GP?

https://www.boards.ie/discussion/comment/118054681#Comment_118054681

Yup. Unfortunately the Brits are falling for the Tories' nonsense. They're determined to run it down as much as they can to sell it off. Labour the fuckin idiots started outsourcing bits and pieces and once that starts it's pretty easy to continue and expand the process.

And let's be feckin honest here, charge a tenner for a GP visit to medical card holders and GP waiting lists here would evaporate.

https://www.boards.ie/discussion/comment/118054532#Comment_118054532

I still don’t think that’s true at all about free at the point of use. And we don’t pay anything like US costs. There are significant caps. This thread is people making it up.

igCorcaigh

https://www.boards.ie/discussion/comment/118054723#Comment_118054723

Same here with the public transport system; that old trick of defund/defunction/sell off.

Jim2007

https://www.boards.ie/discussion/comment/118054532#Comment_118054532

You keep say Europe but fail to appreciate that there are at least 20 different systems in Europe varying from no public healthcare to a complete universal system. Likewise you don't pay remotely close to the states nor even as high as some other European countries. Your opinions are not facts.

coolbeans

https://www.boards.ie/discussion/comment/118054590#Comment_118054590

Quite common actually. I'm six months out of UK and where I was in Herts and Essex a wait of week or more is common. An an awful lot of time wasted in doctors because of no-shows. The GP visit is free so people don't value it. I'd be against free GP visits for this very reason. Something like 20€ would be appropriate imo.

Re more money for the HSE, no chance. Last time I checked it was per capita better funded than the Dutch system yet. More cash is not needed in the HSE.

https://www.boards.ie/discussion/comment/118054675#Comment_118054675

The issue with the UK is if your problem is more urgent or time critical,, the wait is still 3 to 4 weeks. Ringing GP in UK with a child with a high fever gets you redirected to 111

Jim2007

https://www.boards.ie/discussion/comment/118054663#Comment_118054663

It does not really matter what the Brits pay their system is not better....

The last month had been eventful for by family here in Switzerland: Both my wife and my daughter had to go to A&E, my wife with a broken toe and my daughter with an infection. Both were in, seen two and home within an hour. In my case I'm suffering hearing loss and needed to see a specialist and it took me about 48 hours to get an appoint for the following day. But for that level of service we pay about 50% that Ireland.

You can't have the level of service of that people expect for the money people are paying, there is no magic involved.

We don't know anything about people being on trollies nor medical bankruptcy etc... We also don't have a public health service, the Swiss federal department of health employs about 500 people.

riclad

Most people who are not middle class ,have no medical health insurance in america, unless they get it from their employer. self employed people pay at least 10k per year for basic health insurance.working class people can go to the emergency dept, thats all the medical care they can get without insurance .

why are fast food joints , having trouble getting workers in america ,would you like a low paying job, with zero health insurance, dealing with customers who won,t wear a mask. america has about 60 per cent rate of vaccination.our health system was designed in the 40,s , 1940,

its got loads of managers, fewer nurses and doctors .the irish system is way better than the american health care system. i hear people praising the health system in the uk, good medical care and everything is free . i understand it going to a crisis caused by the pandemic .

america has the most expensive health care system in the world, drug x in america can cost 10x what it costs in europe .one weak a drug costs 30 dollars ,in a month it might cost 120 dollars .

or the reason is you get what you pay for ,if we want swedish healthcare we,d have to pay swedish rates of tax.

https://www.boards.ie/discussion/comment/118054821#Comment_118054821

I've never had to wait more than 3 days to see a GP, and my most recent visit was a month ago. Specialist services are another matter, especially since Covid. Following a scan recently, I found myself needing a specialist consultation - not for something life-threatening, but for something that would be unpleasant and sore and that would interfere with my day-to-day life. I was offered a private consultation in seven weeks, or a public appointment next September. I took the private appointment, but at least I can afford to pay the money. I am also aware of someone else whose GP was concerned he might have a serious respiratory condition - or a potentially devastating and fatal one, which he wanted to test for and hopefully rule out. The GP found the person a private appointment in the Beacon in about 2 weeks, but could not source a public appointment anywhere in the system for a year, despite the nature of the illness. Anyone who thinks either of the situations described above is in any way acceptable is utterly deluded.

As to the money, I just took a look at two publications, one British and one Irish, to compare their government health spending in 2019 (to avoid the distortions of the pandemic). UK spending was £2,647 per person. I don't have the prevailing exchange rates for 2019, but at today's exchange rate that's €3,140 per person. The Irish equivalent was €3,712. I appreciate that I could be making a methodological booboo somewhere since I looked this stuff up in a rush - but if it's right it means:

• Irish taxpayers are spending 18% more per head than their British counterparts
• But on top of that we still we have to pay for health stuff that they don't
• And 45% of us are also paying for private medical insurance, compared to about 13% of the UK's population

A mate of mine once described our system in a nutshell as paying too much money to too few people. I've no idea if that's actually the case - because it's so hard to get actual data to work with - but it's a plausible explanation.

https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/ukhealthaccounts/2019#government-healthcare-expenditure

https://assets.gov.ie/45117/6a4f970018d6477bac38f4539f80e927.pdf

On a separate note, I'm surprised the OP hasn't found a way to blame teachers for this. Just saying.

breezy1985

https://www.boards.ie/discussion/comment/118054485#Comment_118054485

Not really true. My GP for instance always holds slots open every morning and after lunch so a decision is made when you call up and if you need it you go that morning. You could be waiting 2 weeks after calling if it's a check up or something non urgent.

Same for the free A&E. If you go in cause you bruised your toe you are gonna wait all night but serious stuff is straight in

dxhound2005

https://www.boards.ie/discussion/comment/118054545#Comment_118054545

We would have SF jumping up and down daily if it wasn't for the fact that they are in government in the North. And are doing a dismal job at providing a health service there. We are in the unique position on this island of having a party both in government and in opposition. So we can judge them by their actions and lack of actions, not just their words.

breezy1985

A half way system between free and pay would be good. Similar to what we have with dentists.

1 free check up a year for anyone not on a medical card and if you are someone who needs periodical visits for medicine reviews or whatever like many do then that's also free. But if you've just got the flu or a sore hand you pay

https://www.boards.ie/discussion/comment/118054795#Comment_118054795

I dunno, PT in Ireland will always be a **** up due to small town sizes. Unfortunately we're continuing a kind of modified-ribbon development and building housing estates outside of towns with basically no options for PT. And putting nothing next to the houses so absolutely everything requires either a delivery or driving into town. Only way to make PT more appealing is make owning a car less appealing and that feeling is pretty damn low as it is. Where I am they've stuck a few thousand houses (and plenty more to come) a couple of kilometres outside of what was the edge of town.

https://www.boards.ie/discussion/comment/118054898#Comment_118054898

OK, let's look at the public health system in both countries.

Prescriptions: Mostly free in UK. Mostly certainly not in Ireland. Prescription and non-prescription drugs cost a fuckton more here as well.

GP: Free vs 60 quid.

Consultants: Free v 200 quid.

Minor surgery following on: Free v €1-€2k?

Waiting lists. It's been making the news in the UK that waiting lists are over a year. 3 years isn't uncommon here. Again, despite the fact that fully half of the population have private insurance.

All of the above to despite half of our population having insurance separately.

Oh and dentists, Christ it'd be nice to just pay what they pay.

https://www.boards.ie/discussion/comment/118054728#Comment_118054728

This in a nutshell is what needs to happen first. But ten euros for all encounters...consult a pharmacist, outpatient appointment, consult the public health nurse. If you think ten euros is too much, just think how much is spent on booze and fags and milky coffees, but no cannot afford ten euros. make it a five euro fee. being stuck with a sick child and tried everything over the counter for 2 days sharing a waiting room with parents having the crack brinfing in a child with a cough or fever and not even trying calpol..because they know they will get it for free on landing in the ED from the first nurse you see after checking in

I have no gra for GPs but I agree with the basic minimum charge of 10 euro per visit. The free for under 6s really pushed them to the farthest edges of care and they might as well have pulled down the shutters. One free visit per year might have been a more reasonable solution for parents with lots of kids. It is a case of being self employed and under the same circumstances Pharmacists wouldn't be dictated to and fought for the prescription fee's in order to sustain their own business interests. These day's you go to a GP's and you're a customer, not a patient but I think it would be better for everyone if they were regarded as such and furnished for provision of their services. The care might improve and more options for care become available.

I know I should probably read the Slainte care programme (I'm just not getting paid to) but the German model is definitely one to look at and could be implemented here. A lot of other points have been made throughout the thread in relation to the NHS provision of care and it does cover a number of areas that are very lacking in our own, we don't have dental care at the moment (or at least very limited) and obviously provision of mental health services is stark. It is time to put the focus back on the public though and start providing them with the care that is needed.

https://www.boards.ie/discussion/comment/118054689#Comment_118054689

I am not sure. I have family in Germany and go there every year but my sister married a German. I know it costs to go to doctors though because when I was over there this year my nephew had to go to the doctor, for a fairly worrying issue. It took 3 weeks to get an appointment and they had to pay up front and get re-imbursed.