A single tier health system will be established, representing a
fundamental change from the current public / private
division.
Every person will be insured for the same package or
"basket" of healthcare services. People will
purchase a universal health insurance policy from a competing
insurer of their choice. This will cover the set basket of
services, which will be determined after a consultation
process. Insurers will not be able to charge a different
premium based on a person's risk profile. Also insurers
will not be able to market a policy selling faster access to
services covered by the standard policy.
The White Paper plans to give every person a universal entitlement
to core primary care services from GPs, practice nurses and public
health / community nurses. It is proposed that the standard
basket will include acute in-patient, out-patient and day-case
care, as well as cancer care. Rehabilitative care would be
included subject to an overall time limit (eg one year).
Every person would be covered for mental health services provided
by community health teams, out-patient clinics and acute in-patient
services for a set time period. Long term social and
continuing care services would not be covered and will be funded by
general taxation. Convalescent and step-down services would
be included in the standard package.
It is proposed that the State will provide subsidies for the
insurance premium for qualifying individuals and would pay the
premium for the lowest income groups. The exact cost of the
standard basket of services is not known, as it has yet to be
comprehensively defined. General taxation will be used to
fund the subsidies and also services such as ambulance
services. It is stated that State spending under the new
system should not exceed spending under the current system.
It is planned that health reform legislation will abolish the
HSE. In terms of timing, it is envisaged that Universal
Health Insurance will be fully implemented by 2019.
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