Costing free health care

I would like to comment on the important points Philip Andrew Ransley has raised on the cost of “free” health care (July 11).

He underestimates what would be involved to present discharged Mater Dei Hospital patients with a reasonably accurate documentation of the cost of their treatment.

I was a departmental director on our healthcare trust management board when we were chosen as a pilot site for establishing how to cost all medical and laboratory services within the British NHS – it took two years (and a seven-figure bill) to do this with the help of a London accountancy firm.

Hospital treatment costs are not just staff salaries, electricity, water and telephone rates and other maintenance costs, but would need to include the capital costs of the building, i.e., the interest payments on the sum to build Mater Dei Hospital (around €600 million). So when Mr Ransley quotes official figures of €306.7 million health recurrent expenditure for 2011, I doubt very much this figure includes the capital costs of all the health ministry’s buildings, including homes for the elderly.

Mr Ransley is quite right to question why private medical insurance premiums cannot be offset against income tax, and why private medical insurance shouldn’t be paying for use of the national health service.

He is, however, 100 per cent wrong in believing his national insurance (NI) contributions paid for government health insurance. Our social security law states that NI contributions pay only for pensions and work-related benefits, not for health or other welfare state handouts.

Strictly speaking, all this “free” health is paid out from taxation, not from NI contributions, although the government has, for over 30 years, been not only ransacking the NI contributions, but also cheating about 6,000 pensioners of part of their pension (as per EU commission reasoned opinion of February 2012), to pay for “free” health, “free” education, and so on.