'Risk Equalisation' set aside by Supreme Court

Risk equalisation always struck me as a very questionable policy. I guess now the free market will determine health insurance premiums.
 
theoneill said:
Risk equalisation always struck me as a very questionable policy. I guess now the free market will determine health insurance premiums.
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Or else the government will legislate to paper over this inconvenience.
 
I suspect thats right, shnaek.
Risk equalisation, or whatever else they'll call it, will stay in some form or other - the Govt WILL find a way to keep it. They are always very inventive when it comes to making people part with money.
 
theoneill said:
Risk equalisation always struck me as a very questionable policy
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Why though?
Removing risk equalisation will make it more difficult for vulnerable members of society to obtain health insurance (ie old, sick etc. Could be you or me some day :rolleyes:)
theoneill said:

I guess now the free market will determine health insurance premiums.
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But why would this be good?
Using market forces in this manner will lead to a deterioration in health care provision, and not an improvement in standards.
Privatisation in this case leads to 'cherry picking' the patients/cases that will be most cost effective for the company (AKA will involve less payouts for the company).
This is great if you're one of those 'juicy' clients (never sick, never in hospital, never see a doctor) but is pretty bad if you are in a different demographic, as it would become difficult to access health care and increase inequality in the community.
This opinion re risk equalisation is aside from the fact that I personally think having to have private health insurance increases inequity across the board, by the way, as I would be in favour of completely socialised medical care (as a cost of increased taxes, if necessary, but with complete restructuring of the current Irish health care system, as it is currently very inefficient)
 
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Don't confuse community rating with risk equalisation.

Community rating is the idea that all citizens have equal access to health insurance regardless of age or previous illness.

Risk equalisation is a method of transferring profits made by a company with a lower customer age profile (so a lower risk of claim profile) to a company with a higher customer age profile.

The supreme court has declared the current risk equalisation method unlawful. It has not been asked to rule on community rating.
 
Is risk equalisation not necessary in order for there to be community rating however?
Remove risk equalisation, and how can community rating (the end point) continue to be viable?
 
NicolaM said:
Is risk equalisation not necessary in order for there to be community rating however?
Remove risk equalisation, and how can community rating (the end point) continue to be viable?
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Yes, but deciding on the source and method of risk equalisation is the question.

Ideally, in my view, the government should stump up from general taxation since this is for the general good and pay all insurance companies an extra sum for anyone over x age (where x is the defined increase risk age).

This would certainly encourage insurance companies to tout for older person's business.
 
yoganmahew said:
Ideally, in my view, the government should stump up from general taxation since this is for the general good and pay all insurance companies an extra sum for anyone over x age (where x is the defined increase risk age).
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Excellent point.
I'd agree, except I'd moot for the government use that money to create a effective equitable socialised/publicly financed care system with the money, rather than building up the private health care coffers.
 
NicolaM said:
Excellent point.
I'd agree, except I'd moot for the government use that money to create a effective equitable socialised/publicly financed care system with the money, rather than building up the private health care coffers.
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Ah, if you want my funding idea? An x% tax on every policy taken out (even by the people who will be in receipt of the equalisation payments). So everyone pays in, then the gathered money is divvied out.
 
yoganmahew said:
Ah, if you want my funding idea? An x% tax on every policy taken out (even by the people who will be in receipt of the equalisation payments). So everyone pays in, then the gathered money is divvied out.
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Ah ha!
We could be coming up with some plans here...
Anyone from Dept. of Health /Government Planning listening?
I always find it frustrating seeing money being wasted, and services being inefficiently run, when there are many (relatively simple) ways to make systems function more effectively.
Mind you, increasing Health Care efficiency would involve a)culling of staff and b)increased taxes.
It would involve a courageous government, as neither a) nor b) curry immediate favour, even if they would be the best things to do in the longer term (probably)
 
NicolaM said:
a)culling of staff ... curry immediate favour
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You want to kill health staff and then curry them?!!

Well, I'll vote for you then!

(I do agree with you - the Irish health system is very much "I wouldn't start from here").
 
Why though?
Removing risk equalisation will make it more difficult for vulnerable members of society to obtain health insurance (ie old, sick etc. Could be you or me some day :rolleyes:)

 In that case why not have the same car / house / holiday insurance for everyone. No other area of insurance works like that why should health be different?
It seems to me the government is trying to shoehorn silly solutions to an already broken system instead of just fixing it. Private health insurance is not the answer; it should only be an addition to a high standard of public cover which everyone should be entitled to.
 
yoganmahew said:
Ideally, in my view, the government should stump up from general taxation since this is for the general good and pay all insurance companies an extra sum for anyone over x age (where x is the defined increase risk age).
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Surely that would be tantamount to the government admitting that the public health service is a failure - political suicide?
 
This is a major embarrassment for Mary Harney, or would have been had her credibility not been shot to pieces already. It has been on the cards ever since the original High Court judgement in favour of VHI in the case brought by BUPA. A child would know that there was something legally dodgy about the State introducing risk equalisation in favour of the VHI incumbent, while at the same time owning that same incumbent.

Time now for the government to rip up their plans and start again, this time with a proper universal health insurance scheme.
 
rmelly said:
Surely that would be tantamount to the government admitting that the public health service is a failure - political suicide?
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It may be political suicide but it’s the right thing to do. Further more if the government admitted they made a mistake and made attempts to rectify it they would guarantee my vote in the next election. Bad decisions and mistakes are made every day by everyone, the problems occur when they are not rectified.
 
rmelly said:
Surely that would be tantamount to the government admitting that the public health service is a failure - political suicide?
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On the contrary, I think if Brian Cowen admitted this, and set out coherent plans for health service reform, he would get massive support from the public.
 
theoneill said:
In that case why not have the same car / house / holiday insurance for everyone. No other area of insurance works like that why should health be different?
It seems to me the government is trying to shoehorn silly solutions to an already broken system instead of just fixing it. Private health insurance is not the answer; it should only be an addition to a high standard of public cover which everyone should be entitled to.
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Because health is different.
You don't need a car, or a holiday, (or at least one could make the argument that you could live without either), however, you certainly at some stage will need access to health care system.
I suspect the reason that people feel forced to purchase private insurance is because they do not trust the public health care system here any longer.
However, your point re private health insurance being in addition to a high standard of cover is spot on.
In the UK (NHS) there is availability of private health care, in addition to the NHS.
It is also un-tenably expensive (£250 (yes, pounds) for a 20 minute standard consultation in a BUPA hospital, paid by yours truly, for example)
The private health care system there is over priced, and to my mind (and from personal experience) no where near as good as public health care.
In addition, there are many concerns there about the 'privatisation' of the NHS, and the negative impact that this will have on the more vulnerable members of society (more cost effective for a private hospital to take an orthopaedic contract on that involves doing knee ops on healthy young people following skiing accidents as opposed to taking contracts that involve admitting a poorly elderly person that just broke their hip, that also has lots of other medical issues also going on , that will lead to a longer stay, and more cost to treat.)
It also leads to de-skilling of doctors, and difficulty in training doctors in the future (if you are paying to go privately, would you object if you were seen by a supervised juniour doctor? I think many might).
You can extrapolate similar problems to here, without the back-up of a relatively efficient NHS behind it (relative to Irish Health care provision, that is)
Improving the public health care system would make much more sense than bolstering up the private health care system (hence my preference for socialised medical care).
rmelly said:
Surely that would be tantamount to the government admitting that the public health service is a failure - political suicide?
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But it is a failure.
 
ubiquitous said:
On the contrary, I think if Brian Cowen admitted this, and set out coherent plans for health service reform, he would get massive support from the public.
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The 120'000 people employed by the HSE will not allow the government to implement any real reform.
It can be done; look at the changes that have taken place in the NHS in Northern Ireland. The problem is that the Northern Ireland reforms were very unpopular amongst health care employees (as few people like change and fewer are willing to admit that they are part of the problem) and while they can be pushed through by the UK government our guys just don't have the power to make it happen.

I do agree that a universal health insurance system is the best and most equitable system and I disagree very much with the idea that public funds should be used to subsidise private health insurance.
 
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