Second Opinions

Harney warns over raising taxes to fund universal healthcare – The Irish Times – Thu, Apr 15, 2010

Fine Gael’s leader Enda Kenny told the conference there had been a massive loss of faith in the health system following a series of spectacular failures.

He said his party, through its fair care policy, would change this. “FairCare will end the two-tier health system, so that everybody will have free or affordable health insurance and equal access will be on the basis of need,” he said.

Such a system could be put in place cost-effectively but it could not be done overnight, he added.

Meanwhile, Labour’s leader Eamon Gilmore said universal health insurance in Ireland was both feasible and affordable.

But he said that in Ireland we need to acknowledge that “the existing state of our public heath service could be one of the biggest obstacles to convincing people that more access to it can be better”.

Sinn Féin’s health spokesman Caoimhghín Ó Caoláin advocated a universal public health system that provides care to all free at the point of delivery, on the basis of need alone, and funded from a general, fair and progressive taxation policy.

There was this one time I got smacked in the face with a pool cue and I went along to the hospital and I got stitched up there and then. And then there was this other time when I knocked myself out, smashed my teeth up and got taken to hospital in an ambulance, got a load of stitches, they put some sort of mould around my teeth and then a couple of days later I went back to get the mould removed and get the smashed teeth repaired. And all this cost me nothing! Because it was the NHS and my treatment got funded out of general taxation. And then there was this other time when I split my head open against the lock of the boot of the car and had to go and get stitches. And I went along to the hospital and they put in staples and didn’t cut my hair though they normally would, and instead they took extra care to not ruin my haircut because I had to go to my own wedding the following morning. And all this cost me nothing. Thanks, General Spanish Taxpayer! (And by the way, thanks for performing heart surgery on all those British and Irish ex-pat residents. For nothing! I know this because I was talking to a Spanish cardiologist the other day.)

See Sinn Féin appended to that report? It isn’t on the Examiner report. And it isn’t in the Independent report either. Now I know the establishment consensus in the Republic of Ireland is that Sinn Féin are nuts. But the establishment consensus in the Republic of Ireland is completely fucking nuts.

I’m guessing one of the reasons Sinn Féin is advocating a ‘a universal public health system that provides care to all free at the point of delivery, on the basis of need alone, and funded from a general, fair and progressive taxation policy’ is because it has lots of party members in the Occupied Six Counties who, like me, were born in NHS hospitals and had free doctor consultations and their families were treated in NHS hospitals and they never paid health insurance, and they think that free healthcare is just one of those things, like sewage, which is a basic entitlement and a fact of life, not some sort of pie-in-the-sky-world-turned-upside-down-bring-me-the-severed-head-of-a-paisleyed-unicorn fantasy.

Like, when I first moved to the Republic of Ireland, I didn’t understand what paying for a doctor was. It was like moving into a well-appointed house and discovering there was no toilet. My girlfriend (now wife) at the time got sick, and we went to a doctor’s surgery, and they said you have to pay, and I thought, you bastards! Does the government know you’re ripping people off like this? Because to be honest, and I hope I’m not disappointing my readers here, I had very little interest in goings on in the Republic of Ireland prior to my being there on a permanent basis. Yeah, I knew Cadbury’s chocolate tasted different, and I’d been to Donegal on holidays and to Castleblayney on Saturday nights and I’d learned a bit about it at school. But I’d gone off to England and hadn’t paid it much attention for the preceding six or seven years, so I was happy to believe the stories circulating at the time that it was a reasonably decent place and I probably assumed you automatically had free health care because that was just the way things were.

But no.

So anyway, my late twenties passed without major health-related incidents, and I didn’t give the health system that much thought. But then my wife became pregnant and she had to go to doctors and hospital consultations. And it was then I had to confront the reality that health care in Ireland is an absolute fucking joke.

But before I probe the specifics, let me say something about the patients. I’m talking about the Irish patients here. Most foreign people I have spoken to are well aware that the health system is a disaster area. But most Irish people, while they will acknowledge that there are general problems relating to health care, are so awed by the symbolic power of doctors and consultants, who are like the symbolic first cousins of monsignors and bishops, only ones who can kill you, that they cannot see the deficiencies when it relates to their own specific situation. They could get their piles treated with a splintery fencepost shoved up their ass and most of them would respond by saying that it was grand altogether and the doctor was lovely. 

So anyway, maternity care. Call me old fashioned, but the fact that in the course of human history women have proven capable of giving birth in all sorts of straitened and desperate circumstances and their children have survived is not really sufficient justification for treating them like cattle. I’m talking here about the VHI semi-private care, which involves consultants. I went along a few times to the semi-private clinic in Holles Street, where my wife would see a consultant. It was conducted out of a set of mobile units, and there’d be a long queue down the stairs, the little reception area crammed with women 7, 8 months pregnant, on their feet, in various states of discomfort.

But fair play to the consultant, by Hippocrates he got through those women at an impressive clip. They’d get weighed, and then the consultant would see them for the best part of two minutes. I watched him. The way he wielded that blood pressure thing, the way he’d have a quick feel around. It looked like the sort of thing that someone on one-fifth his salary might be able to do. But ah! Would they have that consultantly gravitas and paternalistic chuckle? How could you be sure that they hadn’t been out all night testing headshop products? What if they missed out on some vital detail and you ended up giving birth to a runt pig instead of a baby? That’s the secret of the consultant, and the continued existence of private health insurance: a fear premium. People are primed to think that the system is shit, so they pay over the odds for some of that old time authority or marginally better quality to provide some assurance that the system is a little less likely to kill you. And then the consultant chuckles all the way to the bank, safe from the penuries of living on Mickey Mouse money.

Anyway, enough details. Point is that there is no good reason for the Irish health system to be the way it is, unless you consider its use as an instrument of terror by the rich against the poor as a good reason. As with many other aspects of the Irish oligarchy, in so far as there is a ‘public debate’ on such matters, the dice are loaded in the oligarchy’s favour. So there won’t be much ‘debate’ that deviates from the general theme of “Don’t touch our taxes! Don’t do any funny shit like try and redistribute income and wealth downward! You will be poor AND you will die! On the other hand, sit still and shut the fuck up while I confiscate a few billion for this zombie bank-cum-health insurance-cum-cement thing! Your life depends on it.”

Well, I recommend a second opinion.

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5 Responses to “Second Opinions”


  1. 1 Noreen April 15, 2010 at 4:12 pm

    This is brilliant. I think the whole phenomenon of Irish people, repeating with eyes all aglaze, “The doctors and nurses are brilliant” is as clear a case of Stockholm Syndrome as you’re ever going to get this side of a bank robbery.

  2. 2 Hugh Green April 16, 2010 at 12:00 pm

    Thanks Noreen. One related thing I that maddens me is the sense of obligation you notice people labouring under to say things like ‘now I know there are lots of good nurses and doctors out there who are doing a good job but…’.

    Like, isn’t that what human beings who are nurses and doctors are supposed to do: that before they have started working in a hospital they have developed the habit of caring?

    You’d get very worried indeed if every man and woman working in the health system was motivated by pure greed and self-aggrandisement. So to my mind saying ‘there are plenty of good nurses and doctors out there’ is a bit like saying “now I realise there were three perfectly good wheels on that car, and it’s not them I have the problem with….”

    That said, more than half the doctors I have met here -and I exclude the immigrant doctors from this judgement- are a pack of smug, arrogant and patronising turdbag quacks who appear to have got into the medicine gig for the money-grubbing and status and don’t know how to listen and don’t know how to give a shit.

  3. 3 Dr Hfuhruhurr MRI FRCCP NAMA V OTE FF April 16, 2010 at 10:12 pm

    Hey Hugh,
    If you love the occupied six counties so much, why don’t you go and live there?
    ;=)

  4. 4 Tromphe L' January 7, 2011 at 4:23 pm

    Had the Holles Street experience too, just as you said. Quick hello, lie down there, poke poke prod, everythings grand come back in 4 weeks. In all the time going there for the last 4 months of her pregnancy no ultrasound was performed on my wife to see that the baby was alright. Contrast this with the Asian country my wife came from where she was given an ultrasound on every bi-weekly visit.

    My wife thought she had landed in some fucking slum-dwelling backstreet quack-run shack, not our main maternity hospital. Third World doesn’t even begin to describe our health service.

  5. 5 Holemaster January 7, 2011 at 5:43 pm

    Jesus you were one clumsy bollocks.

    Bang on. We’re a nation of children waiting to be told what to do.


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