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Private healthcare patients get exclusive access to cancer drugs

2

Comments

  • Registered Users, Registered Users 2 Posts: 14,862 ✭✭✭✭markodaly


    steddyeddy wrote: »
    No offence M but you seem to use that strawman regularly. No one but no one is saying that. Literally no-one. You sound very young but there's more to debating healthcare, education ect to saying it's rich and poor.

    The complexity of healthcare is lost on yourself and a others. Most people seem to think that in this case private health care customers pay more so should be entitled to greater pay. I'll make this as clear as possible. I have experience in industry and academia in biotech. All healthcare is subsidised. No one pays the full amount for it. Some diseases such as cystic fibrosis aren't common enough to be worth researching were it not for massive government and some charity funding. The idea that an extra 1k a year for VHI should be the difference in life and death for someone with terminal breast cancer is ludicrous. It's not even a rich VS poor argument. 1000 a year isn't huge money.

    It seems you do a fair bit of straw-manning yourself.


  • Closed Accounts Posts: 8,474 ✭✭✭Obvious Desperate Breakfasts


    As a person without health insurance who has spent the last few years relying on these drugs to keep me alive, this makes me nervous. The next drug in the arsenal after my current one fails was only made available in Ireland in May 2018. I think it will now remain available to me as it’s already in the system but what if a decision had been made to just give it to those with health insurance? That option would be gone for me. And I can’t get health insurance now, I’m uninsurable. New drugs are becoming available all the time and some of them really do add on years. How agonising would it be to know there was a drug you couldn’t access?
    The article is quite vague and, frankly of very poor quality. I don't read RTÉ so I suppose I am not missing much.

    Nothing whatsoever is mentioned about these drugs save for that they are new. That's it. Are they drugs in the traditional sense, ie chemo? Or are they something else?

    In the UK, we have the National Institute for Clinical Excellence (NICE) which must approve NHS funding for all drugs. It makes decisions based on drug efficacy, safety and value for money as health spending is finite. I don't know what the Irish equivalent is but the fact that the author of this piece never contacted them or mentioned this suggests that this is a clickbait article. We don't know if these new drugs perform any better than generics of if they just add a few months to a patient's life. If they don't perform well then the HSE has a tough call to make as this money can be spent elsewhere where it might reap more benefits.

    A shame that RTÉ went for the clickbait article on such an important issue.

    Sometimes it’s not brand name versions being kept from people where generics are given, sometimes the brand name version is the only version available.


  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    Candamir wrote: »
    19% response rate in no way equates to ”a drug that can extend your life by 19%”.

    Ah yea fair point. The rest of my paragraph stands though. I should have said "a drug which has a 19% chance of extending your life if you have triple negative breast cancer".

    Anything else you disagree with?


  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    markodaly wrote: »
    It seems you do a fair bit of straw-manning yourself.

    Do these drugs not have the potential to save your life?


  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    ELM327 wrote: »
    If paying for private health insurance doesn't get you some advantages, what would be the point in having it?

    It's not up to the public to come up with reasons for why private health care should provide greater benefit.


  • Registered Users Posts: 531 ✭✭✭Candamir


    steddyeddy wrote: »
    Ah yea fair point. The rest of my paragraph stands though. I should have said "a drug which has a 19% chance of extending your life if you have triple negative breast cancer".

    Anything else you disagree with?

    Well, it doesn’t necessarily mean that either, but I don’t have the full data set to say exactly what it does, or might mean.


  • Registered Users, Registered Users 2 Posts: 14,862 ✭✭✭✭markodaly


    steddyeddy wrote: »
    Do these drugs not have the potential to save your life?

    Well, that is a subjective word, and if you do work in academia you would wise to follow the scientific principle, not some emotive clickbaity article.


  • Registered Users, Registered Users 2 Posts: 22,213 ✭✭✭✭ELM327


    steddyeddy wrote: »
    It's not up to the public to come up with reasons for why private health care should provide greater benefit.
    It's as if you have purposely misunderstood my post.


    If I am paying for healthcare (which I am, approx 2500 per annum for couple), why would I bother if everyone is treated the same anyway??


  • Registered Users, Registered Users 2 Posts: 14,345 ✭✭✭✭jimmycrackcorm


    This wouldn't be an issue if people paid the money on healthcare that they pay for alcohol and smokes every year.

    Bear in mind also that private healthcare subsidises the public system by paying for facilities that the payees are entitled to anyway.


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  • Closed Accounts Posts: 8,474 ✭✭✭Obvious Desperate Breakfasts


    Candamir wrote: »
    Maybe they kept you away from the clinical side of things, but a 19% response rate in no way equates to ”a drug that can extend your life by 19%”. For a start.

    The problem with statistics for cancer drugs is that cancer drugs work really well for some people and not at all for others. I was on a drug for over two years before it stopped working. My quality of life was really good for those two years. I had no side effects. For others, it won’t work at all. And some of the people it hadn’t worked for that I know of have the exact same subtype of cancer as me on paper. So, what will the stats say?

    And I’d challenge anyone to look me in the eye and tell me that giving me a good two years with minimal side effects wasn’t worth whatever it cost the state. I’m in my 30s. In that two years, I got married, travelled to Iceland, saw the Northern Lights, enjoyed two more Christmases, two more birthdays, laughed, loved. The next drug I try might not work for me. Or I might get another two years. Maybe more. The drug that worked for two years for me sometimes works for way longer. Some people get five years out of it.

    With cancer drugs, doctors don’t know if they will work for the individual in front of them. But they have to try because it will or it won’t and if it will, that patient could buy some serious time. If I was denied drugs due to not having health insurance, I probably would have been dead six months out from diagnosis. But I’m now approaching the fourth anniversary of my diagnosis.

    And it’s not just an issue of patients being given generics rather than the brand name. If it’s a new drug, the brand name will be the only one that exists.

    As for why I didn’t have health insurance. The arrogance of youth. Who expects to develop terminal cancer in their 20s? Especially a cancer with a median diagnosis age of about 60.


  • Registered Users, Registered Users 2 Posts: 12,615 ✭✭✭✭mariaalice


    steddyeddy wrote: »
    No offence M but you seem to use that strawman regularly. No one but no one is saying that. Literally no-one. You sound very young but there's more to debating healthcare, education ect to saying it's rich and poor.

    The complexity of healthcare is lost on yourself and a others. Most people seem to think that in this case private health care customers pay more so should be entitled to greater pay. I'll make this as clear as possible. I have experience in industry and academia in biotech. All healthcare is subsidised. No one pays the full amount for it. Some diseases such as cystic fibrosis aren't common enough to be worth researching were it not for massive government and some charity funding. The idea that an extra 1k a year for VHI should be the difference in life and death for someone with terminal breast cancer is ludicrous. It's not even a rich VS poor argument. 1000 a year isn't huge money.

    But that is not the case and I think you know that we are talking about real people, not some Daily mail headline compare the tone of your posts to say the one by suger free. The response to this should be factual and evidence-based that is all.

    Everyone should have the same access to health care and medication.

    I have had treatment in both the private and public system and would complement both.

    The big difference is things like having a private room with a nicer ambiance, less queuing, seeing the consultant, not just the consultant's team, quicker accesses to diagnostic appointments at more convenient times again with less waiting, however, the nursing and medical care was the exact same.

    The perception aspect is interesting.


  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    markodaly wrote: »
    Well, that is a subjective word, and if you do work in academia you would wise to follow the scientific principle, not some emotive clickbaity article.

    I'll say it again. A drug approved for prescription for patients with breast cancer and has shown to be somewhat effective in clinical trials has the potential to save lives.


  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    Candamir wrote: »
    Well, it doesn’t necessarily mean that either, but I don’t have the full data set to say exactly what it does, or might mean.

    You're looking at word semantics now rather than the pharmacology. 19% objective response rate means one thing. It wouldn't kill you to look up the data instead of relying on other people but here you are:
    The 24-week progression-free survival (PFS) rate was 27% and the objective response rate was 19%. Three of the four patients who responded to treatment are continuing to respond.


  • Registered Users Posts: 531 ✭✭✭Candamir


    steddyeddy wrote: »
    You're looking at word semantics now rather than the pharmacology. 19% objective response rate means one thing. It wouldn't kill you to look up the data instead of relying on other people but here you are:

    You’re hilarious! Accusing me of word semantics over science when you completely misrepresented the pharmacology!
    A 19% response rate means exactly that - a response rate. It doesn’t say anything about what the response was. It may equate to an improvement in survival. It may relate to a drop in tumour markers, or radiological evidence of tumour shrinking. And while ‘it wouldn’t kill me’ to dig up and study the data sets, it’s not my argument, so no thanks, I won’t. Perhaps you should study it a bit better since you are using it in your argument, and seem to think it means that “this drug can extend your life by 19%”


  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    Candamir wrote: »
    You’re hilarious! Accusing me of word semantics over science when you completely misrepresented the pharmacology!
    A 19% response rate means exactly that - a response rate. It doesn’t say anything about what the response was. It may equate to an improvement in survival. It may relate to a drop in tumour markers, or radiological evidence of tumour shrinking.

    Mate maybe take a chill pill. There's no need to get so personal over a disagreement. First of all from my first post about the pharmacology and clinical trials I discussed "objective response rate" not response rate. Objective response rate (ORR) isn't the same as response rate. ORR is a term used specifically in oncology meaning the percentage of patients that exhibited a reduction in the tumour burden by a predefined amount. It's perfectly accurate to say there's a 19% objective response rate in reference to triple-negative breast cancer.
    And while ‘it wouldn’t kill me’ to dig up and study the data sets, it’s not my argument, so no thanks, I won’t. Perhaps you should study it a bit better since you are using it in your argument, and seem to think it means that “this drug can extend your life by 19%”

    You're repeating the mistake I admitted to making for what purpose? It's not my argument either. The 19% ORR is referring to peer reviewed data.


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  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    ELM327 wrote: »
    It's as if you have purposely misunderstood my post.


    If I am paying for healthcare (which I am, approx 2500 per annum for couple), why would I bother if everyone is treated the same anyway??

    I don't know but why would I care if the private health care business has a viable business model?


  • Registered Users Posts: 531 ✭✭✭Candamir


    steddyeddy wrote: »
    Mate maybe take a chill pill. There's no need to get so personal over a disagreement. First of all from my first post about the pharmacology and clinical trials I discussed "objective response rate" not response rate. Objective response rate (ORR) isn't the same as response rate. ORR is a term used specifically in oncology meaning the percentage of patients that exhibited a reduction in the tumour burden by a predefined amount. It's perfectly accurate to say there's a 19% objective response rate in reference to triple-negative breast cancer.



    You're repeating the mistake I admitted to making for what purpose? It's not my argument either. The 19% ORR is referring to peer reviewed data.


    Ha ha. I’m not repeating your mistake - I’m just pointing it out to you again.
    And you’re still getting it wrong. Or inferring it. Yes. It’s perfectly accurate to say there’s a 19% ORR. Because that’s what your quote claimed. Your inferences as to what that meant however, are all over the place.

    And just to clarify - ORR refers only to reduction in tumour burden? So nothing at all do do with extending survival. So you just made that up (as if it wasn’t obvious by your data mashing!)

    And I’m totally chilled.


  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    Candamir wrote: »
    Ha ha. I’m not repeating your mistake - I’m just pointing it out to you again.

    Great, cheers man!
    And you’re still getting it wrong.

    We'll agree to disagree here.
    Or inferring it.

    What?
    Yes. It’s perfectly accurate to say there’s a 19% ORR.

    Thanks for that. I feel a bit better now.
    Because that’s what your quote claimed. Your inferences as to what that meant however, are all over the place.

    ORR - Proportion of patients with reduction in tumor burden of a predefined amount. Simple as that man.


  • Registered Users Posts: 531 ✭✭✭Candamir


    steddyeddy wrote: »



    ORR - Proportion of patients with reduction in tumor burden of a predefined amount. Simple as that man.

    Yep, real simple.

    Says nothing about survival, man. Which is what you’ve been trying to infer.

    But look, if you want to agree to disagree.....


  • Closed Accounts Posts: 7,275 ✭✭✭Your Face


    I hate reading about our medical system.
    It's embarrassing and sad.


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  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    Candamir wrote: »
    Yep, real simple.

    Says nothing about survival, man. Which is what you’ve been trying to infer.

    But look, if you want to agree to disagree.....

    Yea we will C. No offence but the fact you've edited your post to include overall survival, another end point in clinical trials leads me to believe that you've just looked it up.

    True objective response rate doesn't correlate exactly with overall survival in terms of clinical trial endpoints but tumour size decrease is associated with greater survival believe it or not.

    While we're at it and you want to move away from the positive overall ORR I'll link an article that shows that Atezolizumab does increase overall survival rate of some cancers such as lung cancer.

    https://www.sciencedirect.com/science/article/pii/S014067361632517X


  • Registered Users, Registered Users 2 Posts: 1,087 ✭✭✭Doc07


    Kurtosis wrote: »
    The National Centre for Pharmacoeconomics evaluates the cost effectiveness of new medicines, and those that are cost effective are then reimbursed by the state. Based on the data submitted to them, these drugs weren't deemed cost effective for the conditions outlined in the article. This is why they aren't funded by the state for public patients. Covering these medicines would mean taking funding from other areas of the health system where it provides more benefit.

    This is a dangerous precedent set by VHI, it's effectively subverting the national process for economic evaluation of medicines. It's effectively going to be a means for pharmaceutical companies to gain extra leverage in getting new medicines reimbursed at higher prices.

    Thank you for posting this. Great point although in the case of these particular drugs it may be that they haven’t been evaluated by NCP yet as the trials that were used to grant the extension of license are very recent. But overall you are correct to highlight the dangers or bypassing the NCP assessment system which is probably out only non-conflicted means of assessment.


  • Registered Users Posts: 531 ✭✭✭Candamir


    steddyeddy wrote: »
    Yea we will C. No offence but the fact you've edited your post to include overall survival, another end point in clinical trials leads me to believe that you've just looked it up.

    I did what now?

    Only a few hours ago you thought a 19% objective response rate to a drug means a drug will extend your life by 19%, and I’m the one looking stuff up?

    I’ll leave it there.


  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    Candamir wrote: »
    I did what now?


    I’ll leave it there.

    Please do.


  • Registered Users, Registered Users 2 Posts: 4,310 ✭✭✭Pkiernan


    There is a multi tier car industry in this country.

    Bugattis and Bentleys are off limits to me.

    How dare someone with more money than me buy something I can't afford.


  • Posts: 26,052 ✭✭✭✭ [Deleted User]


    I don't think comparing owning a particular brand of car with being denied possibly life-saving or extending drugs is particularly illustrative.


  • Registered Users, Registered Users 2 Posts: 12,615 ✭✭✭✭mariaalice


    It is a bit disturbing that there are people who think just because they are paying they should get access to life-extending treatment that those on the public system would not get, and its evening worse if they think that is what health insurance is for.


  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    mariaalice wrote: »
    It is a bit disturbing that there are people who think just because they are paying they should get access to life-extending treatment that those on the public system would not get, and its evening worse if they think that is what health insurance is for.

    Well in fairness that's my situation. I'm an a researcher at the American Department Of Energy so I get complete medical coverage. A lot of people here (Colorado) can't even get insurance and those that do don't usually get the same coverage I get. I worked hard to be in this position. Harder than most I think. Even then, there's no part of me, no matter how hidden that thinks that because I worked hard that I should have better chances of survival based on what I earn.

    Yet there are people in the same position as me who do think that it would be a crime that the Mexican cleaners (an example they use a lot) that I work alongside should get the same healthcare as me should they need it. Not that we work any harder than Mexican cleaners mind.

    I'm not comparing American health care to Ireland but it's a slippery slope. People here are still saying people who pay more should have more access to lifesaving treatment. So the fact that I make in excess of the average Irish worker should mean I'm more entitled to life saving treatment right? Let's say the cost of insurance goes up so only high earners can afford it. You can bet the whole "he who pays more should get more" would go out the window.


  • Registered Users, Registered Users 2 Posts: 2,981 ✭✭✭McCrack


    steddyeddy wrote: »
    Please do.

    You lost the argument


  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    mariaalice wrote: »
    It is a bit disturbing that there are people who think just because they are paying they should get access to life-extending treatment that those on the public system would not get, and its evening worse if they think that is what health insurance is for.

    They're only saying that because they can currently afford it. Increase the costs so only high earners could afford it and they'd change their views on the morality of healthcare.


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  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    McCrack wrote: »
    You lost the argument

    It wasn't an argument to be honest.


  • Registered Users, Registered Users 2 Posts: 4,310 ✭✭✭Pkiernan


    steddyeddy wrote: »
    They're only saying that because they can currently afford it. Increase the costs so only high earners could afford it and they'd change their views on the morality of healthcare.

    Who should be prioritised between 2 patients, one of which has never worked a day in their lives, the other a high earning tax payer who chooses to pay extra money to purchase insurance?


  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    Pkiernan wrote: »
    Who should be prioritised between 2 patients, one of which has never worked a day in their lives, the other a high earning tax payer who chooses to pay extra money to purchase insurance?

    I'll answer this but how much of the person in bold's income would be derived from work? For example if someone inherited the money and never worked a day in their lives should they get better treatment than a poorer person who never worked?


  • Registered Users, Registered Users 2 Posts: 3,426 ✭✭✭KaneToad


    It must be terrible to be the recipient of inferior drugs knowing full well that they are inferior and that you're getting them for cost reasons.

    If they took the nothing-doers out of the HSE there would be no need for this

    Who, specifically, are the nothing-doers?


  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    KaneToad wrote: »
    Who, specifically, are the nothing-doers?

    Having worked in the HSE I can tell you there are plenty. Mostly admin guys and people who give jobs to family members. This was reported in the Irish Independent. Not medical but it happens in hospitals too.
    This weekend, the Sunday Independent has learned the children of another three senior managers in Dublin were appointed to clerical grade-three positions on a temporary basis to aid in the administration of the Back to School Scheme. However, these people are still in their posts over a year later.


  • Registered Users, Registered Users 2 Posts: 12,615 ✭✭✭✭mariaalice


    Pkiernan wrote: »
    Who should be prioritised between 2 patients, one of which has never worked a day in their lives, the other a high earning tax payer who chooses to pay extra money to purchase insurance?

    It does not work like that the person with the insurance will be in a private room in a hospital of there choice at a time that suits them, having treatment form the consultant of their choice, the person in the public system will be in a ward and won't have a choice of hospital or consultant but they will be getting the same treatment as the private patient.


  • Registered Users, Registered Users 2 Posts: 3,426 ✭✭✭KaneToad


    steddyeddy wrote: »
    Having worked in the HSE I can tell you there are plenty. Mostly admin guys and people who give jobs to family members. This was reported in the Irish Independent. Not medical but it happens in hospitals too.

    That article refers to a hiring practice that happened a decade ago...


  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    KaneToad wrote: »
    That article refers to a hiring practice that happened a decade ago...

    Indeed it does. It's still happening. I worked in a biochem lab and someone in charge of the supplies got the job because his aunt worked there. Had no problem admitting it and was completely incompetent.


  • Posts: 26,052 ✭✭✭✭ [Deleted User]


    Pkiernan wrote: »
    Who should be prioritised between 2 patients, one of which has never worked a day in their lives, the other a high earning tax payer who chooses to pay extra money to purchase insurance?

    When I was a student I had health insurance courtesy of my parents. Why would that make me more worthwhile than someone on the dole with an elderly relative dependent on them, or a child with additional needs needing care? Why would I be a worthwhile priority over a child who's parents couldn't afford insurance?

    Is a person with three children worth more than one with two? Assuming one person is more worthy than another based on wealth or circumstance is an empty pursuit.


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  • Registered Users Posts: 234 ✭✭seasidedub


    To posters complaining about people with private health insurance getting access/drugs/treatment faster than public patients - almost all EU countries including Scandinavian countries (I know because I worked there) have robust private health insurance and private hospitals. Those who have either insurance or cash to pay get faster access and treatment in those countries too.

    The difference is that the waiting times for access to consultants and elective operations on the public system is very long in Ireland, less so in other countries. But people need to cop on - relative wealth has always been a determinant of health and always will be. And if you work hard, sacrifice to pay insurance (thus removing the burden from the taxpayer....) surely you have a right to fast, efficient care?


  • Posts: 26,052 ✭✭✭✭ [Deleted User]


    seasidedub wrote: »
    To posters complaining about people with private health insurance getting access/drugs/treatment faster than public patients - almost all EU countries including Scandinavian countries (I know because I worked there) have robust private health insurance and private hospitals. Those who have either insurance or cash to pay get faster access and treatment in those countries too.

    The difference is that the waiting times for access to consultants and elective operations on the public system is very long in Ireland, less so in other countries. But people need to cop on - relative wealth has always been a determinant of health and always will be. And if you work hard, sacrifice to pay insurance (thus removing the burden from the taxpayer....) surely you have a right to fast, efficient care?

    Why would you assume that people who can't afford private healthcare don't work hard?


  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    seasidedub wrote: »
    To posters complaining about people with private health insurance getting access/drugs/treatment faster than public patients - almost all EU countries including Scandinavian countries (I know because I worked there) have robust private health insurance and private hospitals. Those who have either insurance or cash to pay get faster access and treatment in those countries too.

    The difference is that the waiting times for access to consultants and elective operations on the public system is very long in Ireland, less so in other countries. But people need to cop on - relative wealth has always been a determinant of health and always will be. And if you work hard, sacrifice to pay insurance (thus removing the burden from the taxpayer....) surely you have a right to fast, efficient care?

    I work alongside Mexican cleaners who can barely afford insurance. Some can't at all. Who do you think works more hours me or them?


  • Registered Users Posts: 234 ✭✭seasidedub


    steddyeddy wrote: »
    I work alongside Mexican cleaners who can barely afford insurance. Some can't at all. Who do you think works more hours me or them?

    Are you talking about the States? Different thing - no real public system there. We do have o e and by and large it provides good care.


  • Registered Users Posts: 234 ✭✭seasidedub


    Candie wrote: »
    Why would you assume that people who can't afford private healthcare don't work hard?

    I'm not presuming- but some people prioritise it over other things and sacrifice a lot to have it.


  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    seasidedub wrote: »
    Are you talking about the States? Different thing - no real public system there. We do have o e and by and large it provides good care.

    OK who works harder in Ireland. Me or an social worker? I make a lot more than a social worker (which shouldn't be the case).


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  • Registered Users Posts: 234 ✭✭seasidedub


    steddyeddy wrote: »
    OK who works harder in Ireland. Me or an social worker? I make a lot more than a social worker (which shouldn't be the case).

    Sometimes that's just how it is. Are you going to voluntarily take a pay cut?


  • Registered Users, Registered Users 2 Posts: 27,564 ✭✭✭✭steddyeddy


    seasidedub wrote: »
    Sometimes that's just how it is. Are you going to voluntarily take a pay cut?

    No but I'm not going to spout garbage like someone whose already on less pay than me for what may be equally hard work should also receive less health care than me.


  • Registered Users, Registered Users 2 Posts: 568 ✭✭✭rgodard80a


    steddyeddy wrote: »
    OK who works harder in Ireland. Me or an social worker? I make a lot more than a social worker (which shouldn't be the case).

    I still think there's lessons to be learnt from China.
    They are scoring their citizens by "social credits", good citizens are rewarded.
    Sounds a bit like earning "stamps" to get the dole years ago?

    Score people based on their contribution to society.
    That determines housing, health care etc.

    No point on wasting good money on criminals and spongers.


  • Registered Users, Registered Users 2 Posts: 24,202 ✭✭✭✭One eyed Jack


    mariaalice wrote: »
    It is a bit disturbing that there are people who think just because they are paying they should get access to life-extending treatment that those on the public system would not get, and its evening worse if they think that is what health insurance is for.


    That’s exactly what VHI are offering to their customers though? Access to earlier treatments in the event that one should develop a particular form of cancer that they offer earlier treatments for than are available from the HSE, and that’s somehow disturbing? No, that’s simply how private health insurance works, and initiatives like this attract new customers.

    I don’t know what to make of people who expect that the HSE should be able to offer the same level of services to the public as private health insurance providers can, certainly not when we’re paying as little for our public health services as we are. I really don’t know what to make of people who expect the HSE to fund niche drugs for a small group of people at the expense of many thousands of other public patients who will have to go without treatments or will have their healthcare significantly cut to allow for the budget to stretch to afford the millions spent on these new wonderdrugs that nobody can be sure are all that effective.

    But people who pay privately for their own health insurance are immoral? How the hell does that work?

    steddyeddy wrote: »
    They're only saying that because they can currently afford it. Increase the costs so only high earners could afford it and they'd change their views on the morality of healthcare.


    I could never afford private health insurance ed. I had to sacrifice many other things to be able to pay for it. I can afford it now, but my views on the morality of healthcare are the same. This has nothing to do with who can or cannot afford private healthcare, it has everything to do with a small number of people who demand the same levels of service of our public healthcare system as there are in the private healthcare system, but don’t want to pay for it themselves. Most people are satisfied with the standard of healthcare they receive in the public healthcare system, because they aren’t actually paying a whole lot for it. Everyone pays a small contribution. When one group demands that nearly all of the HSE budget be spent on wonderdrugs for them, then it really does beg the question -

    Where the hell are their morals?


  • Registered Users Posts: 1,850 ✭✭✭Lillyfae


    seasidedub wrote: »
    To posters complaining about people with private health insurance getting access/drugs/treatment faster than public patients - almost all EU countries including Scandinavian countries (I know because I worked there) have robust private health insurance and private hospitals. Those who have either insurance or cash to pay get faster access and treatment in those countries too.

    The difference is that the waiting times for access to consultants and elective operations on the public system is very long in Ireland, less so in other countries. But people need to cop on - relative wealth has always been a determinant of health and always will be. And if you work hard, sacrifice to pay insurance (thus removing the burden from the taxpayer....) surely you have a right to fast, efficient care?

    In most European countries they have robust private health insurance that everyone pays into, and may get a discount on according to their means. In Ireland there is a weird, nhs wannabe system whereby you buy priority with health insurance- which is paid for by some who can afford it and some who can't. Some choose not to buy it even if they can well afford it.

    It's just a ridiculous and unfair system from start to finish. Make health insurance mandatory and means tested, and slap a few co-pays on for things like a+e visits for things that can be handled by the gp. Everyone needs to have a base of responsibility for their own health and everyone deserves the highest level of care- but this needs to be bankrolled somehow and has to be equally accessible to everyone. It shouldn't just be for those who can afford it, but everyone should pay what they can afford, even if it's nominal.


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