Tuesday, November 06, 2012


ONE of the most brutal things about any recession is that the less money you have, the more expensive things become.

The very fact that there is less change in your pocket at the end of every week means that, even if a pint of porter costs the same this Friday as it did last Friday, it has become more expensive for you. Over time you have to ditch the drink because other expenses assume more importance. Pubs suffer and you’d think our bodies at least would feel the benefit of a more frugal lifestyle.

But once you start to retreat, as we’ve seen in this country, it doesn’t happen in small, measured backward steps. Even more quickly than we blossomed at the height of the Celtic Tiger, it seems our collapse has been much more sudden and dramatic.

So every time there is a hike now it is much more painful than the extra number of euros on the price-tag. Just by the fact of us having less, the health insurance premium you paid last year is even more costly this year, even if the premium is the same. But fat chance of that happening.

New proposed increases in health insurance premiums will place an estimated extra €300 worth of financial burden on the average Irish family. But the average Irish family has already been paying a bigger percentage for their health insurance, and every other bill, these past few years simply because they have less money to spend. Sadly those who have least suffer most, time and again.

Even in the good times we worried about our health system. In fact, usually there was nothing we liked to complain about more than the substandard service on offer in hospitals. Waiting lists, bed numbers, consultant fees – these issues were topical long before cutbacks were on the agenda. With an aging population, emigration will not be the scourge of this nation in years to come. It will be the standard of care we can provide for the elderly and infirm.

If there’s a reason to worry about the rising cost of health insurance premiums more than any other personal expense it is this: the normal rules of business don’t apply to insurance companies.

When a typical business, like a pub, starts losing customers it doesn’t take long for the landlord to figure out that he better do something to win them back. Lowering prices, offering more options (like a better food menu) and providing a better customer-experience are just some of the tactics the landlord will likely consider in a bid to keep his head above water.

A health insurance company doesn’t think like that. Quite the opposite. Less customers can be a good thing and in some cases, the insurer will deliberately price someone out of the market. Unlike car insurance, which is mandatory so we have to bear it or else ditch the motor, health insurance is optional. But when the normal rules of business don’t apply, it’s not like other options.

What the health insurer offers is more than just the terms and conditions of their policy. They offer people peace of mind – an invaluable yet intangible asset to most of the 2.1 million currently insured in this country. Unlike other businesses which have to fight for your disposable income, insurance companies know they have one-up on the customer before they ever set their prices. They can trade on something more than the value they offer. They trade on the hearts and minds of families who can’t bear the possibility of their children getting sick and not having enough money to pay for quick, reliable healthcare. It is one thing not being able to spend money in the pub but when the normal rules of business don’t apply, you face an almighty dilemma. And that’s just the way the insurance companies like it.

In a documentary about the US healthcare system called Sicko, made by Michael Moore in 2007, there is a litany of stories about ordinary American citizens who have to fight with their insurance companies to secure treatment for serious illnesses. Some people die simply because they can’t get approval from their insurers. The title of the documentary is apt – how sick is that?

Now Irish health insurance customers are likely to need the same kind of advance approval from their provider before certain treatments can go ahead. Currently the patient’s doctor can prescribe the treatment they believe is most suitable and the bill is sent to the insurance company.

In the absence of universal health cover – and who can believe that will be in place anytime soon? – we are facing a much greater crisis in our health service in the years ahead than ever before. With less people insured, and even more people reliant on an increasingly under-funded health service, your health won’t be your wealth; your wealth will determine your health.

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By Brendan Coffey
Contact Newsdesk: 045 432147

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