Sir, – I write in response to Dr McGlacken-Byrne’s letter on Ireland’s two-tier healthcare system (Letters, May 27th). While I totally agree with his assertion that our current two-tier system is inadequate and inefficient, I question his assertion that the best option for reform is a tax-funded system.
As he pointed out, Germany experience very successful results from their healthcare system, which is insurance-based, where German citizens have the option of paying into either public social insurance funds or private insurance funds.
Similarly, Switzerland and the Netherlands operate universal healthcare by health insurance provided entirely by private companies.
In France, their healthcare system is funded by social insurance funds, to which contributions are compulsory and are deducted from payslips.
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Each of the above countries, in addition to Australia and Canada, recognise the strengths (as well as the limitations) of private healthcare.
In France, nearly all primary care physicians operate exclusively in private practice, with the social insurance funds reimbursing the patient. Private hospitals and public hospitals are also often equivalent, with any bed being open to any patient who needs it, and payment to both is provided by the relevant insurance fund.
The Scandinavian countries of Sweden, Norway and Denmark do indeed fund their healthcare through taxation, however their healthcare systems are massively decentralised and managed by local government, and all three have experienced issues with access and waiting times, as well as sufficient facilities for emergency care.
All of the above countries, which consistently rank among the best healthcare systems in Europe, and the world, utilise small copayments for all healthcare services, including primary care, prescriptions and hospital care.
These copayments are capped at manageable amounts.
These healthcare systems have managed to remain consistently superior to both Ireland and the United Kingdom by many metrics, despite the various recent crises of Covid-19 and the 2008 recession (with austerity often blamed for the NHS’s current problems).
I sincerely believe that we should be looking further afield than the United Kingdom for a model to base our reformed healthcare system on. – Yours, etc,
ILLANN WALL,
Cork.