Ireland should give careful consideration to the implications of "corporatisation" of health care as has happened in the US, according to a leading economist, Prof Dale Tussing of the University of Syracuse, New York.
With indications that the Republic may follow the US by allowing large national corporations not only to finance health care but al so to act as its provider, there was a need to evaluate what restrictions might be necessary and the long-term consequences, he told a seminar at Dublin City University Business School.
While corporatisation had occurred in the US in the past decade, such an evaluation of its implications had not taken place, he said. The growth in "managed care" had coincided with the arrival of corporations, which in effect were now employing physicians.
Costs, waste and duplication were reduced; however, consumers were worried about loss of choice, "the possibility that care would be denied when it is crucial". This, he added, was the focus of much media attention, but evidence of this denial was anecdotal rather research-based.
Physicians within the new system did not like less autonomy and increased "second-guessing of their decisions, frequently taken by non-physicians". As a consequence, there had been a decline in morale in the profession.
The one increasing cost was bureaucracy within the US system. Those likely to make most money out of US health-care business were the chief executives of the large corporations, many of whom were on salaries in the million-dollar bracket.
It was possible that large European or UK organisations would move in on the Irish market and offer similar health plans, added Prof Tussing, a former research professor with the Economic and Social Research Institute.
While US corporations wanted "experience rating" of subscribers to their policies rather than "community rating", where subscribers paid the same regardless of age or health status, some states were passing legislation to ensure community rating was retained.
Prof Tussing will address a joint DCU-ESRI public seminar on the economics of Caesarean sections this Thursday at 4 p.m. at the ESRI, 4 Burlington Road, Dublin 4.
