Health and Social Budget overruns - making the rest moot


#202

I genuinely know an Nordie bird whose Nordie dad got the bus back up there after suffering a mild heart attack while visiting her in Dublin rather than face the potential of incurring costs down here…


#203

What is a ‘Nordie bird’?


#205

Government gives sweets, and you’re skeptic people are eating these sweets.

They need to at least put a minimum charge on visits - or government should stop getting involved.


#206

I agree totally. Access to medical treatment should involve a level of co-payment on a sliding scale of ability to pay. From zero in rare cases (rough sleepers for example) to 80% for very high earners.

The current ‘binary’ system where small changes in circumstances tip you from paying zero to 100% is neither efficient nor equitable.

My point on the doctors is that a lot of them get a free pass from having their claims treated with scepticism simply because the prefix ‘Dr’ is used before their name.


#207

A bird from norn iron.

They are fucking dangerous.


#208

Ain’t that the truth


#209

irishtimes.com/news/health/i … -1.2618129


#210

FoI from The Examiner about HSE internal audits for July-December 2015.
Concern over award of €338k contracts
Contracts worth €338,000 were awarded to a private firm by a hospital group whose chief executive had a business interest in the same company.
Tusla: Dozens of pay and timekeeping issues
Payroll issues identified at three locations included a lack of written local payroll procedures or payroll sign off checklists; no records of training for payroll staff and incomplete staff details on time sheets. a ‘Gaeltacht Allowance’ was paid to 44 members of staff. In four of these cases, auditors were unable to find any written decisions signing off on the awarding of these payments, which ranged from €156.90- €427.58 per fortnight
Staff in single HSE region overpaid more than €815k
it appeared that “ in some cases the lines of responsibility as to who is responsible for tracking, following up, and monitoring of the recoupment of payroll overpayments needs to be more clearly defined and agreed”.
COPE charity contract: Salary at odds with medical grades
A doctor contracted to provide services to clients of COPE Foundation was paid €123,799 annually, at odds with Department of Health salary scales for medical grades.
Abuse centres Dublin: Risk of non-compliance at facilities
Some of the issues, included the absence of proper receipting, data protection issues, problematic financial controls, and Garda vetting concerns.


#211

Bump for Coles2

Some of us don’t watch rté :slight_smile:
Besides, hidden health waiting lists are not a surprise. My GP told me about these so-called hidden lists years ago. It is only now that rté are covering it. It’s akin to people removed from the unemployed live register onto jobbridge/ce schemes.


#213

And housing completions statistics, or crime figures, or GDP growth figures and ‘leprechaun economics’…

hmmm… I’m starting to see a pattern here.

With regards to improving the Public Health system, first you have to stop deliberately fucking it. Brendan Howlin let the cat out of the bag when he said that in order to create a private health care ‘market’ they needed the Public system to be inferior.

"Why else, if it was first rate, would people pay for a private system?’

Yes indeed.

Drive down the cost of living and you can drive down Public sector pay and pensions. If you have a stupid government policy to deliberately drive up rents and property prices and you can’t reform anything. With a high cost of living you can’t keep young nurses and doctors; you can’t attract them from abroad. With high public sector wages the private health system can’t compete at an economic level, insurance rates go through the roof, and the entire system fails. The problem is one of stupidity.


#215

Harris says:

He still doesn’t get it.


#217

Hospitals spend an average of €2.88 per dinner. Varies from €0.93 - €7.37 per meal
Prisoners get better food.
pbs.twimg.com/media/C4bKzYlXUAAimYB.jpg:large


#218

am I a raving bigot to think that giving out free anti-HIV pills is not a very good idea?

irishtimes.com/opinion/anti- … -1.3054235

this is a contra to Ua Mllally’s piece ssaying that
irishtimes.com/opinion/una-m … -1.3050896

irishtimes.com/opinion/provi … -1.3051756


#220

I read Mullaly’s article.

The cost-benefit pay-off is only as good as the likelihood that the drug gets actually taken by the people it’s given to.

I am just not convinced that young men engaged in hedonistic and risky behaviour can be relied upon to take a preventive pill daily. I know I am generalising here a bit. But it’s not the elderly on statins we are talking about.

For example women who claim to be on the pill still get pregnant all the time.


#222

Here’s the link to the PROUD study mentioned in the article.

thelancet.com/pdfs/journals/lancet/PIIS0140-6736(15)00056-2.pdf

I don’t know how much it costs here, but in the U.K its around £400 a month to buy privately.

edit: If a person does become HIV positive while taking PreP it can become more resistant to treatment if not diagnosed and given required extra drugs. So as part of regimen the drugs would need regular screening(would probably be mandatory for “free” drugs). It should increase the incidence of early detection, and detection of other STI’s.


#223

Yep as expected


#224

It is hard to paraphrase her argument as it is so weakly made. And anyway we all know that a puppy dies every time someone links to one of her articles.

Basically it’s a bit like saying to boy racers that it’s okay to drive without a seatbelt if you put an additive in your petrol tank every day.

Even if the risk reduction is the same, would you trust them to use it reliably?
And should the state fund it at €500 a month where the alternative is close to free?


#225

Any lad who wants PreP should get it for free, they should be allowed to donate blood too, sure what could go wrong, don’t listen to the homophobes

We should also continue to import people from countries with high HIV rates, sure didn’t saint Barry also change the rules in the US, and I can’t wait until someone I know dies of drug resistant TB, it will be great, just like the 50s again


#226

…aaaand another thread derailed as an immigration debate. Well done.


#227

The adherence issue is covered by the study. I’m not sure whether you saw my comment immediately prior to yours, but the study shows that HIV infection rates are significantly lowered among people who were prescribed the drug. In other words, this includes whatever non-adherence rate there is in the real world.

In terms of whether the State should fund it, set aside the moral question and look at it as a cost-benefit. You have a high-risk population and you know that without PrEP, X% will become infected. Would you rather treat them all prophylactically @ €500/month for a few years while they’re young and irresponsible, or would you rather treat the infected % for the rest of their lives with HIV anti-retrovirals at €2000/month (or whatever- cannot find good numbers for Ireland but apparently the lifetime average cost of treatment is around €500,000). You’d need to know all the variables like how many years they’re likely to remain high-risk etc but it’s not a complicated calculation. Much like the cost-benefit for vaccinations.

Of course you could add in the moral issue – if you can stop people from contracting an incurable disease with a simple and easy treatment, is it moral to not to it, at any price? I don’t know the answer.