Health Policy and Management Social Health Insurance: Further Options for Ireland

The financing of healthcare is the most fundamental mechanism of any healthcare system and, therefore, reform of the financial arrangements is the key lever to use in affecting how any health system performs. This is now increasingly recognised in public debate concerning the crisis-laden Irish healthcare system. Many now advocate a comprehensive compulsory social health insurance system carefully designed to meet clear objectives of equal treatment for equal need and so ending the current unacceptable ‘two-tier’ arrangements. The concept and practice of Social Health Insurance (often loosely referred to as “Universal Health Insurance”) is a central issue in the current major debate concerning the reform of the health system in the United States of America. Leading contenders for the Presidency are now advocating Universal Health Insurance based solutions. Of course, Social Health Insurance has underpinned the health systems of many European Union countries providing more effective and less costly healthcare than that which obtains in the USA. A social health insurance system in Ireland could • provide free GP care for all • provide equal hospital treatment according to need as every citizen would be an insured patient • ensure more effective and efficient healthcare providers as the ‘money would follow the patient’, therefore helping to ensure quality of care • restore transparency and public trust in providing the necessary resources for healthcar