The truth behind Universal Health Insurance.
One of the strangest ironies of Irish society is our near national inability to read between the lines, when across the gamut of western literature, Irish writers are the time honoured authors of many of those same lines.
Personally I suspect that something is happening to the intellect of western man, I firmly believe that it is undergoing a contraction of sorts, one that is equally driven by an increased dependence upon the sugar high of modern technology and the materialist ideology that lies at the heart of globalisation. Collectively our attention spans are becoming shorter, the amount of cerebral activity we are willing to devote to a particular piece of writing (like this one for example) is almost certainly decreasing. The chances of you making it to the end of this paragraph a re much lower than they would have been 20 years ago, when there was not the option of 57 channels and the incoming buzz from an i-phone. Unless there are a few sugar stimulants mid paragraph, like 'sex' or 'cudos'; readers are likely to become bored or distracted by one of the weight loss advertisements at the side of the page. It might be that the rapidity at which information is now disseminated has meant that the western intellect now expects the mental equivalent of junk food, intellectual 'happy meals', 'one for everyone in the audience', and has become entirely averse to that which must be ruminated upon, that does not give up the sugar easily.
This putative contraction in national intelligence has meant that any mode of journalism that attempts at the more demanding task of analysis, beyond the superficial or sugar coat of 'good guys and bad guys' or the good old 'blame game'; places itself at an immediate disadvantage and is unlikely to generate the revenues that validate all forms of contemporary printed discourse.
Recently the flavour of the week for Irish media was the media generated controversy surrounding Minister Alan Shatter and the Garda whistle blowers bla bla. The Minister's incompetent handling of his ministerial brief, prompting opposition politicians to sniff blood and launch an assault upon the Minister in the hope of securing his resignation and destabilising the government for their own obvious ends. This is an old media game that is played out time and time again, it is cheap news that entertains the plebs and allows the state media to continue to dissipate it's massive state funding upon the salaries of presenters and executives, rather than real news or true analysis, the former would cost and the latter offend the hand that feeds them. The vulgarity concealed behind this current bottle of smoke is the obvious reality that politicians behave like children with the usual infantile 'tit for tat' carry on that one encounters (albeit in a less sophisticated form) on any playground throughout the country.
Meanwhile, in the real world, rivers burst their banks as a consequence of global warming, nations brace for internal and external wars, heroin addicts drop dead on Dublin street corners, and rape victims wait for justice outside the gates of a judicial system that is as morally bankrupt as our banking and medical establishments. The real problems in Irish society the real suffering, must take a back seat to the petty politics of 'tit for tat', and what is most amazing is that most Irish people are happy to consume their staple from their national media and accept it as "the news".. that it is as far as the story goes.
This week's flavour of the week pertains to the "news" that the director of one of Ireland's biggest charities Rehab, (Angela something or other) is in receipt of a pre-bonus salary of some 250k per annum. The news here, is the obvious irony that a charity worker should be in receipt of a salary that is higher than that of the president of the United States, or the Taoiseach of Ireland. In Ireland charities are amongst the most corrupt of our institutions (even more than Medicine Law and Banking, these institutions at least pay some taxes), they can afford to pay the highest salaries, and have the deepest expense accounts simply because they are tax immune (no DIRT no Corporate tax, zippo!) and instead of profits being dispensed as 'shares', the dividends are carved in the form of salaries, bonuses and expenses. Being registered as a Charity in Ireland is the holy grail of enterprise, the only thing that comes close, is the favoured status of Multinationals who pay almost nothing in tax.
We Irish are not yet stupid enough to have Apple, Diagio, or Google, register as charities... but if the contraction continues perhaps it wont be long?
And what of the Charities that are also Multinationals?
The RCSI in Dublin is an exemplary example of a multi-billion euro charity with a multi-million euro wages bill. The RCSI has business interests in; Dubai, Malaysia, a Medical School in Bahrain, Private Nurshing homes and hospitals, not because these places are filled with the distended bellies of Somallian famine victims, but rather because that's where the money is. In Dublin the RCSI charges medical students 50k per annum in fees, whilst the state through Beaumont hospital pays the wages of the doctors who teach those students, pays the canteen bills and picks up the tab for the toilet paper etcetera. It even provides the guinea pigs in the form of plebs: living cadavers, for a population of medical students most of whom will leave Ireland once finished their training. Charity begins at home, and in the case of an Irish charity it begins with the charity itself. RCSI must wait its turn in for the inevitable spot light,presently however it is perhaps too powerful an institution to experience the glare of a truly independent media.
We consume our distracting 'muck-news' and actively believe it to be news for precisely the same reasons that consumers return to Mcdonalds to purchase nutrition, time and time again, despite the fact that they are eating little more than sugar, fat and a ball of carcinogens. It tastes good, it makes a turd, one need not suppress ones taste buds as much as ones brain cells.
This particular story of the executive making hundreds of thousands, whilst grandma waits for her new hip or little Johnny waits on his wheelchair and so on, has become the burger and dries of Irish media. The same story is staple of RTE , cheap news in abundance. What is more amazing than the repetition, is the fact that the plebs continue to consume it with relish, on a regular basis, as though it were the cake that Marie Antoinette is supposed to have prescribed for a bread-less proletariat.
The simply reality that there is hardly a man or woman in the state who would have turned down the Charity Directors pre-bonus salary, on the basis that it is too high, confirms that this ludicrous "story" is more about jealously and sour-grapes, than about any notions of governance, social justice or basic morality. That is the sickly sweet irony of contemporary Irish society, the 'shite in the tulips'; that it attempts to be sanctimoniously socialist and brutally capitalist, at the same time! The universal disgust at the salary of the Chief Charity worker is easily reconciled with a universal lust for the same kind of salary; this is the idiocy of modern Ireland. A total lack of honesty that reinforces the complete impossibility of either a clear political vision or real change, beyond the poster variety.
The Charity workers salary of 250k per annum is subject to tax at the rate of 50-60% meaning that she is likely to take home somewhere in the region of 100-120k . If our angelical Angela has a Celtic tiger mortgage, a couple of kids in private school, and a few health insurance premiums to pay, she is not going to be that well off after all. Amongst her pals in Business, Banking, Law or Medicine, she is probably on the relative breadline. In truth, her taxes (like the taxes of the one in four Irish people who actually work), must fund the unemployment benefit for 12% of the population, Medical cards for 40% of the population, the social clean up costs for our national love of the alcohol industry and all the other freebies that socialism dispenses to the needy and the crafty alike. For herself and her family angelical-Angela must pay privately for almost every medical and educational interface with the state thereafter, she will soon pay for her waters and will pay mandatory health insurance. It might pay for one of Angela's begrudger's to investigate what a medical card holder in Ireland is actually "entitled" to before they cast the stone at the charity worker. Perhaps Angela has one hand in the pocket of the poor whom she ostensibly manages, but there are bigger more hungry hands in her pockets.
Undoubtedly a significant portion of medical card holders are no more in need of medical cards than the man in the moon. I encounter the abuse on a weekly basis when I am asked by patients whether they should use their medical card, or their private health insurance for referrals to hospitals and specialists. In Ireland everyone is screwing everyone else. You must either screw or be screwed it's survival of the shrewdest. The system and all of its vast complexities, it's bureaucracies of broken venal institutions, quangos and colleges are constructed upon this brute reality and the media is simply a diversion fro this cold unsavoury truth.
We don't mind paying for the corrupt dealings of bankers and developers, as long as the payment is called something different; like a water charge, or property tax. The proletariat don't mind paying for the screwer's as long as we can do a little screwing of our own.
When the British left Ireland they left behind a broken, malleable, and subject people, who will swallow any auld muck, once it has a bit of sugar on it. After three hundred years of domination it takes no effort what so ever to politically piss upon the backs of the Irsih PAYE worker and simply inform that its raining honey from heaven. It was only inevitable that the English should be replaced by a lordly class of our own making. We Irish have yet to live up to an independence that was so painfully purchased. For as long as we continue to swallow myth and delusion we will never be free, and would be better under the open and honest oppression of our former masters. It is the essential and going mission of state institutions like RTE to keep us stupid, to keep us from asking the right questions.
Contemporary national scams such as "free health care", in the guise of a mandatory health-tax upon workers and employers, the transfer of private fees from GP's to Insurance companies, of water charges and property taxes to bail out bankers, are clear examples of our predilection for delusion; of a national spirit that was broken long ago, or has left on the emigration boat.
The recent diet of muck that is presently being sprinkled with spin and icing sugar, is the notion of free health care. Only in Ireland would you find a media that is willing to continuously describe the coming implementation of "free universal health care", within the same sentence that announces it in the form of a mandatory insurance policy that everyone will have to purchase. Which basically means that the product is free only after it is purchased. How Irish is that?
Current estimates put the figure of this new tax (or insurance policy as it is being called) in the region of 1600 euro per person per year (See Irish Medical Times 28/2/2013). Never mind the fact that the non-free VHI plan B can be purchased for 1700 Euro per annum.
Of course the reality that once everyone has purchased mandatory health insurance, nobody will have health insurance, has been entirely missed by most commentators. Currently the possession of health insurance allows us to be treated at private hospitals and to unethically skip the queues at public hospitals (we the skippers of the queues have no problem with this). However once everyone has the same insurance policy, there will be only one queue, and no opportunity for skipping (at least not for the plebs). Universal health insurance is simply the end of affordable health insurance, and the birth of another new tax, upon a nation that will apparently swallow anything at all, once it is promised by somebody in a suit.
One of the most entertaining aspects of this current charade is the fact that GP care is to become 'free' this is the carrot that most of the public are holding their breath for. All the plebs have to do is simply elect Fine Gael/Labour into office for a second term (the freebies can't or wont be delivered in full, until after the next election). Vote for me and I'll buy you a pint! Asinine as it sounds, it goes down like tea and hot cakes. The mandatory insurance policy will cost us in the region of 1600 per annum. Meanwhile, an entirely private GP franchise (GP NOW) operating with branches in Dublin and Cork and Galway, are offering unlimited GP care for 2 adults and 3 children, including nurse visits vaccinations and blood tests etc for 999 Euro for TEN YEARS. One might save billions if this GP NOW were to take over primary care in its entirety. They are offering private medical care for 5 people for 10 years, for less than one person's, yearly subscription to the government's mandatory insurance plan.
Whilst we the plebs consume the sweets of Alan Shatter and Rehab Charity Workers etcetera, and patiently await the golden shower of 'free healthcare'; Big business and government can get on with the business of running the country, carving the real cake, and stealing money out of peoples pockets under the guise of ever more elaborate hoaxes such as; water taxes, house hold taxes, and mandatory health insurance. Angela pays 60% tax and Apple pays 2% tax, it is as fine as it is Irish.
Once the ongoing enquiry into the recent greed induced collapse of the banking system, reaches the inevitable conclusion that Sean Quinn and the Anglo golden circle, were in fact duped into loosing billions, by the State, via the then Financial Regulator. And the predictable trip to the European court finds the Irish State to liable for Quinn and his Pals (Regulator approved) investments into Anglo; the plebs will have some more bankers bills to pay, and will need to be taxed and milked a bit harder. Of course this will take time but there is no harm extending the milking parlour and preparing for the future. At present there is a lot of money changing hands at the reception desk in General Practice and this is soon to be channelled into the coffers of Insurance companies and the State.
The problem facing the government at present is that one of the more powerful lobbies in the country the Health Insurance Lobby is experiencing difficulties as people are not renewing health insurance policies and revenues are falling. The health insurance companies and their man Minister Reilly have come up with a plan that has been sanctioned by the government. The plan is simple and it involves the transfer of liquid health asset in the form of the cash that is paid to GP's in private fees to the Insurance companies. GP's will then be advertised as being "free" of charge, when in reality Paddy will have to pay a mandatory health insurance.
One year ago the fire brigade came to my house to put out a fire in our Chimney , they left behind a bit of a mess and a bill for 500 euro. Given that in addition to the tax on our wages we plebs pay: television tax, road tax, water tax, property tax, county council rates, GP visits, registration fees at Universities and schools (which amount to the same fees that private Universities in America charge), legal fees to access the justice system, and at last, a health tax through mandatory health insurance.. perhaps now we might ask what (other than the salaries of those who tax us) we are paying taxes for at all? Angelical Angela was a fool to forgo her bonus!
This in essence means that private fees and some more, will now go to state favoured insurance companies who will deduct their own costs fees and profits and then compensate the GPs for the subvention of their private incomes. The state will be selling Health Insurance contracts like mobile phone contracts, and the gravy train will keep running. Only thing is, this is no gravy train, it is more like the train that used to travel beneath the sign that read: Arbeit Macht Frie.
The system is an elaborate hoax that involves the simple transfer of private fees from the GP to private Insurance companies, who will take a share for themselves and pass the remainder onto the medical profession. On the surface the scheme appears "free" but even the most superficial analysis reveals that the additional layer of bureaucracy vis the intermediary of profit driven insurance companies, means that the consumer is going to have his pockets picked whilst he is availing of the ostensibly 'free' services. His Boss will have to contribute to the scheme, so he can forget about looking for a pay increase.
In an Irish context this type of national delusion works perfectly well . Essentially the insurance companies commandeer the private incomes of General Practices, and these monies will be supplemented by a new tax that will be called mandatory health insurance. The incomes of GP's will be eroded to a small degree; to that which the profession will tolerate. Ultimately the insurance companies will be in a position to pay the GP's reasonably well, given that their coffers will be swelled with the revenues from this new tax. The financial burden will be shouldered by the least powerful group in Irish society, the working plebs who pay for all things taxable. They will shoulder this additional burden obediently, as long as the appropriate spin is applied, if like the animals on animal farm they are encouraged to believe that all animals are equal, but some are inherently more equal than others.
Christ have mercy.
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