Money Times - January 23, 2018

Posted by Jill Kerby on January 23 2018 @ 09:00



“Good health!” seems to be the default New Year greeting this year – and for good reason.  The health service continues to fail to provide what anyone with a beating pulse would describe as a consistently efficient and commendable service for the approximately €15.3 billion the state expends.

If good health is what you aspire to, you better be working hard to make it happen yourself.

It’s easy to blame the system.  The HSE is administration-heavy and light on essentials like sufficient hospital beds and front line staff to cope with rising demand from a rising and ageing population. It’s also deficient in well-funded and resourced preventative, community-based services.

A hospital-based service, mainly in cities (where most people now live) is always going to throw up seasonal and geographic anomalies; the inevitable result is that outlying patients will have poor access to even the most basic services, like GPs and non-critical A&E treatment. Seasonal demand (winter flu outbreaks) turns up the pressure to boiling point.

But that’s not the whole story.

As individuals, we’re sleepwalking ourselves into a toxic nightmare of future ill health that is only going to accelerate the rising costs and inefficiency of our already dysfunctional health service. And here’s how:

-       Our level of alcohol consumption remains higher than EU averages with c25% of drinkers, binge-drinking;

-       Despite 76% of the adult population claiming to exercise regularly, only 45% meet physical activity guidelines;

-       18% of the adult population are already obese, which is higher than the EU average. By 2027 this figure is expected to rise to 37%;

-       27% of all disease is related to behavioural risk factors (too much food, alcohol, tobacco use (just 19% today) and too little exercise);

-       Chronic illnesses now account for 80% of all GP visits 40% of hospital admissions and 75% of hospital bed days.

Compiled by the private health insurance company, Irish Life Health and part of its recent annual review presentation to financial journalists, the bad news didn’t end there. 

Looking ahead at the health and fitness prospects of the younger generation (15-24 year olds) it found that 30% of this age group are already overweight (19% of that number are 15 year olds) and 57% will likely be by the time they are age 35.

Irish girls in particular are less physically active than boys of the same age and that 90% of all secondary schools provide on two hours or less of PE a week, versus the recommended seven hours. (The good news is that compulsory PE could be added to the secondary school programme.)

Given the poor government response to all these long-recognised issues, it’s no wonder that all the private health insurance companies are spending millions on preventative health and wellness programmes for their customers:  Laya Health, the state-owned VHI and Irish Life Health have all been promoting fitness programmes in schools and community sports clubs; health screenings and incentives like wellness programmes, initially for their corporate clients but now rolled out for individuals (Laya’s HealthCoach and Irish Life Health’s BeneFit plan with its cashback benefit) and fitness and health social media blogs and member messages.

There is a clear financial correlation between customers – or taxpayers – remaining as healthy as possible or seeking early intervention when a health problem arises and long term profitability, admitted Laya’s Managing Director Donal Clancy. He thinks the private health providers should be working with the state to extend their positive health programmes within the HSE.

As this column has noted many times, in a country where 685,000 people sit on HSE treatment waiting lists (up from 459,000 in 2015); where even children are now lying on trolleys in A&E departments of the of the hildren’s hospitals and medical outcomes fall below the EU average (despite Ireland being the 4th highest spender on health) we need to take more personal responsibility for our health and that of our children.

It’s still January, resolution month. Many of us need to eat less, drink less, smoke less and get more exercise. Losing weight (don’t I know it!) could be the most rewarding thing you do for the next decade health-wise, let alone in 2018.

Consider getting a full medical check-up. Nearly 2.2 million of us have private health insurance. All three providers offer health checks, (Laya’s new 30 minute HealthCoach fitness check is free), in private clinics and hospitals and now, even on-line.  Depending on your plan and the type of check-up you receive you may be able to claim all or part of the cost.

And finally, if you don’t have private health insurance, reconsider that decision.

Contact a good health insurance broker to do the hard work of finding the best and most affordable policy. If your existing plan costs more than €1,800 and you haven’t reviewed it for the last couple of years, says Dermot Goode of totalhealthcover.ie, then you are overpaying.

The 2018 TAB Guide to Money Pensions & Tax is on sale in all good bookshops and on-line. See www.tab.ie for ebook edition.

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