Gerry Adams’ ‘health tourism’ raises more questions than it answers…

So Gerry Adams is getting to that stage of life where health becomes an issue. Early sixties can be a tough time for men, and in the last few months, he’s had two minor procedures. What makes both news is that neither of them were conducted in the Republic, and they raise more questions than answers.

For instance, as Fiach Kelly reports:

The party says Mr Adams, who insists he only takes home the average industrial wage of €33,000, paid for the procedure out of his own pocket. A spokesman said Mr Adams had been advised the procedure was best carried out in New York. When asked if the procedure could not be carried out by the HSE or the National Health Service (NHS) in the North, a spokesman for Mr Adams said: “That’s a matter for Gerry and not for me.”

Now this happened in the summertime, several months before Mr Adams went north to get a procedure on his eyes (which led later to some risible remarks in another place). Mr Adams took the trouble to clarify the matter of whether he could (as a resident of the Republic) avail of NHS treatment in a couple of questions to the Dail:

694. Deputy Gerry Adams asked the Minister for Health if patients making E112 applications are being refused due to a lack of funds to pay for treatment abroad.

695. Deputy Gerry Adams asked the Minister for Health if he will instruct the Health Service Executive treatment abroad scheme office to accept statements from consultants in hospitals here that state clearly that an applicants required treatment is not available here. [52828/12]

The Minister’s answer was pretty unequivocal:

Applications to the scheme are only accepted on the basis of referral from an Irish based consultant and not self referrals, referral from a G.P. or by way of a consultant/hospital outside the state requesting the return of a patient. Patients must be clinically assessed prior to referral and application to the HSE TAS for treatment abroad. [Emphasis added]

So, we might then presume that if Mr Adams was able to access NHS treatment through a GP referral the GP in question must have been in the north, which would suggest that either Mr Adams is still domiciled in Northern Ireland, or the waiting list for his eye condition is over 18 months old.

It’s not something neither Mr Adams or the party seems keen to talk about.

Which brings us back to his laser surgery for a prostate problem in New York. Any patient in Louth would end up being referred for a procedure in either the Beaumont or Mater Hospitals in Dublin. It’s not clear what the waiting time is, but in Northern Ireland there is effectively no waiting list.

What we’re told is that Friends of Sinn Fein in the US paid for his trip to New York (they cannot send money ‘home’ in any case), on party business they say. That he had the procedure and paid for it out of his own pocket. And that he stayed with friends in Manhattan for the length of his recovery.

It ought to be noted that prostate conditions are as common and serious a concern in men’s health as breast cancer is amongst women. But the issue here is one of policy. It’s part of Sinn Fein’s platform that

Public money is being used to subsidize private sector residential beds. The policy of the last government and of this is to encourage the privatisation of the health service…

Except that in the states health care costs are notoriously high (which is one of the problems President Obama has been trying to tackle with his health care reforms). One recent survey put it at twice the rate of the UK:

The U.S. spent about $7,000 per capita in 2008 on health care. Peer countries, like Japan and the U.K., spend about half that amount and achieve equally good results, as measured, for example, by life expectancy at birth.

Todd Hixon writing in Forbes magazine last March offered several explanations, but most notably this one that the high costs in the US…

…are driven by both higher per-procedure rates paid by both public and private payers, and larger proportion of higher-paying private payers in the U.S.

Quite. It would be useful to know if there were mitigating circumstances to this. Why forgo the opportunity to have NHS treatment in Belfast almost as a matter of course, and chose to pay for a US procedure.

In the absence of any clarification from either Mr Adams or his party, it is hardly a ringing endorsement of the public health care systems on either side of the border.

Update: Ed Moloney is reporting on his blog that having rung a local clinic in NYC they put the price of the operation… (ie, the normal cost of such a procedure would be to anyone in his type of situation, i.e. a foreigner with no local health insurance) At $30,000

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