Why is health insurance so high?

Sir, – John F Jordan (December 27th) is perfectly entitled to stimulate debate regarding health professional fees, but the figures he uses should be both reliable and quoted in context.

Comparing GP fees in Ireland to Belgium he attributes a cost of €60 to attending GP here. However, the well-respected 2010 National Consumer Agency report on GP fees found the average “standard” fee was €51. “Standard” fees are usually maximum fees, and these report do not take into account average fees which include reduced charges, or in some cases no charges, for children, those in financial difficulty, multiple family members together, review consultations and telephone consultations.

Also, possibly 20 per cent of the clinical consultations in general practice in Ireland are performed by practice nurses, and these would not attract a “standard” charge. Therefore the true average consultation fee in Ireland would be far lower than €51.

Belgian GPs often work alone without any administration or nursing support, which is very similar to how Irish general practice operated in the 1970s. Belgian patients are refunded much of the fee of €32 through their health insurance, therefore they will be charged the full fee for each consultation. Patients will not have the opportunity to be tended to by a nurse or even an administrator, explaining the higher GP consultation rates in Belgium compared to Ireland.

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The evidence promoting healthcare change should be both reliable and convincing before new policy is enacted. The problem with the current debate in Ireland is that it is often lacking in both balance and reliable data. – Yours, etc,

Dr WILLIAM BEHAN,

Cromwellsfort Road,

Walkinstown,

Dublin 12.