To pick up on Jim's about about market vs state delivery of services, well-funded public services almost always underdeliver, and usually overwhelmingly so. For example, Irish public health expenditure, correctly measured as a percentage of modified Gross National Income, is a top spender in OECD public health spending tables. Every single year billions of euros are added to the annual public health budget and many thousands of additional staff are recruited. The staggering increases in public health spending every year indicate the desire on the part of Government to deliver strong public health services for citizens, but the system refuses to enable the provision of even adequate service. This year, the state will spend over €21 billion on public health, up €6 billion in just four years. The annual increases in Irish public health expenditure are way beyond our peers but have we noticed a demonstrable improvement in health services delivered to citizens? The Irish Fiscal Advisory Council has laid bare the facts about Irish public health provision. IFAC shows the massive spending in comparison to peers. IFAC puts Ireland in the top bracket of OECD public health spenders and concludes that "Ireland's public health spending is high relative to its peers". However, poor planning, controls and delivery by the health service mean that citizens observe and experience massive waiting lists and a litany of negative outcomes. IFAC shows that health spending in Ireland has risen quickly by international standards despite the younger age profile in our population. We now have well in excess of circa 130,000 public sector employees in our healthcare system; one in every twenty-eight adults in Ireland is employed in public health, but Ireland's citizens by and large receive poor services despite it being very well funded, largely by multinational companies and highly progressive personal taxation on higher earners. Until management and unions in the public health system truly embrace and drive the reform that is required in the provision of public health, services to citizen will continue to cost more and underdeliver. Thankfully we have private doctors, consultants, hospitals and insurance to deliver more efficient healthcare and, crucially, more effective healthcare.
Your comments and description about the facts of health spending are well made. I'm becoming increasingly interested in why facts don't appear to change many minds. I've been reading a lot on why various scientists think this is so. Maybe a topic for a written piece and/or further discussion with Jim.
I don’t disagree with what you’ve said. It’s hard to see the benefit of that extra spending in healthcare and from a position of ignorance, I cannot see the bang for our buck compared to other countries who spend less.
To play devil’s advocate on the figures quoted however; I would have to assume a lot of that health expenditure increases were swallowed up by COVID and now inflation. Bearing in mind in the eurozone medical inflation runs at around 4% above CPI, (higher in the US).
In general, I think it’s unavoidable that health will continue to suck in resources from the exchequer. Medical inflation being what it is, and an aging population placing more and more demands for the latest and more expensive treatments. Coupled of course with the elderly wielding ever more power at the ballot box in an effort to protect the unsustainable.
Sean, the IFAC and OECD comparisons I quoted are from prior to this present period of high inflation. Additionally, Ireland has continued to increase spending on health at a higher level than peers during this high inflation period. There is no devil’s advocate to be played with the fact that Ireland is at the very highest end on the range of public health spenders internationally, with poor services provided as the outcome by health managers, health professionals and staff. Unions, staff and managers are responsible for this. They need to collectively embrace reform and a private health sector mentality on personal motivation and service delivery.
ECB have caused this inflation by printing too much and for too long. there also left interest rates at 0 for over 10 years. they are miles behind the curve. Interest rates had to rise and a few quarter percents will not stop the inflation issue.
they said a few months back its was all supply chain issues, then its only transitory.
they have been proven wrong.
I believe the media have given them a soft outing for all their policy mistakes.
The eurozone monetary policy will dominate these discussions for the next while I suspect.
Spare a thought for the market response in this post free money era to having an Irish government who believes we should have defaulted on our debt in the wake of the last financial crisis. It won’t be just Italy with a very large spread over German bond rates.
In the big mistake, it does seem the ECB are on the fence. More a “follow the data” message than a Draghi style “whatever it takes”. I’ve no idea if they’ll make the policy mistake. I would be hopeful that the timing might save the eurozone from the big mistake. If the US, UK and others move first, then their recession dampens demand for energy, and the eurozone benefits.
Thanks Sean, yes, spread-watching is the name of the game. I think there is a good chance, by no means a certainty, that the ECB could be saved from themselves by falling inflation. They will then look like geniuses but, as with most things, it will be entirely fortuitous. EU inflation is currently independent of EU interest rates. EU inflation will rise, fall or stay the same, depending on world food and energy prices. EU interest rates, for the most part, are neither here nor there.
To pick up on Jim's about about market vs state delivery of services, well-funded public services almost always underdeliver, and usually overwhelmingly so. For example, Irish public health expenditure, correctly measured as a percentage of modified Gross National Income, is a top spender in OECD public health spending tables. Every single year billions of euros are added to the annual public health budget and many thousands of additional staff are recruited. The staggering increases in public health spending every year indicate the desire on the part of Government to deliver strong public health services for citizens, but the system refuses to enable the provision of even adequate service. This year, the state will spend over €21 billion on public health, up €6 billion in just four years. The annual increases in Irish public health expenditure are way beyond our peers but have we noticed a demonstrable improvement in health services delivered to citizens? The Irish Fiscal Advisory Council has laid bare the facts about Irish public health provision. IFAC shows the massive spending in comparison to peers. IFAC puts Ireland in the top bracket of OECD public health spenders and concludes that "Ireland's public health spending is high relative to its peers". However, poor planning, controls and delivery by the health service mean that citizens observe and experience massive waiting lists and a litany of negative outcomes. IFAC shows that health spending in Ireland has risen quickly by international standards despite the younger age profile in our population. We now have well in excess of circa 130,000 public sector employees in our healthcare system; one in every twenty-eight adults in Ireland is employed in public health, but Ireland's citizens by and large receive poor services despite it being very well funded, largely by multinational companies and highly progressive personal taxation on higher earners. Until management and unions in the public health system truly embrace and drive the reform that is required in the provision of public health, services to citizen will continue to cost more and underdeliver. Thankfully we have private doctors, consultants, hospitals and insurance to deliver more efficient healthcare and, crucially, more effective healthcare.
Your comments and description about the facts of health spending are well made. I'm becoming increasingly interested in why facts don't appear to change many minds. I've been reading a lot on why various scientists think this is so. Maybe a topic for a written piece and/or further discussion with Jim.
Hi Mark.
I don’t disagree with what you’ve said. It’s hard to see the benefit of that extra spending in healthcare and from a position of ignorance, I cannot see the bang for our buck compared to other countries who spend less.
To play devil’s advocate on the figures quoted however; I would have to assume a lot of that health expenditure increases were swallowed up by COVID and now inflation. Bearing in mind in the eurozone medical inflation runs at around 4% above CPI, (higher in the US).
In general, I think it’s unavoidable that health will continue to suck in resources from the exchequer. Medical inflation being what it is, and an aging population placing more and more demands for the latest and more expensive treatments. Coupled of course with the elderly wielding ever more power at the ballot box in an effort to protect the unsustainable.
Sean, the IFAC and OECD comparisons I quoted are from prior to this present period of high inflation. Additionally, Ireland has continued to increase spending on health at a higher level than peers during this high inflation period. There is no devil’s advocate to be played with the fact that Ireland is at the very highest end on the range of public health spenders internationally, with poor services provided as the outcome by health managers, health professionals and staff. Unions, staff and managers are responsible for this. They need to collectively embrace reform and a private health sector mentality on personal motivation and service delivery.
ECB have caused this inflation by printing too much and for too long. there also left interest rates at 0 for over 10 years. they are miles behind the curve. Interest rates had to rise and a few quarter percents will not stop the inflation issue.
they said a few months back its was all supply chain issues, then its only transitory.
they have been proven wrong.
I believe the media have given them a soft outing for all their policy mistakes.
Hi Lads.
The eurozone monetary policy will dominate these discussions for the next while I suspect.
Spare a thought for the market response in this post free money era to having an Irish government who believes we should have defaulted on our debt in the wake of the last financial crisis. It won’t be just Italy with a very large spread over German bond rates.
In the big mistake, it does seem the ECB are on the fence. More a “follow the data” message than a Draghi style “whatever it takes”. I’ve no idea if they’ll make the policy mistake. I would be hopeful that the timing might save the eurozone from the big mistake. If the US, UK and others move first, then their recession dampens demand for energy, and the eurozone benefits.
Thanks Sean, yes, spread-watching is the name of the game. I think there is a good chance, by no means a certainty, that the ECB could be saved from themselves by falling inflation. They will then look like geniuses but, as with most things, it will be entirely fortuitous. EU inflation is currently independent of EU interest rates. EU inflation will rise, fall or stay the same, depending on world food and energy prices. EU interest rates, for the most part, are neither here nor there.
I do hope that Chris’s guess re the interest rates is the correct one!! (From a selfish tracker mortgage holder😉)