Careful, Canada: What Ireland has learned about two-tier health care

This column is an opinion by Steve Thomas, director of the Centre for Health Policy and Management at Trinity College in Dublin, Ireland. He has been studying the issue of privatization in Canada, is the author of a chapter on Canadian health care in the book ‘Is Two-Tier Health Care the Future?,’ and has collaborated with the University of Toronto and University of Ottawa. For more information about CBC’s Opinion section, please see the FAQ.

Steve Thomas – for CBC News Opinion
December 14, 2019
The introduction of private health insurance in Ireland allowed a two-tier system to develop with long waiting lists in the public system and limited financial protection for households, says Steve Thomas. 

It is striking that as Canada seems on the cusp of embracing two-tier health care, Ireland is struggling to limit it.

In 1957, the Irish Republic decided to set up a voluntary health insurer owned by the state to take the pressure off the public system, allowing health care to be bought by those who had the means.

It sounded reasonable, and 60 years later, private health insurance has taken off with almost half the population covered and plans offered by private companies. This allows faster access to public care subsidized by the state, and queue-jumping of the very long waiting lists by those who are better off financially.

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