Madam, - As a solution to the country's healthcare problems, Messrs Flood, Burke and Grace (Letters, December 5th) propose something called "Universal Healthcare", which appears to be a copy of the UK's National Health Service. The characteristics it shares with the NHS include: i) a national monopoly; ii) run by the Government; iii) centralised monolithic structure; iv) hospitals funded by annual block grants, not for treating patients.
When I went to live in the UK in 1976, the widespread view in Britain was that the NHS was the envy of the world. It had some problems, but a little more funding would make it just perfect. Today, 32 years later, things are just the same. The same fundamental problems still plague patient treatment, the most characteristic being rationing in the form of waiting lists. After 60 years' experience of the failures of the National Health Service, it's extraordinary that anyone would want to copy such a discredited model.
Your medical correspondents seem to have no concept that we can learn from the experience of other countries, let alone that systematic comparative studies are performed at regular intervals, by bodies such as the OECD and Health Power House.
A regular conclusion of such studies is that the worst way to provide healthcare is by mean of a monolithic, centralised, government-run monopoly funded from taxation.
Equally regularly, it is found that the best way to provide healthcare is via universal health insurance, ie, a system where every citizen is insured for medical treatment and is treated as a private patient. In this country, such a system is advocated by the Labour Party and, at the time of the last election anyway, by Fine Gael. Bafflingly, the three wise men from Limerick fly in the face of such findings and propose abolishing health insurance.
Not only do they want to abolish health insurance, they want to abolish private hospitals. This madcap scheme would put patients in Ireland completely at the mercy of the HSE, with nowhere else to flee when the HSE fails them.
No other European country has banned health insurance or private healthcare, but the medics of the Midwest see it as the road to our healthcare salvation. One would have thought that any normal person, reaching the conclusion that such draconian, authoritarian measures are necessary, would realise that he had made a wrong turn somewhere. But Limerick doctors are made of sterner stuff.
One thing that's remarkable about the missive from the three medics is how little it addresses the patient. We read about politics, how medics can get their hands on more money, power struggles, elimination of competing institutions and resulting monopoly power, but nothing about how all of it would benefit the patient.
We are told "such a scheme would work well with established structures".
So this wonderful scheme would preserve the failed, dysfunctional institutions that have us in the state we're in! What we patients really need is to be liberated from the stranglehold of the medical monolith. The most important single measure to improve the lot of the Irish patient would be the abolition of that monstrosity, the HSE. Oh frabjous day! - Yours, etc,
NORMAN STEWART,
Seapark,
Malahide,
Co Dublin.