Dimly understood and poorly explained, universal health insurance is a policy that deserved to be put on the long finger, as Minister for Health Leo Varadkar has decided.
In his first three weeks in office, Varadkar has shown common sense in identifying what might be attainable in health in the Coalition’s remaining 18 months, and what is not.
By taking his predecessor James Reilly's pet project off the agenda for the lifetime of this administration, Varadkar has done us all a favour. Universal health insurance, despite years of hot-housing in Fine Gael back rooms and the Department of Health, has remained a muddle. First, it was to be modelled on the Dutch system, then the German, then it was to be a peculiarly Irish composite; whatever happened, it was going to cost a lot – up to €1,672 a head, according to one estimate.
Contentious policy
That alone was going to be a millstone around the Government parties’ necks going into the next election; when added to the other problems in health, it could have threatened a repeat of the disaster that befell Fine Gael and
Labour
in the polls last May.
Putting universal health insurance on the back burner and delaying the dissolution of the HSE will allow this Minister time to concentrate on the more immediate problems of the health service, such as budget overruns, crushingly low staff morale and, in some areas, a crisis of patient confidence.
As he has recognised, the immediate challenge is to get extra money to keep the service ticking over and fund some crowd-pleasing initiatives. The first of these, the extension of free GP care to under-sixes and all over-70s, have been agreed at Cabinet, but potentially tricky talks with nettlesome GP representatives must first be surmounted before these plans can become a reality. Dental and optical services, as well as minor surgery, will also come under the scope of free GP care, Varadkar signalled for the first time yesterday.
Reilly's failures in the health job can largely be traced to his failure to win over Minister for Public Expenditure Brendan Howlin and Minister for Finance Michael Noonan, whose control of the purse strings is crucial for a high-spending ministry. Year after year, the HSE's budget was slashed, though its failure to keep to targets meant that funding of the service remained flat.
Howlin and Noonan are former ministers for health and, as Varadkar noted, they secured handsome budgetary increases when they were in the post.
Those, however, were different days, when money was more freely available. Varadkar has offered to find fresh areas where savings can be made, but mostly he will be relying on the goodwill of his Cabinet colleagues to dole out extra money for health to avoid or minimise politically damaging controversies such as the medical card fiasco.
