In recent years the health care sector has been the focus of much debate. Even during the boom in Ireland, the Health Care Sector was widely criticised as having poor outcomes for patients compared to other countries and being a ‘two tier’ system. Despite large increases in Health Care expenditure during the boom these problems continued. One problem that can still be noticed and felt today in any A&E department in Dublin for instance is the over crowdedness and the incredibly long waiting time for to be seen. Also in recent times some politicians/experts have repeated money or funding is ‘not the problem’ for the Health System but the system itself.
The operation of the complex mix of public and private health care has changed radically over the past decade as the nature of the insurance market has changed in response to EU regulations.
Private health insurance plays a distinctive role in the Irish health care system, with nearly half the population now having such insurance despite the fact that everyone has entitlement to public hospital care (subject to certain charges unless the family falls below a specified low-income threshold), and much of the insured’s private care is delivered in public hospitals which is a crucial difference between Ireland and many other countries. The resulting two-tier system is problematic from both an efficiency and an equity perspective. Private health insurance figures are declining slightly at present due to current recession and latest budget (just below 50%).
Public hospitals in Ireland allocate a certain number of beds for private use and consultant activity is monitored to ensure that they do not exceed their private activity cap. There are concerns that public hospitals and consultants are sidestepping these restrictions. This results in public hospital resources being diverted away from public patients towards private patients. This means it is cheaper for private