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Dublin: 16 °C Sunday 19 May, 2013

Government urged to use VHI shareholding to negotiate consultant fee reduction

An average of 6,000 people leave the private health insurance market every month and Fianna Fáil said there is little incentive for young people to take it on.

Image: Eamonn Farrell/Photocall Ireland

FIANNA FÁIL will this week table a motion encouraging the government to use its position as a shareholder in VHI to negotiate a reduction in consultant fees.

The Private Members motion asks that the government note the “ongoing and persistent increase in the cost of private health insurance”. An average of 6,000 consumers leave the private health insurance market every month and Fianna Fáil said there is “little incentive for younger people” to invest in it.

“The haemorrhage of younger, healthier policy holders is threatening the sustainability of the private insurance market by generating further upward pressure on health insurance premiums for those who remain and many of those who remain have downgraded their level of cover,” it said.

The party called on the government to “use its position and purchasing power as a VHI shareholder to negotiate a reduction in consultant fees”. It also asked that it allows public hospitals to negotiate with health insurers and revise the legal definition of non-advanced plans so that the 300,000 holders of lower level plans will not face a substantial rise in their health levy.

The Private Members motion will be debated on Tuesday.

Read: Aviva to increase insurance premiums by 4 per cent>

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Comments (52 Comments)

  • had to leave it meself last month,it has doubled in past 2yr.but im sure minster reilly will look aftar me

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  • I had a day care procedure a while back. I got rang to ask if I occupied a bed… I did for 5 mins while my BP was checked…. Cost 800+e. I was in day care including procedure for a total of wait for it 30 minutes!!! I opted not to have sedation as they forgot to tell me i needed a person to collect me plus I have been in my senses for worse things…The final bill was over 1000. I told the claim checker yes I occupied the bed for all of 5 mins as I couldn’t lie… I specified 5 mins and yes they paid as I’d been in the bed!!! No wonder my premium is so high!! I had this done before in the consultants office but now he cannot do it due to infection control! I have had other procedures where I get a chair and not a comfy one – that’s the one I could do with the bed for!! But hey the cost of the chair is the same as the bed almost!!! It’s a joke!

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    • You premium is not affected by the use of your use of your insurance. It not like car insurance in that way. Also the majority of that bill would have been from the hospital and a very small part would have been for the consultant.

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    • Someone once said “If you knew the cost of health care you’d never get sick”.
      I do agree though – charging for the bed is overly much, especially when realistically speaking, there was most likely another person charged for the bed you were in for all of 5mins…

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    • The premium is high because of all the crazy charges. It’s just like car insurance except not individualized.

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    • The charge for the bed would be understandable if it was stripped and washed down completely before the next occupant , as it is in a ward. For 5 mins, somehow I doubt that is going to happen,

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  • What about the government ask the public hospitals to stop charging grossly excessive fees to insurance companies for private patients needing care in public hospitals?

    The consultants get paid for their care – but the hospitals in turn charge literally thousands for the bed and overnight charges.

    Let them break down the bills and you’d be surprised where the division of the money go.

    This is the real expense – not the consultants fees.

    How about some honesty in how the private health monies actual are used to subside and fund the Public Health Service?

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  • My child needed an ultrasound but it wouldn’t be covered as an outpatient, so the child and parent had to spend the night before in hospital for a fairly straightforward procedure … Total cost =1300 euro … This is the madness that they need to tackle first!

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  • I hate paying for things twice !!!!

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  • Can someone please explain what health insurance is for?? I tried to get details from their national body a few years ago about the difference between public and private and they couldn’t tell me. Basically I wanted to know if I got a life threatening disease would the waiting time be any different if private or is private for non essential care?? I’d love to know cause I’ve been scared into having insurance and I often wonder what it is for

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    • Insurance is like having a set of keys to the healthcare system. You open the door, let yourself in. Those without a key, stand and wait outside. Until they get to the front of the queue that is.

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    • That is what they tell us (and want us to think) but when I asked they couldn’t provide the stats to prove it. What’s to stop me paying a consultant up until the point when he is going to do something and then telling him to do it in the public hospital. I still have not seen any stats on it or example scenarios. For this reason I see the system as a bit of a con. If everyone stopped paying tomorrow the problem would be solved

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    • I don’t follow. Elaborate there

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    • Paddy, you have violated a sacred rule. Do not cheat , this is the only reason I can fathom from your comment getting such lacklustre ratings.

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    • Paddy, that’s a great question. Basically, the irish public system looks after everybody. If your care is urgent, you get treated as quickly as possible. For free, if you have a medical card. Everything else goes on a waiting list. The length of that list depends on demand, urgency, feasibility, local policies etc etc. Unfortunately, it costs the state a lot of money to treat all these patients, and this incentivizes the state to try to avoid doing so. Hence we have the HSE closing hospitals, operating theatres, “restructuring services”, etc etc. It is cheaper to pay middle managers to rearrange the deckchairs than to actually treat patients.

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    • Where insurance kicks in is twofold. If your visit to the public hospital is urgent, you might get offered better treatment if you chose to use your insurance. It is rare to get a single room in a hospital in Ireland because they are all filled with patients who require isolation, but you might get placed in a two bed room instead of a six bed ward. If you are having a specialised treatment/investigation/ surgery, the consultant will do your operation. (if it is a difficult operation, they do it anyway, regardless. Otherwise it can be done by a trainee under supervision).

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    • If your problem is not urgent, you can use your insurance to see a consultant privately. This may be in a public hospital, or in a private hospital. If a private hospital, you are seen by a consultant in their free time, outside of their public hours, or it may be a consultant who only does private work.

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    • If you attend a private hospital, your medical treatment, radiology tests, surgery etc, are performed much faster than if you are on a public waiting list. If you attend a public hospital, your waiting times are variable, but because the hospital pockets the bulk of the cash made from insurance claims, the management encourage consultants to see as many private patients as possible. Consultants are offered to augment their salary by a maximum of 20% extra for seeing these private patients. The advantage of seeing a consultant in a public hospital is knowing they have achieved their position through a rigourous training and selection programme. You also have more “back-up” available if you have any complications with your treatment. This may or may not apply in the private sector.

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    • There are different types or “plans” in your insurance, reflected by the cost of the premium. Some will only cover cost of emergencies. Some will let you see a consultant privately, but not cover your treatment privately (I think you raised this in your post- so you get seen quickly, but go on a public waiting list for treatment).
      The insurance companies are all private, and they make a lot of money. They like young, healthy patients, and offer them attractive deals. They dislike older, sicker patients who cost them money, and so these clients have to pay higher premiums. Because there are limits to what they can charge (allegedly), the insurance companies need young clients to effectively cover the costs of the older patients. The VHI (state insurance) cried foul at newer companies taking all the young patients, so the government hit these other companies with penalties (so called risk equalisation)- So much for competition!! You can get more information from the HIA (health insurance authority) website.

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    • From my own experience, an excessively private insurance based system (as in the US), offers very good healthcare to most of the population, and terrible or no care for the remainder. Which is wrong in my book. A universal healthcare system like Canada offers very good care to all, but you wait forever to get it. Which is not good in my book. A universal healthcare system like the Netherlands means everyone gets good, timely care, but is way too expensive for Ireland….and possibly the Netherlands also. An insurance based system like Switzerland, in which everyone buys insurance, and the state pays for those who cannot afford it, works very well. This means everyone gets covered, and those who want to get treated quicker can pay extra.

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    • Ireland used to have a similar system also. Everyone got looked after, and those who had money could spend it on being seen faster. Paying patients essentially supplemented the cost of care for those who were less well off. Consultants supplemented low public salaries with money from private work. It worked well, although due to improper policing, a minority of consultants abused the system, making it unpopular.

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    • The government plan to introduce universal healthcare in 2016. It is popular with the voters, but unfortunately destined to fail. Ireland cannot afford this model. It will make lots of money for insurance companies, and private hospitals who will “cherry pick” healthy patients. But the cost has to be borne by somebody- in this case,it will be the state. We will have a healthcare system like Canada alright, but, not having their money, it will be more similar to those other two countries with a similar healthcare system- North Korea and Cuba.

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    • No, if you are in urgent need of care, there is no difference.

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    • Incorrect statement, the Irish private medical insurance market is community rated this means that everyone is entitled to the same level of cover regardless of age etc. whilst insurance companies might recommend certain policies for different stages of a persons life old people can still buy policies marketed towards the younger lives at the very same cost

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  • Why not urge the government to reduce politicians salaries based on the unavailability of consultants due to emigration.

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  • The Consultant fees part of a hospital bill are the smallest part. They were reduced 3 years ago by over 10% in some cases. There is also no reason why a consultant needs to follow the fee schedule that VHI sets, and in fact a majority of consultants that I know were willing to stop billing to VHI prices if they had gone through with the reduction midway through last year which would mean that EVEN if you had VHI cover you would have still ended up with a balance bill for the remainder of the service. (This is how a lot of consultants charge in the UK when BUPA and AXA attempted to do the same thing).

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  • There has been a significant reduction in fees – the big costs are clinics charging €650 a time for use of a trolley in day wards – sometimes as many as 4 people the same trolley each day . The use of theatre for a simple joint injection about €500 – the Doc gets €95 for it .
    Politicians have NO idea about where the real costs are – fees only a minuscule part of the real costs !!

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  • The rates paid to consultand are horrific. No commercial company ought to abide them. The fes paid to private hospitals, especially for day care patients are obscene. Someone in the VHI needs to reevaluate their costings drastically. It is absurd.

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    • Consultants pay most of that fee to the hospital for staffing the procedure, the bed used, the admin used etc etc etc etc etc

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    • Rory used to work in daycare in private hosp till this week…totally agree, obscene charges, major overhaul needed. We need to stop penalising the people who work there (Savin Croke Park), and overhaul the system in general, would save millions, cut down on civil action and generally make those who work there, and I mean ALL, those that work there, feel genuinely appreciated.

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  • http://www.solashealth.com @solashealth is a service currently available in Cork and expanding nationwide which delivers pre negotiated rate for primary care services. It is not insurance, purely a service for consumers to access pre agreed lower treatment rates, from local, trusted medical providers.
    There will be no charge to the consumer from next week. A typical family can save €500-€1000 per year by using the service.

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  • There is something morally wrong with an Insurance Company deciding the procedures that a patient is to receive. The cost then becomes the priority. The American system is an example of this. We need to avoid this at all costs. Our problem is the lack of consultants and I suspect this is due to exclusivity rather then qualifications. Like everything else in this country, when it comes to costs, it’s a mystery wrapped up in an enigma which suites a certain few.

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