Health and Social Budget overruns - making the rest moot


#241

I blame the Pope for chemsex and I blame the Archbishop of Canterbury for the bugchasers


#242

Seems fair.


#243

I had a quick look at the study. My point is that even if non-adherence is accounted for, over time adherence will probably fall, given the risk profile of the people we are talking about.

That is why I made the boy racer analogy. We are talking about a high-risk practice consciously undertaken by a very small minority of young men. They are fully aware of what they are doing. No amount of ‘education’ will change this.

I wasn’t aware of the lifetime cost of anti-retrovirals compared to the cost of PrEP. On these grounds the cost-benefit payoff. To be honest Una’s article annoyed me in the first place because she grounded this in a minority rights argument rather than a public finance one.

It may be a hard sell though. The vast majority of taxpayers (straight and gay) are either celibate or monogamous so the ‘Why should I pay for their behaviour?’ argument will spring to mind.


#244

Preventative medicine is odd like that though. Almost nobody would argue against the State paying to treat sexually transmitted diseases, or life threatening obesity, or smoking/bacon-induced cancer, or people who’ve fallen off cliffs whilst rock climbing.

Maybe we feel that’s OK because the “irresponsible” person is suffering.

But would you want the State to pay for free vapes, or diet pills, or personal fitness trainers, or rock climbing supervision?

I think the only way to process it is to ignore morality and look at pure costs/benefits to the State. If the State is going to have to pick up the resulting bill then it makes sense for effective prevention to be funded, if that preventing returns its investment.


#245

I take your point. My point is a little more meta though.

Studies invariably show that preventive medicine is more effective than treatment after the event.

These studies often don’t highlight the fact that:
-People are lazy and often don’t take the treatment
-People get complacent. If the preventive practice appears to be working they stop with the treatment

There are many things about my diet (quantity and quality) that I know are bad for me in the long run. But I still consciously consume them.

Of all the groups I would trust to adhere consistently to preventive medicine, young men on the chemsex scene is pretty low down the list.


#246

Well I have to bow to your superior knowledge of the chemsex scene, but in my experience of dangerous sports, participants both novice and experienced tend to be incredibly careful because they know the risks. Some of them still ended up dead, but not for lack of diligent preparation.


#247

HSE overspending to create €300m financial deficit

irishtimes.com/news/health/ … -1.3211986


#248

You could read that headline in two ways. My first thought was that they are deliberately overspending to create the deficit to secure more funding. But surely they wouldn’t do that.

Money always finds a home. I think of councils that will dig up a perfectly good road and resurface it to use up their budget allocation otherwise they wouldn’t be able to justify receiving the same funding next year.

It’s such a complex monster I can’t begin to get my head around it all.

There are always plenty of incentives to spend more and more but what are the real incentives (professional or personal) to actually saving money? Kudos, promotions, pay rises?

Or is a stick approach being applied at all?


#249

State/Industry Medicine Pricing Agreements, Cost Savings and Counterfactuals: the Case of Ireland

ESRI paper here
esr.ie/article/view/862/181


#250

This article was written a little cryptically for RTE’s audience. Like something from the old game show 3-2-1.

rte.ie/news/business/2018/0404/952146-exchequer-tax-revenue/

So ahead of a probable election spending increases are on the table, instead of getting into surplus to pay down some of the Sovereign debt while the sun shines.

10% increase in PAYE tax take, suggests either 5-10% pay increases, or 10%, maybe more in employment and paying higher tax than 1 year ago. Or most probably a combination of both. If PAYE tax increases by 10% year on year this somewhat justifies 10% increases in housing costs, through the higher demand.


#251

Progressive nature of Irish tax system makes the tax take non- linear.

Small increases in income of those at the higher rate has a disportional effect on the tax take.


#252

My employer probably shelled out €10m in bonuses in the last month (not all to me sadly) up maybe 20% on last year, ~50% of this goes to the exchequer so that’s 1 of the 300 from just one employer without hiring a single extra person or raising anyone’s salary. Some would have bought stock with it but PRSI and USC is still due.


#253

Nice one. We could short circuit things madly, on the back of a fag box, and suppose govt revenues and accomodation prices are correlated with bonus payments, which in turn are a function of global stock indices. Which some might argue are firmly in bubble territory.


#254

HSE deficit set to reach close to €100m for first quarter

irishtimes.com/news/ireland … -1.3471712


#255

First line of article

“There are growing concerns within Government that spending in the health service is out of control.”

Patently obvious to anyone with half a brain for the last decade.


#256

An Apple A Day will sort this out. 8)


#257

HSE may record deficit of €200m-€300m for first half of the year

irishtimes.com/news/ireland … -1.3543455


#258

Finance have made it way harder to find the monthly figures. Finally got them here

per.gov.ie/en/exchequer-statements/

By end May-18
Health were +66m over their Net Voted Expenditure budget
Justice were +30m


#259

An on-call consultant paid more than €14k for one week’s work at Cork University Hospital, and a €25k monthly payment for radiology services at Bantry General Hospital
& more
irishexaminer.com/breakingn … 55973.html


#260

independent.ie/irish-news/p … 15280.html

Deja deja deja vu.