I had set my sights on studying in Ireland to see firsthand how another country took on major health reform, hoping it might provide a powerful example for the American health system. Just a year before I arrived, Ireland’s parliament (known as the Oireachtas) passed a plan for the future of healthcare. Known as Sláintecare (sláinte is the Irish word for health), the reforms would provide universal access to all kinds of health services for all Irish people, at no cost to them.
When I attended a September meeting on the future of Irish health reform hosted by Trinity College Dublin, one of the Sláintecare architects mentioned how challenging it had been to reach cross-party consensus on what universal healthcare in Ireland would look like, how universal it would be, and how it should be financed. My ears perked up when Trinity health policy researcher Dr. Sara Burke remarked that the Sláintecare committee members often used the George Mitchell model for reaching consensus. She spoke of bringing the group back to the core values agreed upon at the beginning of the process in order to bridge any divides and keep the work focused on the end goal: providing better healthcare access and services to the Irish people.
As I work on research on Irish health reform with some bright minds from the Oireachtas Committee on Health, I am struck by the similarities of the barriers to reforming both the Irish and US healthcare systems. Both have entrenched public-private systems, where the public system is left underfunded in comparison to the private health care industry, where those with means can pay for quicker access to care, and sometimes better care.
One key difference, however, is that Ireland has decided that the status quo is no longer acceptable, and all Irish people should have access to “universal, single-tier health services where patients are treated on the basis of health need, not ability to pay.” In the US, the health system is a common topic of debate, but I believe we will see no real progress in achieving meaningful health reform until there is widespread agreement that all Americans should be able to access high-quality, low-cost healthcare, regardless of income, race, or background. Perhaps the US should draw on the George Mitchell principles as well – not for crafting a Good Friday Agreement, but rather, for coming to consensus on our values and how we will keep our nation healthy for generations to come.
With an idea for the future of healthcare in place, Ireland now wrestles with how to fund such an ambitious plan. It will be no easy task, but hopefully consensus-building and critical policy analysis can be coupled in order to realize the goal of providing care for all Irish people. I continue to be daunted by just how complex healthcare can be, but my time in Ireland has strengthened my resolve to return to the US and continue working for a health system that serves all Americans.