From Socialist Voice, February 2006

Harney continues to drive private medicine

The recent decision by Mary Harney to push for the implementation of risk equalisation between the publicly owned health insurance company VHI Healthcare and the British private health insurance company BUPA is to be welcomed and indeed is long overdue.
    There are three main health insurance companies in the Republic: VHI Healthcare, BUPA, and Vivas. The VHI insures 80 per cent of private subscribers, four times as many as the 440,000 Irish people insured by BUPA; but it also has 50 times the number of policy-holders over the age of seventy. It therefore has more subscribers who would be likely to avail of its services. BUPA, on the other hand, is aimed at younger people, who are more profitable.
    The chief executive of the VHI, Vincent Sheridan, has stated that it will need €44 million in risk equalisation by 2007 if it is to remain solvent. BUPA estimates that it will be forced to pay more than €30 million to the VHI this year alone.
    BUPA’s primary objective is to make a profit, and the vehicle is providing private medical insurance. There is no altruistic motive: just making a profit, as large as possible; and, most importantly, the rate of profit should be more than the previous year.
    BUPA was granted a temporary injunction preventing the introduction of risk equalisation over the Christmas period, but this was then overturned, and the new condition came into effect in early January. BUPA has appealed the decision to the Supreme Court and has stated that it will take it “all the way to Europe.” It has threatened to pull out of the Irish market, as it claims that it would take up to three years to exhaust its legal appeals.
    When BUPA entered the Irish medical insurance market it was aware that risk equalisation was a condition of entry. This is the problem when we have elements of private and public medicine. Private medicine will always be more expensive, because of the fact that the primary objective is to make a profit, that is, to have a surplus over and above the cost of providing a medical service to the individual citizen.
    The growth of private medicine and of private hospitals and clinics is undermining the public health service. With people like the former “beef baron” Larry Goodman being one of the main investors in the private hospital outside Galway, we know that his involvement in the provision of private medical care is not about ending or shortening queues in public hospitals: it is to ensure the maximum return on his investment. Sides of beef or sick people—it doesn’t matter to him.
    The fact that Harney has activated the risk equalisation payments does not mean that she has any real commitment to public health. There is a real danger that the VHI could be privatised in the near future if the courts uphold the decision of the High Court. Under the old conditions, where risk equalisation was not operational, no private company would be prepared to buy the VHI. It is clear that private medicine will only grow and expand under Harney’s stewardship of the Department of Health. The vehicle for expanding private medicine is the consultants, who are in many cases mere front men or women for American private medical companies.
    One example of this is Our Lady’s Hospital for Sick Children in Crumlin, Dublin. The director of the private Beacon Hospital in Sandyford recently proposed that the children’s hospital should be moved to a new site, next to his private hospital, and that they could then avail of and share their medical facilities. He also stated that the existing staff would lose their public-service status if this move was to take place.
    This particular individual is believed to be a major financial contributor to both government parties. It is clear that Mary Harney is very much in favour of moving the children’s hospital to a new site; it has also emerged that a group of consultants attached to the children’s hospital recently purchased the leisure complex next to the hospital to provide recovery facilities. The vultures are circling the prime site of the hospital and the new operating theatres, built at a cost of €30 million, of which a significant amount was raised by ordinary people around the country.
    The Treatment Purchase Scheme, introduced as a temporary measure, has now become a permanent feature of our health service. It is a very effective conduit for pushing public patients through private hospitals, filling the coffers and the bank balance of people like Larry Goodman.

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