Should be means tested too.
It absolutely should.
I have heard that in Ireland they have a major issue with their health care - some even challenge it call it Ponzi scheme and such.
The major issue in Ireland is the length of waiting lists to access surgery for non-life threatening but chronic and often very painful conditions. The other issue is shortage of hosptial beds leading to people on trollies in corridors for protracted periods of time. It's more to do with poor management and a badly organized system. There's certainly no suggestion of a 'Ponzi' scheme which suggests deliberate fraud.
Also for years people abused the fact that you were seen for free at an emergency room 24hrs a day and turned up with kids who had a scratch on their finger, that type of thing. 'Jaysus doctor, she'll get blood poisonin' or a queasy tummy after stuffing themselves with sweeties and Tayto crisps at a birthday party. Now there's a charge of 100 euros in the emergency room which people complain about. We also have a charge of about 80 euros per night for a hospital bed (but there's a cap on how much you can be charged if you're in for a long stay or have to go back for further treatment, can't remember how much but it's under a grand over the course of a year). Nobody pays for surgery.
However, certain groups of people are exempt from
any charges. In Ireland we have the system of the Medical Card which is issued to people of limited means and entitles them to free treatment in the emergency room and free hospital beds in all circumstances. You also pay a max of 20 euros per month for prescribed medicines if you have the medical card. If you have a chronic, incurable or long term illness your meds are all free.
So for example when I had to have a tonsil out for biopsy it went like this:
I was a working person and not entitled to a medical card.
I went to see my GP, paid 40 euros for the consultation.
She looked at my throat, said 'ooh don't like the look of that, I'd better refer you to a specialist.'
Now because it could have been cancer, I needed to be seen quickly. If I'd gone public, the consultation would have been free butI wouldn't have a choice of specialist and I would have had to take the next available appointment with the first person who could see me, it would have been a two/three week wait.
I decided to go privately and paid 180 euros for an appointment within about ten days.
I saw the Prof at the Blackrock Clinic where he had his private practice.
He said 'that needs to come out immediately so we can see whether it's malignant.'
I said 'can't afford to have the op here, no private health insurance.'
He said 'no problem, I'll see you as a public patient at the Eye and Ear hospital. How soon can you come in?'
Two weeks later I had the op, one night's stay in the hospital. 60 euros was the charge back then.
Total time form GP visit to biopsy, under four weeks. Total cost 280 euros. I'm happy with that.
No further charges for follow up visits.
Bear in mind, all of this would have been free of charge if I'd had a medical card.
However, there is definitely an issue in Ireland with private health insurance providers because everyone I knew who had it (usually VHI) complained about the amount they were charged for x, y and z despite paying a fortune each month. And certainly there is no difference in the quality of care you receive privately to publicly. Private hospitals and clinics are few and far between and all the surgeons work in the public hospitals alongside their private practices.