Upcoming Events

National | Anti-Capitalism

no events match your query!

New Events


no events posted in last week

Blog Feeds



offsite link Ukraine Buys Huge Amounts of Russian Fue... Fri Jan 20, 2023 08:34 | Antonia Kotseva

offsite link Turkey Has Sent Ukraine Cluster Munition... Thu Jan 12, 2023 00:26 | Jack Detsch

offsite link New Israeli Government Promises to Talk ... Tue Jan 10, 2023 21:13 | Al Majadeen

offsite link Russia Training Iranian Pilots Ahead of ... Tue Jan 10, 2023 15:19 | The Times of Israel

offsite link Lukashenko Abolishes Copyright Protectio... Tue Jan 10, 2023 15:05 | Nikki Main

Anti-Empire >>

The Saker
A bird's eye view of the vineyard

offsite link Alternative Copy of thesaker.is site is available Thu May 25, 2023 14:38 | Ice-Saker-V6bKu3nz
Alternative site: https://thesaker.si/saker-a... Site was created using the downloads provided Regards Herb

offsite link The Saker blog is now frozen Tue Feb 28, 2023 23:55 | The Saker
Dear friends As I have previously announced, we are now “freezing” the blog.  We are also making archives of the blog available for free download in various formats (see below). 

offsite link What do you make of the Russia and China Partnership? Tue Feb 28, 2023 16:26 | The Saker
by Mr. Allen for the Saker blog Over the last few years, we hear leaders from both Russia and China pronouncing that they have formed a relationship where there are

offsite link Moveable Feast Cafe 2023/02/27 ? Open Thread Mon Feb 27, 2023 19:00 | cafe-uploader
2023/02/27 19:00:02Welcome to the ‘Moveable Feast Cafe’. The ‘Moveable Feast’ is an open thread where readers can post wide ranging observations, articles, rants, off topic and have animate discussions of

offsite link The stage is set for Hybrid World War III Mon Feb 27, 2023 15:50 | The Saker
Pepe Escobar for the Saker blog A powerful feeling rhythms your skin and drums up your soul as you?re immersed in a long walk under persistent snow flurries, pinpointed by

The Saker >>

Public Inquiry
Interested in maladministration. Estd. 2005

offsite link RTEs Sarah McInerney ? Fianna Fail supporter? Anthony

offsite link Joe Duffy is dishonest and untrustworthy Anthony

offsite link Robert Watt complaint: Time for decision by SIPO Anthony

offsite link RTE in breach of its own editorial principles Anthony

offsite link Waiting for SIPO Anthony

Public Inquiry >>

Voltaire Network
Voltaire, international edition

offsite link Transnistria appeals to Russia for help Fri Mar 01, 2024 13:34 | en

offsite link Vladimir Putin's Address to the Federal Assembly, by Vladimir Putin Thu Feb 29, 2024 06:29 | en

offsite link The European Union against farmers, by Thierry Meyssan Tue Feb 27, 2024 06:58 | en

offsite link The Silence of the Guilty, by Manlio Dinucci Mon Feb 26, 2024 13:24 | en

offsite link Thierry Meyssan's interview with the Serbian daily Ve?ernje Novosti, by Thierry ... Mon Feb 26, 2024 05:29 | en

Voltaire Network >>

Why going Dutch is going for broke

category national | anti-capitalism | feature author Saturday April 02, 2011 00:09author by Marie O Connor Report this post to the editors

Fine Gael's UnFairCare policy

featured image
Uncertain Future for our Public Health system

Fine Gael’s UnFairCare policy demands more scrutiny. At a time when support for the Dutch model is declining in its country of origin, Fine Gael proposes to import this charter for privateers into Ireland. Marie O'Connor looks at Dominic Haugh's study, which reveals an unaffordable three-tier system, growing waiting lists, cancelled operations, out of control budgets, bankrupt hospitals, professional gravy trains and spawning bureaucracies, all encouraged by pro market think-tanks.

Going Dutch will make private health insurance compulsory for everyone. Around 75% of healthcare funding will still come from taxation, however. The state––taxpayers–– will pay for medical card holders and children up to 18 years of age, and give those on low incomes an allowance payable to their chosen insurance company. Many taxpayers will pay on the triple, once through general taxation, a second time through mandatory insurance premiums and once more through employee deductions.

Everyone is compelled to take out the basic package, and supplementary insurance is also available for those who can afford it. As premiums have risen, however, the numbers buying top up insurance have declined.

The Dutch system is expensive. Research by Dominic Haugh reveals serious cost implications for the average household. The annual cost of health insurance per household in the Netherlands ranges from €4 525- €5 625. The basic private health insurance package there currently costs €1 194 per person. On top of this sub, payment of which is compulsory, employers deduct a further 6.9 per cent, up to a ceiling of €2 233. And on top of this deduction, there are co-payments. Government cut backs on entitlements have led to more out of pocket expenses for patients. Over 10 per cent of health care funding comes from co-payments for care and medicines not covered by the basic insurance package.

Economies of scale will reduce insurance costs, FG has claimed, but the Dutch experience shows the opposite. Premium costs have risen by 41 per cent since 2006. The market is now controlled by a small number of insurance companies, who have exploited their monopoly by hiking up prices and paring back benefits. An initial excess of €150 per person has risen to €210, for example, and is expected to rise further. Admin costs have been reduced, mainly by sacking workers. This has led to delays in processing claims.

While UnFairCare promises to abolish long-term waits on trolleys and slash waiting lists, the new system has seen growing waiting lists and wholesale last-minute cancellations of operations (just as in Ireland). The Dutch system also has parallels with America’s, where up to 40 million are without health insurance.

Holland’s two-tier health system has been abolished––and replaced by a three-tier health system, where half a million people are either uninsured or in arrears. The Dutch Government now deducts insurance premiums at source from wages and welfare payments of uninsured and defaulting citizens and imposes significant fines for non-payment.

Each person pays the same regardless of age or health status (‘community rating’) and nobody can be refused cover: this is FG’s promise to the electorate. But again, the Dutch experience shows that companies are findings ways to circumvent the ban on ‘risk selection’, or cherry picking, as insurers manoeuvre to eliminate high-risk patients from their books. The Dutch system was introduced in 2006. By 2008, the number of insurers requiring applicants to complete medical questionnaires had doubled from 12 to 25.

Costs have been rising steadily there since the insurer-driven system was introduced. The system is a gravy train for professionals. Dutch GPs, for example, negotiate a fee with the largest insurer, and then impose that fee on the rest. Not surprisingly, GP incomes have risen significantly. Ditto medical consultants, who saw their incomes rise by 50 per cent in 2008 alone. Some specialists, including anaesthetists, radiologists and pathologists, even doubled or tripled their incomes.

Healthcare costs have spiraled since 2006 and this trend is continuing. The overruns have shaken the idea that regulated competition can control costs. Fixed budgets––the system we have now–– may now be reintroduced to stem the tide of rising health care costs. More than 50 per cent of hospitals in the Netherlands are now facing bankruptcy and this has been attributed to universal health insurance. Some hospitals have difficulty financing their capital investments because banks are reluctant to fund them. Meanwhile, health insurers are pushing for lighter regulation, and the government has responded by increasing the percentage of the hospital budget vulnerable to negotiation by private insurers.

Nor is the model cost effective. Indeed, the ‘money-follows-the-patient’ formula has spawned a massive bureaucracy. There are now a staggering 30 000 diagnosis and treatment combinations in use in the Netherlands. Negotiating and implementing deals between insurance companies and individual hospitals based on these baskets of care requires more bureaucrats. More money is being spent on bureaucracy, leaving less to spend on care. (The same pattern can be seen in England, where the NHS is being privatized.)

It is clear that market competition has failed in the Netherlands. So why would any party want to bring in such a health system here? Fine Gael cites the Euro Health Consumer Index, which in 2008 declared that the Netherlands’ was the most successful health system in Europe. The index is produced by a private think-tank called the Health Consumer Powerhouse. FG also relies on REFORM, another private think-tank that promotes insurance incentives in healthcare. Both of these organizations are funded by a lobby group in London with close ties to giant pharmaceutical companies, private health insurers and private health care providers. All have a stake in the system that Fine Gael proposes to implement.

 #   Title   Author   Date 
   Insurance for all     Louise    Sun Mar 27, 2011 15:19 
   Critique of Fine Gael's Faircare health policy     Jolly Red Giant    Tue Mar 29, 2011 20:34 
   Looking at the wrong end.     Ratonal Ecologist    Mon Apr 04, 2011 12:51 
   Re: Looking at the wrong end     T    Mon Apr 04, 2011 23:46 
   you've got T...     opus diablos    Tue Apr 05, 2011 10:40 
   rally now     author    Tue May 03, 2011 22:15 
   social welfare     Serf    Sat May 07, 2011 09:01 

Number of comments per page
© 2001-2024 Independent Media Centre Ireland. Unless otherwise stated by the author, all content is free for non-commercial reuse, reprint, and rebroadcast, on the net and elsewhere. Opinions are those of the contributors and are not necessarily endorsed by Independent Media Centre Ireland. Disclaimer | Privacy