Need for more transparency in Irish medicine

This week's Independent News & Media Irish regional newspapers' column.
Michael Commane

It’s generally accepted that if we do not personally have to pay for something we are not too bothered about how much it costs. Of course there are the ethical and noble people who will make it their business not to waste. 

The current discussion about climate change and the increasing popularity of the Greens is a reminder to all of us that waste and profligacy wherever and however they happen are no good for any of us. 

Never forget that old adage, there is no such thing as a free lunch.

I was reminded of such matters in recent days when I had minor surgery.

I am a privileged person in that I have private medical insurance. The surgery costs were covered by my insurer. So far I have not received any details about how much it all cost.

I have been told by my insurer that as soon as they receive the bill from the hospital they will send me a breakdown of the costs. Half-jokingly, half-seriously I asked if I would be told how much the hospital charged for the tea and toast. Politely, the person at the other end of the phone told me that no, there would be no information as to how much the tea and toast cost.

I am wondering why.

Within a few days of the surgery I received a letter from my consultant confirming the date of my appointment to see him. Included in the letter was the price of the appointment. It was there on the page, clear to see how much I would have to pay. Just like when I go to buy a pair of shoes or a carton of milk, I know the price before I purchase.

And now I’m saying to myself why does the medical insurer not give its customers a breakdown of prices before they incur any costs. I think it would make us all more cost-conscience if we knew how much something was before we walked inside the door of the hospital.

And back to the price of the tea and toast. Someone has to pay for it. I doubt the hospital or the insurer picks up the tab. That means it is hidden somewhere in all those large sums of money swirling around in the billions that we are spending every year on healthcare. I can’t help wondering, what else is hidden under the bonnet.

How do the medical insurers do deals with the various hospitals? Does an appendix cost the same price in all hospitals? Do different doctors charge different fees? When I asked my insurer these questions I was told to phone the relevant hospital to find out how much they charge. Is all this information easily available in the public arena?

Guess what, I’d love to know how much the tea and toast cost and who actually paid for it.

But deep down I know of course it’s my annual subscription that pays and pays handsomely for every single item.

It goes back to that belief when we know exactly how much something costs it’s only natural that we will be more careful in how we spend our money.

Oscar Wilde has a point when he says that we know the price of everything and the value of nothing. Nevertheless, more transparency right across the medical world could prove invaluable to all of us. It might help a sense of reality prevail and allow us and the State to plan wisely for the future.