HARRY McGEE
The Government has insisted that the introduction of universal health insurance (UHI) is a key pillar of Government policy and will be implemented but how it will be costed and structured will be the subject of on-going discussion, a Government spokesman said last night.
Speaking on the eve of a meeting of senior Ministers to discuss a controversial White Paper on the initiative drawn up by Minister for Health James Reilly, a Government spokesman said: "We cannot afford not to have UHI. It is happening. It is a pillar of health reform and will be included."
Revised paper
It is understood that a revised version of the White Paper to be presented to the Cabinet sub-committee on health by Dr Reilly today will contain provision for a cap on State expenditure on healthcare under the proposed reforms, a key concern raised by the Department of Finance.
The Minister’s plans for universal health insurance – under which everyone in the State would have to have insurance cover for a basic level of health services – has created deep divisions within the Government over recent weeks.
The Department of Public Expenditure and Reform warned earlier this month the proposals could threaten the financial stability of the State. That department also suggested that the basic package of insurance could cost €1,672 per year which the Opposition described as “a major tax hike”.
The Department of Health has strongly rejected the claims made by the Department of Public Expenditure and Reform. Health sources have accused it of peddling "fantasy figures" .
Sources on the Fine Gael side of Government said Dr Reilly had been very staunch, and correctly so in their view, in his defence of UHI in the past week. They also noted that the Department of Public Expenditure and Reform had seemed to change the point of its attack on UHI from talking about the financial costs to talking about additional quangos – however, concerns about the proliferation of quangos under the UHI plan were contained in its original criticism.
However, the indications are that Taoiseach Enda Kenny will support the views of Dr Reilly on the issue of UHI, notwithstanding concerns raised by the Department of Public Expenditure and Reform and the Department of Finance.
Subsidies
Under the Minister's proposals the State would pay the insurance premium for lower income groups and subsidise the cost for others. However, no details of the income thresholds for the application of subsidies have been set out.
The Irish Times reported last week that under the proposals people who refused to purchase the standard package of insurance would have the costs deducted from their earnings or benefits.
The Sunday Indepe ndent reported yesterday that the Department of Finance had argued the absence of "a clear articulation of a budgetary cap on expenditure" makes a proper assessment of the fiscal sustainability of UHI "very difficult". The Department of Finance also said the plans could "necessitate reduced spending in other departments or the introduction of specific tax increases to pay for the increases [in funding], the economic consequences of which would be far from clear".
