Future Government reforms should aim to increase the extent of universal health coverage while building from the existing system, a new paper drawn up by the Economic and Social Research Institute (ESRI) has said.
The paper criticises the last government’s policy – now abandoned – of moving towards a new system of universal health insurance. It says the policy of universal health insurance – set out in a 2014 Government White Paper – could have increased costs without achieving universality and equitable access.
The paper drawn up by Maev-Ann Wren and Sheelah Connolly recommends that "future policy should aim to increase the dimensions of universal coverage – population coverage, service coverage and pooled payment to replace user fees – while building from the existing Irish system in the most cost-effective way possible".
Free GP care
The paper praises the introduction of tax-funded free GP services for young children by the previous government and suggests this model could be used to extend similar services to other groups.
“This extension of coverage for young children will facilitate the roll-out of new public health measures, such as wellness checks, at relatively low cost to the exchequer and very low cost to Irish society, when the removal of private fees for this grouping is taken into account.”
The paper suggests that the existing two-tier access to hospital care could be addressed, for example, by developing a public purchaser of hospital care – a reworked model of the National Treatment Purchase Fund – which would guarantee equitable access to healthcare.
Ensure payment
The paper says alternatively a system of compulsory private insurance for elective or non-urgent care could be put in place “in a system designed to ensure payment according to ability to pay and Government control of insurers’ margins and other costs”.
However, the report warns that universal coverage could lead to “universal rationing” of healthcare if supply of services could not increase to meet demand.
Minister for Health Simon Harris welcomed the ESRI publication, calling it a “timely and important contribution to our thinking on how to improve health services and healthcare in this country”.
Mr Harris said that, while he would not pursue the model of universal health insurance, he did intend to “pursue options to achieve accessible, affordable, high-quality healthcare for everyone in a timely way”.
