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

ronano

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

Probably been said already but while HSE receives funding similar to UK etc now, it didn't for basically 70s-90s.

Icepick

Because our systems favours the rich and poor.

If you are working earning average salary, you will spend a lot on everything.

https://www.boards.ie/discussion/comment/118056022#Comment_118056022

You didn't write the report so I don't think there's any need for you to get defensive about it. I was simply pointing out that the people who produce it don't necessarily have an independent and objective view of the issues it covers. This is quite common in policy agenda-setting; the world is full of "think tanks" from all shades of political opinion whose job it is to get policy messages out there. There's a veneer of independence about the stuff they produce, but it is generally obvious where they're coming from on the political spectrum.

"rabbit hole stuff". Honest to Jaysus.

Strumms

https://www.boards.ie/discussion/comment/118062452#Comment_118062452

This x 1000

While I couldn’t be classed as poor or close to being...medical card holders and I say this having been one for a couple of years when I had an LTI... they have to contend with waiting lists.....but that’s it.

people earning an average salary have to put up with waiting lists, the same list and then paying for the privilege..

nozzferrahhtoo

https://www.boards.ie/discussion/comment/118055874#Comment_118055874

I am living here in Germany well over 10 years.... closer to 15..... and have not had the experience you are describing. Medical is around 13/14% of my salary and overall in Germany I take home 55% of my salary. 45% goes away on taxes and medical insurance and pension. But I pay little to no "stealth taxes" after that. In fact one of the reasons I can not move back to Ireland is I simply could not earn enough money to live the quality of life I do here.... with the quality of schooling, medical, and public facilities that we live with here. We would take a serious quality of life hit if we ever moved home in pretty much every area of our lives.

Firstly I never put my hand in my pocket for money when visiting a GP or any other doctor or even therapist. At least not now. There was some years ago a fee of 10 euro for your first and only your first visit to a doctor in a given period. But that was done away with. There was no fee after that. So basically it was 10 euro for one visit or 50 visits. Which sort of incentivised more visits I guess... which might be why they did away with it? Perhaps it was costing more money than it was bringing in.

I have never paid for a doctor and had it "reimbursed" later though as you describe above. Not just a GP but any doctor. When I approached 40 for example I went to have my eyes checked by one doctor.... my ears nose and throat by another (HNO doctor they are called).... a full dental checkup by another.... an all over check of my skin for cancers by another.... and a full workup including blood work by my GP...... all in one week and it cost me not a penny.

Recently I had an issue that I was a bit worried about. I went to my normal GP and got the full work up done again. Nothing paid. And I was not entirely confident in the final result so I went to three other doctors in one day without any appointment for second opinions. Again not a penny spent.

Our children are automatically covered on my partners medical insurance so once again when we take them for their check ups or for any reason.... again never had to pay a penny. Never had to wait long for an appointment either. There are so many options here you can usually just walk in off the street. Perhaps if you are fixated on one particular doctor and that doctor is very popular.... you might have to wait days or weeks for an appointment? But for me it has been unheard of. There are also certain mandated checkups all kids are meant to get at specific times during their development. Each numbered specifically. We have gone to pretty much all of those. Again not a a penny.

Appointments exception is: For some reason the particular city I live in does have a lot of appointments for Therapists. But all the surrounding cities don't so really getting an instant appointment just entails a 20 minute drive. Not particularly sure why my city has such a backlog.... whether its a lower number of therapists per capita.... or a higher number of issues per capita..... or a higher uptake of therapists per capita.... I never looked into it. But it is strangely booked to the brim here.

Our daughter at age 3ish got a mild enough viral infection years ago too. I remember getting similar infections when I was a kid in Ireland and the doctor gave me something for the diarrhea and told my mum to feed me on Flat 7up. Here in Germany they put my daughter on a drip in the hospital and kept her for observation for two nights. Again.... not a penny paid.

My son around the same age sucked on a bottle of super glue so just in case it closed off his air ways suddenly we rushed him to the hospital. Got seen instantly by a nurse. Then told a doctor would check further if we wanted but we might have to wait a couple hours. Which we did. All good, not a penny.

I take myself and my two kids for Dental checkups 4 times a year.... and we all get a professional teeth clean each twice a year.... again all covered on the medical. As someone pointed out the basic filling is paid for too. Better quality materials you pay a nominal cost for. I once opted to be put "Under" for a group of dental procedures all happening at once too and was asked to pay for that as I opted for it rather than it being medically recommended. However I have a very cheap additional dental insurance which I had never used so just for fun I sent them the invoice for the anesthetics and because I had never claimed anything at all on that additional insurance they paid out on the invoice as "good will".... including the cost of the higher grade filling material which I had also opted willingly for....... which I was genuinely surprised by as it was about 80% of all the contributions I had made to that insurance until that date. So I almost broke even on them paying an invoice they had no basis for needing to pay. Really happy with that at the time as I had genuinely written off that chunk of cash as gone.

I remember my brother in Ireland talking about the costs of his wife giving birth in the hospital. Again the births here cost not a penny and nerry an invoice either. Just handed over the medical card on the way into the labour ward and job done. Even when we opted for a more complicated water birth in one case.

Think the last time I ever had to pay anything to a doctor for anything was in Ireland when I was hit with a moderately surprising bill for having an ingrowing toenail removed. And I was 6 months on a waiting list for that so in the end I just went and had it done by an incompetent GP who managed to make the entire thing agony for me :( He could not even get the anesthetic to take properly so in the end he ripped off the nail and cauterized it while I had about 40% feeling. Not the top experience of my life :(

munchkin_utd

+1

also in Germany. We pay a fortune in compulsorary medical insurance but the magic smart card then takes care of nearly everything.

To go to the GP I just go to the GP and wait in the waiting room. The health insurance card is swiped and everything gets paid by magic (from the €15,000+ that myself and the wife pay between us in medical insurance yearly)

Our child needed a spot of speech therapy. There was a bit of ringing around but we got a place with free spots and he had weekly sessions for a few months for nothing starting pretty much straight away.

I once needed a CAT scan on the ankle, I got an appointment at a private diagnostics clinic within a few days and again only needed to swipe the card (and again, the 15 grand we pay in insurance covered it)

For Physio treatment I have a vague recollection of having to pay the guy a €20 in registration fees or something, but otherwise the card covered the bulk of the cost for a few months of treatment.

When I hear irish based people complaining, I only think of the 15 grand YEARLY in cash that we would have if we werent paying medical insurance and if you look at it, the €50 here or there for a gp visit or €200 for a one off consultant visit, is not actually all that dear compared to what people abroad pay for their medical cover !!

nozzferrahhtoo

oooooooooo I forgot about speech therapy. Thanks for reminding me.

My daughter came across as "shy" in kindergarten here. In the end we brought this up with doctors and so forth (not a penny) and they diagnosed her with a social condition called "Selective Mutismus" which basically means a social inability to communicate in certain contexts and situations. She was very verbose with us in private and took to both languages really well.

They sent her to a developmental doctor then (also free) who tested her to make sure she had no learning difficulties or similar. He concluded she was significantly above average intelligence and development so no problem there either.

SO in the end to help with this they brought in a special learning teacher who normally would work with children with learning difficulties to visit her once a week in Kingergarten one on one. And also a speech therapist who would normally work with kids with actual physical or other speech impediments. Also once a week one on one. For two years.

They worked wonders with her getting her to speak more openly and confidently and all of it "free" covered on the medical insurance. Weeks of one on one care for two years with two diverse medical professionals.

As above I probably pay 10k a year on medical insurance. So I guess how valuable that works out depends on what you get out of it. If you spend 15 years paying it and never needing to go to a doctor once you might feel hard done by. And in fact the first years I was in Germany I used almost nothing. I might have taken a week off here or there with an illness and of course the Medical Insurance ensures my company still pay my salary for that time. But mostly I did not use it until we had kids and I started to age. But certainly using it quite often in the last 5/6 years.

What would two years of once weekly visitations by two distinct child therapists have cost me in Ireland? I have literally no idea! But would be interesting to know.

Well I wasn’t lying about the experience I had. My family over there do have private insurance though, so maybe that matters in terms of reimbursement. And the doctor was popular, so it took about a month to be seen. He was a specialist

nozzferrahhtoo

Don't think anyone suggests you were lying :) Just saying I have never experienced what you describe myself. There could be all sorts of explanations for your experience that I have not considered or know about.

For example I am in West Germany. For all I know they do things differently in East Germany. I honestly do not know.

And perhaps Private Insurance works differently to public as you say. Again I do not know. I was warned against opting for Private once I started earning enough to qualify for it (which I only started earning enough in the last 2 years for the first time) because of the difficulty in getting back to public if you need to. I have not yet been given a reason FOR going private. I have only heard ominous rumblings about why its a bad thing.

I have heard, but never experienced myself, that popular or over subscribed doctors only take on new patients who are privately insured. I do not know why they do this or what their incentives are. Having never experienced it myself I have not felt compelled to look into it.

Geuze

@nozzferrahhtoo ,

thanks for the detailed information.

FYI, the cost for maternity care in Ireland is zero, as it is tax-financed.

Your brother may have chosen to go private.

I recall reading about the 10 euro a quarter fee that you mention.

Geuze

The German public health insurance (GKV) is a case where single/childless people subsidise people with kids, as a one-earner married couple pay the same premium as a single/childless person on the same income.

Statutory health insurance premiums

The sickness funds all charge the same basic rate of 14,6% of your gross salary (up to a maximum limit of 4.837,50 euros per month in 2021). This contribution is split equally between you and your employer (7,3% each) and topped up with government subsidies.

What treatment is covered by statutory health insurance?

German statutory health insurance offers fairly comprehensive coverage, including:

• Hospital treatment
• Visits to GPs and doctors
• Rehabilitation, such as home care or physiotherapy
• Health checks from the age of 35
• Cancer screening
• Medicines, dressings, therapies and aids such as hearing aids or wheelchairs
• Dental check-ups
• Dentures and crowns
• Orthodontic treatment up to age 18

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

there isn't actually any such thing as the "UK NHS", health is a devolved function, so presuming your brother didn't go to Bristol for his appointment, the NHS he would be relying on would be under the control of the Welsh government, which is Labour run.

I keep hearing of these long waiting times to see GPs, but our daughter registered with a GP on the day she registered with her Uni (Two local GP surgeries had stalls in the main area registering students) and two weeks later picked up tonsilitus (spend two weeks living on Gin and pizza and you get sick, who'd have thought it). Phoned her GP at ten in the morning and picked up her antibiotics from the nearest pharmacy at 4pm that day. total cost £9.35. It's really hard to fault that service.

rossie1977

Decades of right wing government

https://www.boards.ie/discussion/comment/118073852#Comment_118073852

Yeh, in general going private isn’t considered a good idea in Germany. They are civil servants and in that case private is subsidised. It’s one of the few categories where it’s even allowed. Which seems weird.

https://www.expatrio.com/living-germany/health-insurance-germany/private-health-insurance-germany

the doctor took a few weeks because it was a second opinion, presumably their normal doctor would be free and quick.

anyway I probably saw a part of the German system that’s a bit unusual.

machiavellianme

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

I blame the middle management. I've been in hospital a lot recently and have spent more time with "admin nurses" answering the same questions over and over than I did with anyone providing any kind of treatment. All in, I spoke to a doctor for less than 4 minutes and the surgeon for less than 1 minute over a 3 day stay requiring surgery. However, I spent several hours answering the same queries upon arrival and in the ward. How many times do I need to tell you that I'm allergic to nuts and have no previous conditions or concerns? Box ticking is too expensive for what you get!

Asking why you have to pay for a private GP visit is kinda the equivalent of asking why you have to pay to stay in a private hospital, to be fair.

if I were you, I’d be careful what you wish for re: free GP visits paid by the HSE. The fact is you’ll likely receive substandard care & i’m not sure 100% but I imagine the NHS free GP visits mean you see whatever GP is free the soonest?

i know my doctor years, we’ve been with them as a family doctor for as long as I can remember and we have a great relationship with them now. I have a few underlying health problems and if I ever end up (as I have a few times) in the emergency room; it’s exhausting having to constantly explain whats wrong besides the issue ur there for.

I perish at the thought of needing to visit a GP on a public waiting list if it was a different doctor every time! What a nightmare.

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

Glad to hear your general ailments are not bothersome enough that potentially 6 months is not a big deal.

might I ask possibly if the reason you had to wait a few weeks to see your GP was at all because there were folks who needed assistance more urgently? ;)

https://www.boards.ie/discussion/comment/118076281#Comment_118076281

A 6 month or so wait so far while private is a bit of a big deal. If I was public I've already been on a 4+ year waiting list that I was eventually removed from without getting treatment and without my knowledge.

Yup. I'm sure there were people who had an appointment 9 working days later who simply had to be seen then and not before. Again, the wait is annoying, it'd be annoying anywhere, it's more annoying when you have to hand over 60 quid for the privilege.

https://www.boards.ie/discussion/comment/118076327#Comment_118076327

I mean you don’t have to, really. Your only alternative however are to present at ED & wait all day or night to be treated. It may be annoying but I would have to guess (as it’s been the case with my own GP) that the waiting has increased somewhat dramatically due to covid?

I would wonder though for folks who are barely able to afford a doctors visit but not entitled to a medical card or GP card would their family Dr charge a reduced rate.. surely they would?

i only wonder cos I know of some family members who were declined either cards in the past - one of whom was rejected because their partner made €1 (ONE EURO!) too much per annum.

i think THATS the problem we should assess, rather than look at a public GP setup.

P.S: I lost myself for a moment and forgot how to spell assess, almost said asses. 😂

https://www.boards.ie/discussion/comment/118076355#Comment_118076355

Again, main comparison is being made to the likes of the UK and people are trying to let on that their system is worse than ours. Talking about wait times and lists in their free at the point of use system. Meanwhile our system with the same amount of public money going in, plus half the population having insurance plus paying at the point of use we don't have what I would consider excellent access.

nozzferrahhtoo

https://www.boards.ie/discussion/comment/118076162#Comment_118076162

There probably is some advantages to private I just do not know about. Because I simply have not been compelled to look. I am a bit lazy that way. I have the "If it ain't broke don't fix it" mentality down to perfection and quite a few times in my life it has bitten me in the ass when I realized if I had only done X Y or Z I would have been massively better off :-)

It probably covers more things that public doesn't. But most of the things it could possibly cover that are (so far) relevant to me are not things I spend a lot of money on. For example my glasses are not covered on my insurance. Maybe they are on private, I dunno. But I spent about 200 euro on new glasses every 3 maybe 4 years. So.... meh.

Knowing my past luck I will catch some relatively rare disease in my 50s and it will be exactly the disease private covers and public doesn't :) Or when I suddenly need a wheelchair to get around I will find public gets a standard old thing that is akin to a "fixie" bicycle.... while private affords you an electronic wheelchair with dual joystick control and rechargable battery. Something like that will happen to me I am sure. It always does. I am the discworlds Rincewind of things like that.

But I have heard a few times now from different sources the anecdote that you try to ring a relatively popular doctor and they FIRST ask you "Public or Private" and if you say "Public" they ONLY THEN respond "Sorry we are not taking new patients at this time". Which leads me to believe that had the sources of those anecdotes said "Private" they would have been taken on. Maybe. The reason WHY this might be... I have thus far been too lazy to research.

Perhaps AvB will write in from his supposed house in Germany and tell us with his usual air of contrived derision and lack of self awareness why the average pleb on public insurance is missing out and how his private insurance covers him for deep therapy whenever his shares and bitcoin earnings drop to less than 100k profit per day because only earning 90k on a given day makes him feel like a failure and a laughing stock around the penthouse office :)

Galwayguy35

Its the ones with medical cards that are clogging up GP surgeries, fook all wrong with them and going over every little thing when they don't have to pay for it.

Andrewf20

Im pretty happy with the healthcare in Ireland. What I have experienced for me and the family has generally been very positive. Some things can be slow like allergy testing but these are outliers. VHI swiftcare clinics are brilliant and have got me out of a hole at short notice on a number of occasions.

I feel that if it was free you would end up paying for it some other way, i.e. through insurance or taxation.

Mad_maxx

https://www.boards.ie/discussion/comment/118074899#Comment_118074899

Yes , appeasing unions who oppose reform is quintessentially right wing

Strumms

https://www.boards.ie/discussion/comment/118076227#Comment_118076227

My long experience in hospital was about 1.5-2 hours of treatment / medical assistance a day, 8 hours sleeping 1 hour or so eating, and from memory ( it’s been a while ) 3 hours visiting time... there was about 10 hours of downtime which is ridiculous especially when then there was no WiFi (2016/2017) which was fûcking aghhh, it was installed the week I left... I used to chance my arm with negotiating an xtra 30 or 40 minutes in the gym ( a physical problem ) just around 3.30 when boredom was at its highest... and the physios were doing their reports... 9/10 times they’d be accommodating...unless a manager or consultant was sniffing around....

https://www.boards.ie/discussion/comment/118078360#Comment_118078360

it isn't the unions that oppose reforms, they are just the excuse. Senior Management don't want changes because the whole thing is a corrupt gravy train that they will do all in the power to keep rolling.