March 2007 Archives

Harney and Health

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Your correspondent Dr X (Tuesday 6th March) asked how private health subscribers would secure private treatment if proposals to limit consultants' output to 20% of their clinical output are implemented. The answer is that a large proportion of these subscribers will opt out of this insurance if and when national waiting lists are reduced and the health service reverts to one-tier based on need rather than capacity to pay. With reduced economies of scale, risk equalisation and medical inflation, the cost of private insurance would become prohibitive and cease to offer any queue jumping benefits to the majority of subscribers.

This begs the question as to why the Government is failing to treat waiting lists with the same urgency as the introduction of tax-subsidied private hospitals and reform of the private heath insurance which accounts for only a small fraction of heath expenditure. Instead of breaking the VHI into a series of competing companies, the Government should absorb this State-owned organisation into the Social Insurance Fund, adjust health contributions and purse a single-tier, publicly-owned  and -operated health system for the great majority of citizens.

M50 takes its Toll

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By any standard, NTR has already been well-remunerated for its investments in the M50 West-Link toll bridges. The southbound bridge which opened in 2003 at a cost of �23 million places the proposed payment of �600 million to NTR in context.

Assuming that this bridge handles half the West- Link traffic, NTR's return would be about 13 times the initial investment even before past revenues and future inflation are taken into account.  How can this be justified?

It is noteworthy that negotiations on tolls for the second bridge took place after the huge surge in traffic during 1996-7 so it wasn't as if traffic and profit projections were being made in a vacuum as was the case for the first bridge.

Furthermore, the buyback appears to have been negotiated around toll revenues rather than NTR's projected net profits which would be substantially lower.

This deal - and all prior agreements with NTR - should be thoroughly investigated by the Comptroller and Auditor General and the Committee of Public Accounts before one brass cent is paid over.

As part of these investigations, the barriers must be lifted on a trial basis to establish the level of disruption caused by tolling delays and to check whether NTR is providing tolling facilities that are adequate for the current levels of traffic as per its operating agreements.

Letter published in the Sunday Business Post on 4th March 2007.

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