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A new health insurer? Big deal.
[ by Niall Hunter, Editor www.irishhealth.com]
So a new health insurer has entered the Irish market. Be still our beating hearts.
Mind you, if your heart isn't beating too regularly, you might well need private insurance to get that seen to quickly.
This just in. There's going to be more health insurance competition which will push prices down. Indeed.
Now one is of course reluctant to rain on GloHealth's parade, and they are all obviously very competent people with considerable experience of the health insurance market.
Certainly you have to admire their entrepreneurial spirit, but the overwhelming desire in response to the hoopla about a fourth insurer is to yell 'big deal'.
We should perhaps dampen down our expectations a little of substantially cheaper health insurance arriving on our doorsteps anytime soon. And indeed, of such bargains, if they do materialise, lasting very long.
The reality is that a more competitive health insurance market may provide some marginal savings benefits for health consumers here and there, but ultimately it is a marketplace, not a charity. A guiding feature of the private-public divide in Irish healthcare is that people can make money out of it.
And to be fair, it is difficult in the current environment of rising health costs and changes in Government policy for insurers to make money or to offer 'bargain basement' cover in the health insurance market as currently structured.
However, profits certainly can be made, particularly if you are not burdened too much with a plethora of older subscribers, otherwise we wouldn't see any new companies coming into the system.
New entrants to the market, since it was opened up to competition in the mid-1990s, have constantly sought to attract younger and less expensive members at the expense of older and more expensive-to-cover members.
We can expect more of the same with the entry of GloHealth to the marketplace.
Yes, we can be sure there are going to be all sorts of special offers in any new price war - kids go free, etc.
How long these special offers, bargains and competitive price cutting frenzies will last remains to be seen. But we shouldn't get too excited.
Private healthcare provision is expensive for insurers to cover, and increasing costs are all sooner or later passed on to the consumer. And insurers are not in the business of offering us free lunches.
A rule of thumb here amidst all the in your face advertising and confusion over rates and levels of cover is that with all health insurance nowadays, if a health plan sounds cheap, it may not cover you for all you think it does. This may well be the case even if it's not that cheap.
You would certainly need to keep your wits about you when purchasing health insurance nowadays and shop around very carefully.
Whatever attractive price your insurance plan may be now, even if it goes so far as to cover you for the machine that goes 'beep' and glows in the dark, it probably ain't going to stay that way very long as the regular ritual of premium hikes gets into gear.
Then we have the regretful 'really sorry about this folks' statements from insurers about rising costs, Government levies, increased public bed charges etc, which will be a far cry from the upbeat way they were talking when they were trying to sell us their wares.
The public will view this new dawn of increased competition with a withering glance, because buying healthcare insurance these days is getting more and more like buying a mobile phone service or cable TV.
Except in this case, lest we forget, we are talking about paying extra money to try to get treated more quickly when you're sick, not to get Sky Sports or an iPhone.
The healthcare consumer will often have little or no real idea of whether or not they are getting a bargain, from whatever company they deal with, if they buy a policy that appears to be, for example, 10% cheaper than its rival.
Until they get sick and read the small print and see what procedures aren't covered and which hospitals they can't have them done in. It's the 'Ellis Island' model of healthcare - 'welcome to America'.
When you talk about real 'choice', those who have never been able to afford insurance, or those who have recently stopped being able to afford it, or who have downgraded their policies to minimal cover, don't have any real choice.
Whatever apparent insurance bargains they may now see dangled before them, they must largely rely on an increasingly under-pressure public health system.
You need a colonoscopy? You probably don't have bowel cancer but you can't be sure, so, if you don't have insurance or your downgraded policy doesn't cover it, you go on a on a three month waiting list at a public hospital and take your chances.
You want one right away even though you're not deemed 'urgent'? God, aren't patients really demanding these days?
Well if you've got a grand in your back pocket, the professor in that nice clinic with the water feature will do it for you next week. Or you can fork out more for better cover and make sure you get treated quicker in future. Except you can't afford this as you recently decided that your mortgage took precedence over your health.
Here's a thing they don't state often enough by Government or insurers - sometimes people die if they can't afford to get treated quickly enough.
This isn't the insurers' fault - they are simply responding to market forces. Whether what they are operating in should be allowed to be a 'market' at all is open to question.
Inequality in healthcare in Ireland is the fault of successive Governments. Our much vaunted 'public- private mix' has always been a licence for certain people to do very nicely thank you out of unequal access to healthcare.
The current Government has promised to end this inequity through the introduction of Universal Health Insurance (UHI) around 2016.
Further details about how UHI will work will emerge later this year.
Health insurance 'competition' is just one of the symptoms of a broken health system that Health Minister James Reilly is now trying to fix. This system, at its simplest, provides a perverse incentive for people to make money out of healthcare queue-skipping. Again, it's a marketplace, not a charity.
Dr Reilly has welcomed the added consumer choice in the insurance market.
Well, he's gearing us up for the UHI system, in which private as well as public insurers are set to play a pivotal role, so his enthusiasm is hardly surprising.
James Reilly's universal healthcare system will, it is hoped, deliver us from our current healthcare 'rich man poor man man' lottery. The problem with this is that 'the market' could well end up running this system too.
It's going to be a 'money follows the patient' system, we are told. Proper regulation of it will need to be put in place to make sure it's not a 'money follows the provider and to hell with the patient' system.
Otherwise, UHI is just going to look suspiciously like VHI (and all the others) - getting dearer all the time, confusing and not very equitable.
Basically, all people want is certainty and security when they get sick - they are tired of having to spin the wheel of fortune at a healthcare lottery.
Over to you Minister.
(Confused about health insurance? Check www.hia.ie This site includes comparison of GloHealth's plans with that of other insurers.)
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