Republican News · Thursday 06 July 2000

[An Phoblacht]

Equality in health care abandoned

The right to affordable and quality health care has been the promise of many Dublin governments. Yes, we all know that this has never been delivered, but this week the current Fianna Fáil/Progressive Democrats coalition took a major step backwards from even this unfulfilled commitment.

A new Health Insurance Amendment Bill is laying the ground work for the privatisation of the Voluntary Health Insurance (VHI) agency. The VHI has become the health insurer to over 1.3 million Irish people. Originally set up as a way of covering health costs for the self employed and farmers who were not covered by the public health system, the VHI has transformed itself into a substantial part of the 26 Counties' inequitable two-tier health care sector.

VHI subscribers use the agency as a means to bypass a poor quality and underfunded public health care service. VHI membership can cut down waiting list times and give patients smaller ward sizes as well as letting patients pick their own hospital consultants and at times a hospital of choice. The VHI has even opened its own exclusive private hospitals to cash in on the demand from the higher income earners for hotel-like accommodation and fast track medical treatment.

Up until now, VHI subscribers all paid what was termed a community rating where everyone, regardless of their age, paid the same VHI subscription for a particular level of service. Under the new Health Insurance Bill published this week, over 35s who join the VHI will be charged a higher rating than those who joined earlier.

This could perhaps be justified on the basis that those with longer VHI membership have made a longer term investment in providing for their health care. However, thousands of people spend their early adult years in education or working in temporary, part-time and contract posts where there is simply not enough disposable income to buy private healthcare.

The new act also allows for charging on an age related basis for outpatients and GP services. Given that older people are more likely to need these services, there is every reason to believe they could be penalised under the terms of the new act.

The 1994 Health Insurance Act that the new bill is amending guaranteed ``in the interests of the common good, for the regulation of the business of private health insurance''.

Now, with the VHI set to be privatised, the real meaning of the new act is to deregulate and abandon the interests of the common good. Most people who are VHI members have joined because of the poorly funded service in the public health care system. This new bill is going to cause more inequality in the health service.

The government should be moving towards delivering a quality health care service for all not a just one for those on high incomes.

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