I do not believe that the relatively modest declines in private health insurance coverage in recent years will make universal health insurance (UHI) unfeasible. UHI will cover the total population, not just those who can afford to pay. Under UHI, everyone will be insured and will have equal access to a standard package of primary and acute hospital services, including acute mental health services. An Insurance Fund will subsidise or pay insurance premiums for those who qualify for a subsidy. The Programme for Government commits that everybody will have a choice of insurer. The Department is currently preparing a White Paper on Universal Health Insurance which will provide more detail on the model of UHI for Ireland. Intensive work is proceeding with a view to publishing the White Paper by the end of the year.
Intensive work is also underway in relation to the key building blocks that will bring benefits and drive efficiencies in advance of and pave the way for the introduction of Universal Health Insurance. These include:
- the strengthening of primary care services to deliver universal GP care without fees for the entire population. The Government has announced, as part of Budget 2014, that it will commence the roll-out of a universal GP service by providing all children aged 5 and under with access to a GP service without fees;
- the work of the Special Delivery Unit in tackling waiting times;
- the reorganisation of public hospitals into more efficient and accountable hospital groups that will deliver improved outcomes for patients. That reorganisation was informed by two expert reports, namely, The Establishment of Hospital Groups as a Transition to Independent Hospital Trusts and The Framework for Development – Securing the Future of Smaller Hospitals, which were published on the 14th May 2013;
- the introduction earlier this year of a new scheme of risk equalisation for the private health insurance market;
- the delivery of a 'Money Follows the Patient' policy which will commence in shadow form shortly and will be phased in to adjust hospital budgets from January 2014;
- the approval of national healthcare standards and ongoing work in relation to supporting licensing legislation.
The reform programme is a major undertaking that requires careful planning and sequencing over a number of years. The Government will consult widely, as part of the reform implementation process.