Austerity measures have resulted in an erosion of universality in many European countries. The Irish healthcare system is unusual within Europe in not providing universal access to primary care; while there are long waits in the public system for hospital services. For the first time in Ireland there appears to be broad political support for achieving universal healthcare (UHC); however there is little clarity about how to transition from the current system to one of universality.
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. A comparative context will be developed by reference to the international literature and by examination of the systems in Northern Ireland and Germany, countries with tax-financed and social-insurance financed approaches to delivering UHC.
Work package 1 will identify the prevailing definitions and rationales for UHC as well as frameworks to measure universality. A sector-specific analysis of Ireland’s healthcare system will be undertaken to identify which features of the primary and hospital care systems are potential barriers to universality. Work package 2, building onwork package 1 and using estimates identified from the literature, willdevelop methodologies to identify the potential cost and selected outcomes, such as improved access, associated with alternative approaches to achieving UHC. 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.
