Madam, - Susie Long died last Friday from colon cancer. Earlier this year she told Joe Duffy on RTÉ's Livelinethat she had waited seven months for her bowel test, while a patient with the same condition who had private health insurance waited three days.
Subsequently, Joe Duffy gave me time on his show to discuss this issue, and I explained the reasons why insurance and other aspects of our health financing system create inequity in access to hospital care.
Regrettably, such inequity is not surprising, as research carried out internationally by the Health Equity Research Group of the OECD and here in Ireland by the ESRI has shown that one of the benefits of health insurance is that it encourages doctors to treat patients quickly. This is because insurance remunerates doctors through fees and fees are a financial incentive to get patients into hospital.
Prof Eddy Van Doorslaer of the Health Equity Research Group studied 21 OECD countries health systems in 2004, to ascertain which were pro-poor or pro-rich. He found that Ireland had the third most pro-rich system in respect of access to hospital doctors. He went on to determine what factors contributed to this inequity.
Not surprisingly, he found that private health insurance was one of the leading contributors to our system being pro-rich, and therefore inequitable. To his surprise, but not mine, he also found that having a medical card was one of the other major factors creating this inequity. He could not understand why a card which entitled someone to free hospital care created this inequity. Medical cards are an insurance system against the cost of medical care but they do not pay fees to hospital doctors and are therefore a financial disincentive to hospital access.
It is a system I deplore and one that should be changed. Our politicians have created this inequitable system, and with some exceptions among the Opposition, they seem content to continue with it.
They have failed Susie Long and her family and many other patients. Susie Long could have criticised the medical profession for the delay in diagnosing her condition but she recognised that it was the politicians who created and continue to support the current financing system. Both Susie and her husband had great courage, decency and principle in retaining a core belief that health care should be provided on the basis of need and not on ability to pay.
Our political parties have not forcefully made the case for change and the need for that change. Is it because most of the members of the Dáil have private health insurance and recognise the inequitable benefits accruing from it? - Yours, etc,
Dr JOHN BARTON, Physician, Portiuncula Hospital, Ballinasloe, Co Galway.
Madam, - Condolences to the family and friends of Susie Long - a heroic Irishwoman in an Ireland that has become devoid of genuine selfless heroes. - Yours, etc,
JOHN McNAMARA, Salmon View Terrace, Sunday's Well Avenue, Cork.
Madam, - I wept when I read the full text of Susie Long's email in yesterday's Health Supplement, as I did when I heard her talking to Joe Duffy. My tears are for her and for her family in their grief.
I also weep in a different, angrier way for the uncaring responses of our Government, a Government that allowed Susie Long to die, and will allow many more to die in the same way, despite the parroting of "It must never happen again" and other anodyne phrases.
The sad reality is that Susie Long will soon be forgotten by those in authority, while they continue the headlong dash towards an ever more unbalanced health service.
As Fintan O'Toole says ( Opinion, October 16th), we truly do live in a vicious little place. - Yours, etc,
BARBARA O'CONNELL, Ballydehob, Co Cork.