Questions FG and LP must answer on Health before you vote for them

[Jolly Red Giant]

Both Fine Gael and the Labour Party plan on introducing mandatory Universal Health Insurance after the next general election. Fine Gael’s ‘FairCare’ plan lauds the Dutch system of Universal Health Insurance. The Labour Party’ ‘FairHealthCare’ plan is similar but instead of using the Dutch system as a model, the Labour Party refer to the German system. In reality both systems face the same issues – issues that should be answered before anyone votes for Fine Gael or the Labour Party.

Twelve points that need to be addressed in relation to the Dutch model of Universal Health insurance –

Both Fine Gael and the Labour Party plan on introducing mandatory Universal Health Insurance after the next general election. Fine Gael’s ‘FairCare’ plan lauds the Dutch system of Universal Health Insurance. The Labour Party’ ‘FairHealthCare’ plan is similar but instead of using the Dutch system as a model, the Labour Party refer to the German system. In reality both systems face the same issues – issues that should be answered before anyone votes for Fine Gael or the Labour Party.

Twelve points that need to be addressed in relation to the Dutch model of Universal Health insurance –

1. The Netherlands has gone from a two-tier health system to a three-tier health system. Almost half a million people are now uninsured or defaulting on the health insurance payments.
(Leu, R. E., Rutten, F. F. H.. Brouwer, W., et al., “The Swiss and Dutch Health Insurance Systems: Universal Coverage and Regulated Competitive Insurance Markets”, The Commonwealth Fund, (January 2009), p.5)

2. Private health insurance companies are findings ways to circumvent the ban on ‘risk selection’.
(Maarse, H., “Testing Market Practices”, Health Care Cost Monitor, (8 June 2009) p.13)

3. The current cost of the Universal Health Insurance basic package in the Netherlands is €1194 per person for this year. On top of that Employers deduct a further 6.9% of a workers income up to a ceiling (€2233 in 2009).
(Baxter, G., “Is going Dutch our best healthcare option?”, Irish Medical Times, (March 18, 2010))

4. With annual income running at €53,000 per household, the annual cost of health insurance is somewhere between €4,525 and €5,625, or 8.6 to 10.7 per cent of household income.
(Baxter, G., “Is going Dutch our best healthcare option?”, Irish Medical Times, (March 18, 2010))

5. Since the introduction of Universal Health Insurance in 2006, premium costs have risen by 41% and could double from the current rates by 2014.
(Dutch News, “Health insurance rises 41% over five years” Dutch News, (dutchnews.nl, 9 Nov. 2010))

6. More than 50% of the hospitals in the Netherlands are facing bankruptcy as a result of the introduction of Universal Health Insurance in 2006.
(Maarse, H., “Testing Market Practices”, Health Care Cost Monitor, (8 June 2009) p.1)

7. There has been a significant and continuing increase in healthcare costs since the introduction of Universal Health Insurance in 2006.
(Rosenau, P.V., & Lako, C.J., “An Experiment with Regulated Competition and Individual Mandates for Universal Health Care: The New Dutch Health Insurance System”, Journal of Health Politics, Policy and Law, Vol. 33, No. 6, (December 2008) p. 1040)

8. The necessity to negotiate and implement 30,000 Diagnosis Treatment Combinations (DBCs) between private health insurance companies and individual hospitals has led to a massive bureaucratisation of the system.
(Maarse, H., “Testing Market Practices”, Health Care Cost Monitor, (8 June 2009) p.12)

9. It is not known how many hospital beds there actually are in the Netherlands.
(Schäfer W, Kroneman M, Boerma W, van den Berg M, Westert G, Devillé W
and van Ginneken E., “The Netherlands: Health system review”, Health Systems in Transition, (2010) 12(1) p.117)

10. The Dutch healthcare system has growing waiting lists and short-notice postponement of operations.
(Schäfer W, Kroneman M, Boerma W, van den Berg M, Westert G, Devillé W
and van Ginneken E., “The Netherlands: Health system review”, Health Systems in Transition, (2010) 12(1) p.133)

11. The Dutch healthcare system is no better than average in comparison with other wealthy countries.
(Schäfer W, Kroneman M, Boerma W, van den Berg M, Westert G, Devillé W
and van Ginneken E., “The Netherlands: Health system review”, Health Systems in Transition, (2010) 12(1) p.XX)


12. 41% of people say that the quality of the health system has worsened since the introduction of Universal Health Insurance in 2006, while 8% indicated that it had improved.
(Rosenau, P.V., & Lako, C.J., “An Experiment with Regulated Competition and Individual Mandates for Universal Health Care: The New Dutch Health Insurance System”, Journal of Health Politics, Policy and Law, Vol. 33, No. 6, (December 2008) p. 1047)


In Germany –

1. The public health insurance system has a projected deficit of €11billion in 2011
(Rainer Buergin – ‘Merkel Government to Raise Health-Insurance Premiums in Bid to Cut Deficit’ Bloomberg News, Jul 6, 2010)

2. Older patients and those with chronic or long-term illnesses are dumped off of the private insurance system onto the public insurance system causing rising costs for public UHI.

3. Patients with private health insurance (rather than UHI) are automatically seen before UHI patients – even in a GP’s surgery.

4. As the crisis in the German healthcare system continues to grow those on lower incomes are being disproportionally hit by rising costs.

5. German Health Minister, Philipp Rösler, plans on switching from health premiums based on a percentage of income to premiums based on a flat rate charge, thereby further hitting those on low incomes.
(The Economist, 29th April 2010)

6. Procedures covered in the basic UHI package are dropping and out-of-pocket payments by patients are increasing.
(Kaiser Family Foundation, Cost Sharing for Health Care: France, Germany, and Switzerland, (January 2009), p. 13-15)

In terms of both systems of health care the issue are the same.

- Rising costs – despite claims from both FG and LP to the contrary

- Rising insurance premiums

- Rising deficits

[C. Flower]

Can I ask what is ULA and SP policy on health ?

In terms of FF/FG, I am assuming that they will follow the IMF/EU 4 year plan, and related agreements, and will privatise and decimate health services.

[Jolly Red Giant]

Can I ask what is ULA and SP policy on health ?
Free universal health care for all funded by progressive taxation


In terms of FF/FG, I am assuming that they will follow the IMF/EU 4 year plan, and related agreements, and will privatise and decimate health services.
The Dutch government view the introduction of mandatory UHI as a step towards complete privatisation of the healthcare system.

[C. Flower]

Free universal health care for all funded by progressive taxation


The Dutch government view the introduction of mandatory UHI as a step towards complete privatisation of the healthcare system.

Well, the current situation is that there will be heavy pressure from the IMF to privatise. This election is leaving me cold as there is so much pretence about where the real issues are - solvency and sovereignty.

[Jolly Red Giant]

Fine Gael praises the Dutch health service based on the rankings published on the Euro Health Consumer Index. Given the weight that Fine Gael place on the EHCI it is necessary to review what the EHCI is and where it comes from.

The EHCI is produced by a Swedish registered privately-owned European think-tank called the Health Consumer Powerhouse. In 2009 a study was carried out into the 2007 EHCI in the University of Twente. The report goes into detail in outlining the shortcomings of the EHCI. In concluding the author states:

“In the Index 2007 there are serious shortcomings in respect of quality. The most acute concerns are about the Index validity. The Index 2007 is neither transparent (does not elaborate on choice of indicators and their meaning) nor based on relevant information (limited sources of information, irrelevant to the reality statements). As the systematic process of indicators choosing is absent, the Index touches upon only specific services and particular groups of patients. Thus, standards of comprehensiveness are not met. There are concerns in respect of relevance and reasonable. The Index overlooks consumers because takes a high level of aggregation - national health care systems, but not the level of hospitals.”

When you actually look into who the Health Consumer Powerhouse are then these conclusions of secrecy are not surprising. The Health Consumer Powerhouse was founded in 2004 by Johan Hjertqvist. He was previously the founder of a venture capital company that invested in private health care in Sweden and was among the foremost promoters of the expansion of private health care into the Swedish health system. Prior to establishing Health Consumer Powerhouse, Hjertqvist has developed a right-wing Swedish based think-tank called Timbro. Timbro's mission is to originate, promote and disseminate ideas and issues supporting the principles of free markets, free enterprise, individual liberty and a free society. Timbro's main research areas going into 2009 are wealth accumulation, health and welfare reform, and aid and global development.

In relation to Health Consumer Powerhouse, what can been seen from an analysis of their EHCI is that countries with privatized or semi-privatised health systems always perform better than state-run healthcare systems.

Health Consumer Powerhouse refuses to disclose who funds the group or how much funding it has available to it. Both Health Consumer Powerhouse and Timbro are members of the Stockholm Network.

[C. Flower]

Fine Gael praises the Dutch health service based on the rankings published on the Euro Health Consumer Index. Given the weight that Fine Gael place on the EHCI it is necessary to review what the EHCI is and where it comes from.

The EHCI is produced by a Swedish registered privately-owned European think-tank called the Health Consumer Powerhouse. In 2009 a study was carried out into the 2007 EHCI in the University of Twente. The report goes into detail in outlining the shortcomings of the EHCI. In concluding the author states:

“In the Index 2007 there are serious shortcomings in respect of quality. The most acute concerns are about the Index validity. The Index 2007 is neither transparent (does not elaborate on choice of indicators and their meaning) nor based on relevant information (limited sources of information, irrelevant to the reality statements). As the systematic process of indicators choosing is absent, the Index touches upon only specific services and particular groups of patients. Thus, standards of comprehensiveness are not met. There are concerns in respect of relevance and reasonable. The Index overlooks consumers because takes a high level of aggregation - national health care systems, but not the level of hospitals.”

When you actually look into who the Health Consumer Powerhouse are then these conclusions of secrecy are not surprising. The Health Consumer Powerhouse was founded in 2004 by Johan Hjertqvist. He was previously the founder of a venture capital company that invested in private health care in Sweden and was among the foremost promoters of the expansion of private health care into the Swedish health system. Prior to establishing Health Consumer Powerhouse, Hjertqvist has developed a right-wing Swedish based think-tank called Timbro. Timbro's mission is to originate, promote and disseminate ideas and issues supporting the principles of free markets, free enterprise, individual liberty and a free society. Timbro's main research areas going into 2009 are wealth accumulation, health and welfare reform, and aid and global development.

In relation to Health Consumer Powerhouse, what can been seen from an analysis of their EHCI is that countries with privatized or semi-privatised health systems always perform better than state-run healthcare systems.

Health Consumer Powerhouse refuses to disclose who funds the group or how much funding it has available to it. Both Health Consumer Powerhouse and Timbro are members of the Stockholm Network.

That's a useful post JRG. I think we need to wake up to the fact that whatever government is formed, it is going to operate primarily as a wind up operation for the economy and an asset stripping body.

[Jolly Red Giant]

The second group that Fine Gael use for arguing in favour of their mandatory universal health insurance is the REFORM think-tank.

So where do REFORM come from? It is based in London and was founded in 2001 by Nick Herbert (now a Conservative MP) and Andrew Haldenby (former head of the Political Section in the Conservative Party’s Research Department). It function is outlined on its website as follows:
“We believe that by liberalising the public sector, breaking monopoly and extending choice, high quality services can be made available for everyone. Reform would remove public services from the escalator of ever-rising costs. It would enable policy makers to aim for a lower level of taxation and public spending which would better suit the UK's current and future economic challenges.”

REFORM argue for cuts in welfare spending and the privatisation of health and education. Many of REFORM’s research publications have been heavily criticized. One report into falling standards of mathematics in UK schools was should to have incorrect calculations in the data (Goldacre, 2008). In 2009 REFORM produced a budget submission that argued in favour of cutting back what they call "pensioner gimmicks" such as the winter fuel payment and free TV licensing for the over 75s. and the introduction of market rates for student loans which would result in UK students paying an extra £1.2billion a year in interest payments.

REFORM are also a member of the Stockholm Network.

[Kev Bar]

Jolly.
Any advice on the subject in terms of who to vote for or is that implicit in your title?



(Or should I track down Sarah Burke and ask her?)

[Jolly Red Giant]

Jolly.
Any advice on the subject in terms of who to vote for or is that implicit in your title?
I am a member of the Socialist Party / ULA and would recommend a vote for same.

FG and LP want to introduce Universal Health insurance - FF haven't a clue what to do with the HSE.

[Kev Bar]

I am a member of the Socialist Party / ULA and would recommend a vote for same.

FG and LP want to introduce Universal Health insurance - FF haven't a clue what to do with the HSE.

Hope politics does not make you stoop. Ta. K.