infosantésuisse : Dossier Die europäischen Gesundheitssysteme im Vergleich 1/2010 281 Annex: summaries of health care financing by Member State 153
and ophthalmic services, although some help for these costs may be available via the “Treatment Benefits” scheme. In 2005 the Government introduced a new means-tested GP Visit Card to provide free access to GP services. The income threshold for this card is 50% higher than the threshold for Medical Cards. Private health insurance covers just over half the population. It plays a mixed supplementary and complementary role, offering faster access to care, as well as access to private sector care, reimbursement of inpatient cost sharing and (limited) reimbursement of outpatient cost sharing. Collection of funds
The health system in Ireland is mainly funded through general taxation and progressive earmarked health contributions (see Fig. A26). Health contributions are levied on earnings (2.0% on earnings under €100 000 and 2.5% on earnings above this level). Medical Card holders and other low-income individuals are exempt from making health contributions. General taxation and health contributions account for approximately 70% and 10% of total expenditure on health, respectively. Private health insurance is sold by three companies and the market is heavily regulated. Insurers are obliged to offer open enrolment (up to age 65), lifetime cover, community rating (for a given level of benefits) and minimum benefits. They are also required to make financial transfers under a risk-equalization scheme activated in 2006. Pooling
General taxation and earnings-related health contributions are collected by the Department of Finance and transferred to the Health Service Executive (HSE) and the National Treatment Purchase Fund (NTPF; established in 2002 to address hospital waiting times). The health budget is voted for by the parliament annually. Purchasing health services
The HSE and NTPF contract with providers and hospitals. The health budget is largely determined based on historical allocations, with fixed allocations made to public and voluntary hospitals. In some hospitals, however, resource allocation is adjusted according to case mix and activity volume. The NTPF is available to all patients who have been waiting for treatment for three months or more. Provider payment
Public GPs are paid according to a fee schedule mainly based on weighted capitation, with supplementary fees for special services such as out-of-hours home visits or influenza vaccinations. Private GPs are paid on a FFS basis. Hospital-