Brian Stanley warns private health insurance is "another tax"

The cost of private health insurance is putting a huge burden on people. It is particularly putting a huge burden on pensioners who feel they have no choice. And the reason people feel compelled to take out private health insurance is because of the delays and inefficiencies in our public system. Some progress has been made in some areas, and in particular some of the screening projects that are being run are very effective, but we must do a lot better than that. It is another tax on people, and this is the reality of it. I have dealt with pensioners who are on 280 euros a week, but they are paying 40 to 60 euros in private health insurance, and we are having several hikes into one year. Into one year we are having several hikes, not one increase, but a number of them, some of them in double digits. We have a market model. One of the things that the government needs to do while we are stuck with having to use private health insurance is the charges that are put on public facilities by private companies such as the VHI and Leah. There are flaws in this approach to private health insurance. It is profit based, it is based on medical needs. It is a two-tier system, and I have weekly examples, as I am sure you have, of people who urgently need medical care or who need surgery. That could be a hip replacement, it could be anything. But they are offered, and they are being told, and this is a scandal of the two-tier system, despite the fact of what the proclamation said that was read out in 1916, treating everyone equal, what they are being told is, if you pay we can get you in next week. But if you cannot pay, you will sit there for two years or three years. I have seen several examples of that, and that is what we need to change. Now, those who profess to say that the private sector will sort everything, and I am not, if somebody wants to operate a private hospital, well and good, good for them. That is okay if they want to do that, but it needs to be separated out. And I welcome the fact that we have the 80-20% consultant model at the moment. It is a step in the right direction, but we need to get the whole way on that Minister. Mary Harney famously said, we either go with Boston or Berlin model. So what she meant was, was that we go with the American model. So previous speakers here said, oh, you know, we just go with the Thatcherite private model. Now to have that in America, let's see how that works out. So you have to be a millionaire to get treatment. Is that seriously what we are being told? Is that seriously what we are being told? That that is the route that we go down, the American model, where you have to be a millionaire, or very close to a millionaire, before you can get your appendix. before you can get your appendix taken out, or something else done. That is not where we need to go. We need to look after people. And if you look at the figures here in this country, we have 2.53 million people who have private health insurance. We have 1.57 who have medical card cover. Now this is based on the start of the year figures, and they are probably still fairly accurate. But we have 1.3 million who have neither. 1.3 million people without proper health care of any kind. Some of them may have a GP-only card. Okay, it is a help. It is a help. Yeah, it is a help. I acknowledge that. But it is still a long ways off. A small number of them have that. Now this category, let's look at this category of people for a moment. These are the same people who can't get on a local authority housing waiting list. Many workers and their families, they can't get on a local authority waiting list. They can't get a mortgage. And if they do get a mortgage, they will be crucified, trying to pay it out of their wages. They most likely are paying for a car to travel to work. And they are facing, if they are in private rental accommodation, like they are really at the mercy of a Wild West system. Now just think about these people for a minute. These people are really trapped in a very, very difficult place. And on top of all of that, they don't have medical cover. And I've met those people, and you meet the Minister, and they say to me, why are we being left out the whole time? I'm paying taxes, I go up every morning, I'm driving a car to Dublin to work in the building site all day, or I'm driving to wherever, and I'm working a 10-hour shift and doing the best I can, and here's what I have. I don't even have basic health cover. And that's what we need to change. Now, while we're stuck with the current system, the bill, you know, accept that we have to do this every year, and the risk equalisation fund is the only way it can be done. And they accept that. We are where we are. So when we're here, we have to do this. And spread out the burden. Because obviously those who most need health care, if you were to go on the basis of charging them on their age and their health needs, they wouldn't be able to do it. We'd have people falling through the cracks. So, you know, that has to be supported, and I recognise that. That's recognising the real-world situation we're in now. But what I'm saying is that we need to change it. We need to change this current model. The fact that a lot of people don't have the option, we need to change it. The risk equalisation, it's an annual adjustment. It's a logical approach. And as I said, it spreads that burden. Now, the value for money in the health system, and I want to address this with you. We had the 100th anniversary of the Public Accounts Committee today. And I attended it as a former Cahirla of that committee. And the one thing that I found, Minister, and no doubt about there's people in the health system doing great work, but it's a fog in terms of the finances. You know, we put in a lot of money, as a percentage of GDP. We are behind some other countries, but in actual, in the amount of funding, we do have a high GDP, which is good. But in hard cash, we do put in, we compare very, very well with other countries, and we exceed most of them. No argument there with that. And certainly where I come from, as on the left of the political spectrum, I won't argue with you on that. But the value for money that we get, and the gap between the money actually going over to the Messiaen Plaza, to the headquarters of the Department of Health, and the actual services on the ground, it's a long and winding road. And the one thing I would implore on Ministers is that, you know, is to make sure that you can actually track where that's going. Because I know that the CNHE's office would have had difficulty at times trying to follow that route. I certainly had, and the members of the Public Accounts Committee, in the five-year period, I was there, and we tried very, very hard at times. We made some progress, but it's a difficult route to follow. And that route must be shortened. You know, money, budget, and action. That needs to be a straight line that people can see exactly who is accountable along the way. That's the shortest possible route, and that there's not too many diversions. So we must do that. And slouch your care, this is the big thing. So it's a 10-year, as I recall it, 10-year implementation program. So we have that much time left in it. And I accept that COVID slowed it up. I accept that. That's the real world. You know, I'm not going to go shout to that government about that. That's something that we all had to deal with. Okay, we might have dealt with it different if it came back now, but everybody's done their best at the time, and done what the top is right. But what I would say to you about this is that we have to get this launch here. You know, we're an outlier in Europe. We don't have a national health system comparable to other North European countries. We're counted now amongst, per head of population, one of the richest. Okay. It's not a panacea for all. They have an NHS in the North. That's not perfect. There's big, long waiting lists. My niece works in it. I know all about it. It's a difficult system. So, you know, if you put in the system and don't put in the necessary checks and balances and procedures in it, you wind up with that. But what I would say to you is that we do need to move to a single tier system to remove that fact away from people that I started off with, that don't feel compelled to actually pay that 40 to 60 euros a week. That's the charges. Okay. And if you're on a pension of 280 a week or 285 a week, you know, you're paying 40 to 60 euros a week. That's the first thing to go out of it. Like, that's a huge pile of money. That's a huge take out of the income of a pensioner. And even if they have, for example, if they have an occupational pension of typically, you know, maybe 80 to 100 and 100, 120 euros a week, it's still a huge pull on it every week. And we must do better than that. So what I'm asking is, is that we try and move to slantia care. And in the short-term minister, I will ask you, and I've asked Minister MacNeil this before the budget, can we do something to help those 1.3 million citizens who do not have medical care cover? There are mainly workers and their families. I really think it's unfair. You know, these people are, like the medical care thresholds, the income threshold for that has not changed as long as I'm here. And even before that, as I recall it, and I'm opening a correction on this, it's certainly over 20 years since that was increased. The threshold, the income threshold, it's 186 euros for a single person. You know, like social welfare, the basic, the lowest rate of social welfare for a single person is over 230 euros. Now, you automatically get it if you're on social welfare. But you're not automatically entitled to it if you're working in a part-time job, if that was your only income. Now, that's a scandal. It's an absolute scandal that we're, you know, we're ignoring that group of people. They're the people who can't get a house, they can't get a mortgage, they have to, they're paying taxes, they have to get to work, they have to make payments on cars and everything else. And yet they have no health cover. And their children. I mean, I was challenged when I was canvassing last year, this time last year for the election. And one person said to me, what he actually said to me was, he said, I'm travelling to Dublin. I know them, him and his wife, she comes from the same area as myself. And he said to me, the people beside me have a medical card. He said, I don't begrudge them that. But he said, I don't have a medical card. And they had it by virtue of the fact that, you know, because of their status in this country. And I don't like saying that. I don't want to take that off them either. But the point to make is, is that he could not, that family, that family had been sick, the children were sick, they could not go to the doctor in the month of November. And if you recall last November when you were canvassing, as you and I were, you remember how cold the weather was and everything else. And remember him saying that to me at the door, one freezing cold night. That's not good enough that we do that. We have to help those people. We have to help the workers and their families in this country. And, you know, we've had a lot of time to do it. We've made a lot of progress. But the one thing that has not moved as frozen in time is income thresholds for medical cards.