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 The fallacy of private health care efficiency

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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 1:40 pm

Kate P wrote:
seinfeld wrote:
cactus flower wrote:
I think we should sort out the public system first and foremost and should certainly not be building new private hospitals with tax rebates at the same time as closing hospitals down.

We are not building private hospitals; the private sector is, to serve the 52% of the population who want private health care.

Name one hospital that has closed in the last 5 years.

How many new hospital units remain unopened?

Where does the 52% figure come from Seinfeld?
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 1:42 pm

Kate P wrote:
seinfeld wrote:
cactus flower wrote:
I think we should sort out the public system first and foremost and should certainly not be building new private hospitals with tax rebates at the same time as closing hospitals down.

We are not building private hospitals; the private sector is, to serve the 52% of the population who want private health care.

Name one hospital that has closed in the last 5 years.

How many new hospital units remain unopened?

No idea. Whats your point?

I'm responding to a poster who claimed that we are "building new private hospitals with tax rebates at the same time as closing hospitals down".
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 1:49 pm

cactus flower wrote:
Kate P wrote:
seinfeld wrote:
cactus flower wrote:
I think we should sort out the public system first and foremost and should certainly not be building new private hospitals with tax rebates at the same time as closing hospitals down.

We are not building private hospitals; the private sector is, to serve the 52% of the population who want private health care.

Name one hospital that has closed in the last 5 years.

How many new hospital units remain unopened?

Where does the 52% figure come from Seinfeld?

http://www.hia.ie/sec3%5Freports/The-PHI-Market_in-Ireland-ExecutiveSummary-22-09-05.pdf
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 2:00 pm

seinfeld wrote:
Aragon wrote:
Strangling public health care to death

2,500 unfilled vacancies in Health since beginning of recruitment freeze

http://www.ireland.com/newspaper/frontpage/2008/0512/1210503983364.html

So much for the HSE being 'bloated' with administrators.

As you know full well Seinfeld, it is front line medical staff that the recruitment freeze applies to - the ones that could really make a difference to waiting list and health care quality. No such freeze applies to 'administrators' - as the setting up of the privatising body known as HIQA is clear evidence of - and if you have been folloiwng this thread properly, where is your concern about the iniquity in Mary Harney handing out outrageous subsidies to private health care providers while imposing this freeze at the same time. It's grossly dishonest to pretend that the need of private health care providers to make a profit does not add an additional and considerable expense to health care provision. If people want private health care, then let them pay the full and true price of it themselves. The rest of us want to see every last cent of tax we pay going directly to the services that count. We do not want our money going into the pcokets of these public service raiders.

If we had a referendum tomorrow asking people whether they would like to see their taxes being spent on doctors, nurses and facilties rather than on subsidies to profiteers, I'd bet my farm, if I had one, on the outcome.
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 2:31 pm

Aragon wrote:
seinfeld wrote:
Aragon wrote:
Strangling public health care to death

2,500 unfilled vacancies in Health since beginning of recruitment freeze

http://www.ireland.com/newspaper/frontpage/2008/0512/1210503983364.html

So much for the HSE being 'bloated' with administrators.

As you know full well Seinfeld, it is front line medical staff that the recruitment freeze applies to - the ones that could really make a difference to waiting list and health care quality. No such freeze applies to 'administrators' - as the setting up of the privatising body known as HIQA is clear evidence of - and if you have been folloiwng this thread properly, where is your concern about the iniquity in Mary Harney handing out outrageous subsidies to private health care providers while imposing this freeze at the same time. It's grossly dishonest to pretend that the need of private health care providers to make a profit does not add an additional and considerable expense to health care provision. If people want private health care, then let them pay the full and true price of it themselves. The rest of us want to see every last cent of tax we pay going directly to the services that count. We do not want our money going into the pcokets of these public service raiders.

If we had a referendum tomorrow asking people whether they would like to see their taxes being spent on doctors, nurses and facilties rather than on subsidies to profiteers, I'd bet my farm, if I had one, on the outcome.

I’d suggest you’d probably lose your farm.
Tax payers in general aren’t hung up on whether the health service is 100% publicly run or has a small or large private element, they are interested in having a health service that works.
The one thing we do know from experience is that a 100% publicly run service is hugely expensive, hugely wasteful and doesn’t work to anyone’s satisfaction.

So we have a choice, we can argue until the cows come home about the merits of private versus publicly provided services, which is of interest only to the unions and the workers concerned or we can concentrate our efforts on providing a service that works, which at the end of the day, in my opinion, is the only thing that matters.
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 2:38 pm

tonys wrote:
So we have a choice, we can argue until the cows come home about the merits of private versus publicly provided services, which is of interest only to the unions and the workers concerned or we can concentrate our efforts on providing a service that works, which at the end of the day, in my opinion, is the only thing that matters.
I'd tend to agree. I'd be interested to know what you mean by 'works' though.
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 2:49 pm

Aragon wrote:
seinfeld wrote:
Aragon wrote:
Strangling public health care to death

2,500 unfilled vacancies in Health since beginning of recruitment freeze

http://www.ireland.com/newspaper/frontpage/2008/0512/1210503983364.html

So much for the HSE being 'bloated' with administrators.

As you know full well Seinfeld, it is front line medical staff that the recruitment freeze applies to - the ones that could really make a difference to waiting list and health care quality. No such freeze applies to 'administrators' -

From the article you referenced:

"Details of the scale of employment reductions in the health
sector come as around 28,000 staff prepare to take industrial
action in protest at the recruitment restrictions. The union Impact, which represents health professionals and
therapists, social care workers, administrative and managerial
staff, says its members will refuse to co-operate with HSE advisers
or the HSE's transformation programme as part of the industrial
action from Wednesday of next week."

Why are IMPACT going on strike if the freeze doesn't effect administrators and managers?
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 2:52 pm

Auditor #9 wrote:
tonys wrote:
So we have a choice, we can argue until the cows come home about the merits of private versus publicly provided services, which is of interest only to the unions and the workers concerned or we can concentrate our efforts on providing a service that works, which at the end of the day, in my opinion, is the only thing that matters.
I'd tend to agree. I'd be interested to know what you mean by 'works' though.

By “works” I mean a system that is capable of providing a high quality service to those who need it in a reasonable time.
I do not mean a service that will satisfy everyone’s whim for every service know to man and do it yesterday on their doorstep nor do I mean a service that will look after the elderly for families who are in a position to & should be looking after their elderly relations themselves.
Into each life a little rain must fall and we can’t always expect to borrow someone else’s umbrella.
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 3:00 pm

tonys wrote:
Auditor #9 wrote:
tonys wrote:
So we have a choice, we can argue until the cows come home about the merits of private versus publicly provided services, which is of interest only to the unions and the workers concerned or we can concentrate our efforts on providing a service that works, which at the end of the day, in my opinion, is the only thing that matters.
I'd tend to agree. I'd be interested to know what you mean by 'works' though.

By “works” I mean a system that is capable of providing a high quality service to those who need it in a reasonable time.
I do not mean a service that will satisfy everyone’s whim for every service know to man and do it yesterday on their doorstep nor do I mean a service that will look after the elderly for families who are in a position to & should be looking after their elderly relations themselves.
Into each life a little rain must fall and we can’t always expect to borrow someone else’s umbrella.
What about geography and distance to travel as well as what people pay (and what people earn)?

About everyones whim getting catered for - do we need to start looking at a few good home cures rather than going to hospital for every fiddle-faddle? What about low-tech cures and preventatives? I'm convinced that salt is better to treat infections in the throat than anti-biotics, that sugar is disastrous for the teeth in any form, that in-grown toenails can be treated effectively by some home pruning. I haven't suffered from much else thanks bit of J-.
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 3:13 pm

Auditor #9 wrote:
I'm convinced that salt is better to treat infections in the throat than anti-biotics

I'd agree, as would most doctors.

However, if a patient presented to a GP with a sore throat, and that GP told them to go home and gargle salt and water, that patient would go home and ring Joe Duffy.

Anti-biotics are one of those inventions like plastic that have enormous value until we start over-using them.
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 3:21 pm

We're hardly paying more in insurance costs here overall? - I mean the insurance cover in the health industry needed to protect itself from litigation and mistakes etc.
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 3:46 pm

It's ludicrous to say the only people who care about private versus public health care are the unions and the public health care workers. We are all affected by that debate - we are not some stupid amorphous mass out here, happy to allow these things to be decided over our heads like so many simpletons: it os OUR money you are talking about: OUR health. It's us who will feel the disadvantages.

The private/public debate goes to the heart of any discussion of what is efficient and works best. The need to make profit is an extra expense that we cannot afford. That is why there is a recruitment freeze on frontline staff. The service is being stripped of as much expense as possible so the private providers can make as much profit as possible. The ground is being prepared. Meanwhile, our taxes are being diverted into administrative quangos and subsidies for private companies instead of frontline medical staff, the objective being to facilitate the entry of private health care providers above all.

In Harney, we have an idealogocical zealot who is without principle or conscience about privatising the health service and who thinks nothing of spending gazillions on that while allowing patients to suffer horrifically for lack of services that her deliberately imposed cuts can only result it. Is she putting profit ahead of lives? I believe so.

In so far as there has been inefficency (and there is, let's not forget, atrocious waste within the private sector, which is NOT, as gullible people seem to beleive, impervious to human stupidity, incompetence and corruption), the problem within public services across the board has been the abject failure of every Irish government to appreciate let alone apply an ethos of real accountability. If people are not properly held to account for the way they do their jobs, then nothing will ever improve. That is one of the biggest reasons that our health service has not succeeded as well as it should - people are allowed to escape culpability for any sort of incompetence. However, if we introduce a private health care system subsidised by the taxes of those who will be seriousldy disadvantaged by that system, the problem will be much worse. Not only will there be less value for money, but the businesses involved will savage any government who dares to tackle them for their failures or negligence once they are installed. The pharmaceuticals and others are all behind this push - and it is emphatically not for the good of the ordinary person.

Aside from the failure to introduce an ethos of accountability into the health service, though, the most pernicious evil has been the deliberate failure to invest properly. Most health service workers are dedicated, efficient people - lumbered with the rule of administrators and politicians who subvert their responsibility to people.

The profit motive is the worst possible solution to the problem: it will make things ten times worse. We will look back on even these days as golden times if we don't stop this.
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 3:54 pm

That's just a diatribe.

Any chance you could momentarily presume that you're not the only person in the whole world who is concerned about the health service and discuss the matter in a calm and reasonable way?

My understanding is that this site is about discussion, not advancing political agendas.
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 4:09 pm

I am sure we can discuss this in a non personal way even though people clearly have strong feelings both ways about it. What might help would be if we could focus the discussion on a published policy document or report, so at least we have some substantial base of data to rely on. Is anyone able to produce a link to the HSE finance report, or to a hospitals policy document?
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 4:16 pm

12/05/2008 - 13:54:12
Protestors have gathered outside the gates of Waterford Regional Hospital today to express frustration at long waiting lists
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 4:21 pm

cactus flower wrote:
I am sure we can discuss this in a non personal way even though people clearly have strong feelings both ways about it. What might help would be if we could focus the discussion on a published policy document or report, so at least we have some substantial base of data to rely on. Is anyone able to produce a link to the HSE finance report, or to a hospitals policy document?

That'd be my preference. I'm not exactly sure how calling someone an 'idealogical zealot' fits into this framework, however.

I'll re-state what I've said to try and get back on track.

I'm not aware of any hospital having closed in the last 5 years.
52% of Irlsh people have private health insurance (see IHA link above).
Recruitment freeze applies equally to administrators and mangers in HSE, based on fact that IMPACT are threatening industrial action.
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 4:56 pm

seinfeld wrote:
cactus flower wrote:
I am sure we can discuss this in a non personal way even though people clearly have strong feelings both ways about it. What might help would be if we could focus the discussion on a published policy document or report, so at least we have some substantial base of data to rely on. Is anyone able to produce a link to the HSE finance report, or to a hospitals policy document?

That'd be my preference. I'm not exactly sure how calling someone an 'idealogical zealot' fits into this framework, however.

I'll re-state what I've said to try and get back on track.

I'm not aware of any hospital having closed in the last 5 years.
52% of Irlsh people have private health insurance (see IHA link above).
Recruitment freeze applies equally to administrators and mangers in HSE, based on fact that IMPACT are threatening industrial action.

Speaking as one of the 52% (group scheme at work), I am not in favour of privatising health care and think that all proven good-practice medical treatment (not including cough drops, Prozac and overprescription of anti-biotics) should be delivered on the basis of need, not wealth. I am perfectly happy to pay more tax for that if need be.
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 5:19 pm

DoCH

This link is to the 2008-2010 Department of Health Strategy

HSE LIBRARY LINK

This link goes to the Brennan and Hanley Reports (staffing) and other useful items.
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 5:28 pm

cactus flower wrote:
seinfeld wrote:
cactus flower wrote:
I am sure we can discuss this in a non personal way even though people clearly have strong feelings both ways about it. What might help would be if we could focus the discussion on a published policy document or report, so at least we have some substantial base of data to rely on. Is anyone able to produce a link to the HSE finance report, or to a hospitals policy document?

That'd be my preference. I'm not exactly sure how calling someone an 'idealogical zealot' fits into this framework, however.

I'll re-state what I've said to try and get back on track.

I'm not aware of any hospital having closed in the last 5 years.
52% of Irlsh people have private health insurance (see IHA link above).
Recruitment freeze applies equally to administrators and mangers in HSE, based on fact that IMPACT are threatening industrial action.

Speaking as one of the 52% (group scheme at work), I am not in favour of privatising health care and think that all proven good-practice medical treatment (not including cough drops, Prozac and overprescription of anti-biotics) should be delivered on the basis of need, not wealth. I am perfectly happy to pay more tax for that if need be.

i'm not suggesting that the fact that 52% of the population have private health insurance means that 52% of the population don't want further investment in the public system.

What I am suggesting is that if 52% of the population have private health insurance, the State has a responsibility to encourage the development of private healthcare.

Otherwise, the 52% end up jumping the queue in the public system, as is currently happening.

And its all very well saying that you as an individual would pay more taxes for better health care etc, but the State cannot base it decision-making on these sorts of presumptions and cannot deal with tax increases re. health in isolation from the wider economy. There's no point in raising tax in one area if it results in an overall decrease in tax revenue at the end of the cycle.

One thing the State could do is remove tax relief for private health insurance. That is totally inequitable. It means that private health insurance holders are getting to use public assets ahead of public patients and that they are getting a tax rebate.

Of course, in the cacophony of rhetoric about the 'bureaucrats' in the HSE and the 'idealogical zealotry' of the Minister for Health, no one ever discusses these real and meaningful changes that would actually make the Health Servive more equitable.
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 5:34 pm

LINK to info on OECD Report

A recent OECD Report shows that Irish people spend longer in possible than average and have less treatment. There are far more nurses than the OECD average. The report suggests the HSE is trying to do to much too quickly.

Quote :
According to the CSO National Employment Survey for 2006, public sector workers enjoy average earnings which are 49% higher than the private sector. Research from the European Central Bank (ECB) found that between 1999 and 2006, average public sector pay in Ireland increased by 67%, while that in the euro area grew by just 22%. In the private sector, average pay in Ireland increased by 42% compared to just 15% in the euro area. Benchmarking has resulted in Irish public sector pay growing faster than any other country in the EU and actual pay levels overtaking those in almost every other OECD country.
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 5:41 pm

cactus flower wrote:
The report suggests the HSE is trying to do to much too quickly.

Where does it say that?
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 6:00 pm

OECD Report on Public Services 2008

This report makes constructive suggestions for improvement of management and planning of some aspects of health services in Ireland.

It points, interestingly, to the fact that French and German hospital population catchments are in the order of 150,000 persons, rather than the 500,000 model in the UK. How does this fit in with the Hanley report, I wonder?
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 6:02 pm

seinfeld wrote:
cactus flower wrote:
The report suggests the HSE is trying to do to much too quickly.

Where does it say that?

Underneath the bloody little flashing green and yellow pop-up Paddy Power ad. Mad
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 6:48 pm

cactus flower wrote:
seinfeld wrote:
cactus flower wrote:
The report suggests the HSE is trying to do to much too quickly.

Where does it say that?

Underneath the bloody little flashing green and yellow pop-up Paddy Power ad. Mad

Said ad was blocking out that text in my browser. A HSE conspiracy no doubt!
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PostSubject: Re: The fallacy of private health care efficiency   Mon May 12, 2008 7:26 pm

Don't bet on it Seinfeld. Very Happy
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