Brendan Keenan: maybe in Ireland there is a national health without the NHS?

  • Brendan Keenan: maybe in Ireland there is a national health without the NHS?
    Independent.t. E.
    How strange. There was a huge fuss recently in Britain – not a wedding, or a funeral, or a birthday – and the anniversary of the National health service. In any other country there is a national memory to create its health system?
    https://www.independent.ie/business/irish/brendan-keenan-can-ireland-have-national-health-without-an-nhs-37220378.html
    https://www.independent.ie/business/article37220377.ece/76dd4/AUTOCROP/h342/2018-08-16_bus_43282166_I1.JPG

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How strange. There was a huge fuss recently in Britain – not a wedding, or a funeral, or a birthday – and the anniversary of the National health service. In any other country there is a national memory to create its health system?

But then, the NHS strange. First of all, it was a genuine act of creation, in many ways an excellent Minister of labour Aneurin ‘nye’ Bevan. Most medical services have been long in gestation. He was also Minister of housing in war-torn Britain and has gone a long way towards correcting that too. Of course, they are not doing more.

Revolution health, which then made the NHS the UK has a national coat of arms, royalty apart. It is also considered as one of the best in the world.

It could be true, but hardly more. Even so, one of the most effective is the campaign a false British exit from the EU that EU membership was bad for the NHS.

One would perhaps expect that the anniversary was celebrated more here. The NHS is something of a touchstone for Irish policy in the area of health care wonks because it’s “free” for patients, due almost entirely from taxation.

Brooding with respect to this method goes through the report of the Committee of Parliament Sláintecare the implementation of which, as we said last week, is about to begin. The Chairman of the Commission, social Democrat co-Director Róisín Shortall TD, described it as a version of Ireland NGS.

It is a lot more questions than just providing free services to the patient. The beginning seemed more about the plans, tips and reports than health care. It’s a bit beyond the purview of this column, but MS Shortall, a graduate of the economy, he said, it’s all about funding.

This is true, and it’s a big economic issue, as you can find. Confusion on the Irish health services – for example, what exactly is it doing how much work on this and a fifth of young people in Europe are waiting for treatment? – corresponds to entanglement in the economy.

A recurring theme in the discussions was that the financing of the Irish system is really weird, and the goal is to make the service like a normal EU country. No, really, there’s no such thing as a “normal” European health care. The NHS is not normal – quite exceptional really, and not always in a good way.

An invaluable source for the economy of the health system is health OECD publishing first sight’ – a cornucopia of statistics. Fortunately, the economy is a bit simpler than in the day care or the waiting time for cataract surgery, but the differences between the systems are still making the comparison difficult.

The Committee is right that health insurance plays almost no role in the UK system. He encouraged Ireland to move towards this model, but this is not the norm. In the OECD, only Iceland, Latvia, Mexico and Turkey have a similar system where insurance is 10pcs or less of health care costs.

Insurance systems are the norm, not the exception, but they greatly vary in mind. Additional insurance, to purchase additional benefits is common. Around 80pc of the population in the Netherlands there is such insurance. More common still is the additional insurance that satisfies any additional costs not covered by the General system. Almost everyone in France has such insurance.

Ireland, however, has a “duplicate coverage” is defined as covering services that are already free. This is where we’re abnormal. In 45pc of the population, Ireland has the highest share of such insurance, followed by New Zealand at 29pc.

We all know the reasons – the ability to queue – but it misses the point a country mile, to suggest that the Irish problem can be solved by replacing insurance is meant to bypass the shortage, not being able to do anything about the shortage.

Queue and high cost. It is the financial issues that no one wants to discuss and who will condemn all these grandiose plans before they start – if they ever start.

The OECD uses three measures in relation to health care costs (at least) – in percent of GDP, dollars. per person taking into account purchasing power, and in percent of government revenues.

The true level of Irish expenditure was hidden exaggerated GDP, but it is now so grotesque that no one dared to defend it, although it is still the OECD-method. The best measure is now GNI* (adjusted national income). Irish spending on health, on this basis, more than 11pc, which is the best in the whole OECD.

Adjusted dollars means that they buy the same amount in each country, which removes the effect of high prices in Ireland. Based on this, one of the youngest populations in Europe spends $5500 per person per year. The British spend 4,200$.

The share of state revenues, just over 18pc, tells the tale. This is about the same as the UK, which is an indicator of how much less profit the British government collects, with growing evidence that it is not enough to collect. Was the NHS’s expenditure on the Irish level, it will have an additional €80 billion a year to play.

I looked in the other direction, the Irish system will cost EUR 1 billion less than it does to be “normal” European country, and €2 billion less to reach the level of the NHS. This is what happens when the money all comes with the ever-stretched public funds.

This elephant, who all carefully closed one eye. It is simply not possible to Fund the kind of extra expenses that in the existing system must comply with the best services in Europe and rising demand for services that comes from the aging of the population.

Simple budget cuts will not. All medical services must the annual increase just to maintain standards. You can see the effect of freezing spending in Ireland after the accident and an actual reduction in the UK.

We should not pretend that the system can be improved by simply adding more services is unclear, or even nonexistent, budget. Simple question: how many employees will be transferred or become redundant, and how much room is closed due to the switch to primary care? Answers on a postcard, please.

The Committee is right about one thing. Since the government owns most of the health insurance system, the transition to European-style insurance will not work; as the labor party found out and fin Gal, who seems to not read the documentation, found out again.

Theoretically it would be easier to go to a purely public system the NHS but the existing prohibitive costs would make it politically and financially impossible. The loss of their duplicate insurance will be accompanied by much higher taxes for those who have such insurance, since we are talking about the people who pay the bulk of income tax.

Yet nobody asks why the costs are unsustainable, or why the soon to be only weird us system more expensive and what can be done about it. Probably because they suspect they know what the answers are.

Costs doom all these Grand plans before they start – if they ever start.

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