Alternative approaches to achieving universal healthcare -potential costs, outcomes and challenges

For the first time in Ireland there is cross-party political interest in achieving universal healthcare (UHC); however there is little clarity about the meaning of universality or how best to transition from the current Irish system to one of universality. In Ireland, most people currently pay relatively high fees to visit general practitioners; while those without private health insurance can face long waits for hospital care.

The aim of the proposed research is to identify alternative approaches to achieving UHC in Ireland and elsewhere and to assess potential costs, outcomes and challenges in such approaches. This will be achieved through three work packages, in which Ireland will be examined as a case study. The health systems in Northern Ireland and Germany, two universal healthcare systems, will be examined for comparative purposes.

Work package 1 will identify the prevailing definitions and reasons for UHC as well as frameworks to measure universality. Building on this, the primary care and hospital sectors in Ireland will be examined in order to identify features which are potential barriers to universality. Work package 2 will quantify the potential costs and selected outcomes, such as improved access, of alternative approaches to achieving UHC. Building on work package 1 and using estimates identified from the international literature, methodologies will be developed to identify the potential costs and outcomes from alternative system design features. Work package 3 will identify implementation challenges (in particular capacity and cost control) that could arise for a country which moves towards UHC and will examine and assess those challenges.

It is envisaged that the proposed research will provide an evidence base for policy makers seeking to identify the most appropriate method for achieving UHC in Ireland and elsewhere.


Award Date
29 June 2017
Award Value
Principal Investigator
Dr Maev-Ann Wren
Host Institution
Economic and Social Research Institute
Investigator Led Projects