Universal Health Insurance

In line with the Programme for Government 2011 – 2016,  the then Government embarked on a major programme of health reform, a principal aim of which was to deliver a single-tier health service, supported by Universal Health Insurance (UHI), where access to services is based on need and not on ability to pay.

This means:

  • Equal access for all to health care, based on need, not income;
  • Everyone insured for a standard package of curative health services;
  • No distinction between “public” and “private” patients;
  • Universal GP care;
  • Universal hospital care to include independent, not-for-profit trusts and private hospitals;
  • Social care services remaining outside of the UHI system, but integrated with health care services around the user;
  • A multi-payer health insurance funding model with competing health insurers.

In April 2014, the White Paper on Universal Health Insurance was published. The White Paper proposed a competitive, multi-payer model of UHI to support achievement of universal healthcare, i.e. implementation of a single-tier health service where access to care is based on need and not ability to pay and with a system of financial subsidy for those facing financial hardship.

Following its publication, the Department of Health initiated a major costing project, involving the Economic and Social Research Institute (ESRI), the Health Insurance Authority and others, to examine the cost implications of a change to the particular UHI model proposed in the White Paper. Having considered the findings of the costing exercise, it was concluded by the then Government that the high costs associated with the White Paper model of UHI were not acceptable and that further research and cost modelling in relation to the best means to achieve universal healthcare were needed.

The All-Party Oireachtas Committee on the Future of Healthcare is considering this issue. Among its terms of reference is that of examining and costing different funding models for the health service and  making recommendations on a funding approach that is best suited to the Irish context. The deadline for completion of the Committee’s work is 28th April 2017.

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