MY WIFE’S BROTHER, Gavin, is a fairly chilled-out sort of person. Our conversations are mostly about football or history podcasts. One of the family’s favourite anecdotes describes how, when Gavin was five years old, he was dismayed to be told that they were all going on a day trip: “ugh, no – you and Dad are just gonna talk about boring adult stuff.”

He made a disgusted face. “Like insurance.”

This is an article about insurance. If you are five, you can tune out now. Specifically, this is an article about health insurance – why health insurance premiums are going up for Irish customers, and why our mixed model of healthcare financing means they’re almost guaranteed to continue doing so.

Ireland’s health system is complex and highly unusual. We operate a mixed financing model, which combines State-funded services, out-of-pocket costs, and, for about half of the public, increasingly expensive private health insurance to supplement what we already pay for. We are used to this, but it is not the norm elsewhere. Put simply, most countries do it one way or the other: you pay tax, or you pay for insurance. I believe that our system combines the disadvantages of both with the advantages of neither. What we get in return is inefficient, unfair and unsustainable.

In 1946, the constitution of the World Health Organization declared that “the highest attainable standard of health is one of the fundamental rights of every human being”. Most national health systems are based on the idea that healthcare is something everybody should have. There are different ways to achieve a universal health system. However, for any of them to work, you need to pick one and stick with it.

The United Kingdom and Scandinavian countries run their system on tax, often called the Beveridge Model, after the economist whose proposals formed the basis of the British welfare state. The deal is that the government keeps a chunk of your money, in tax, and in return, health services are free or close to free. Some people take out private health insurance, but most do not see the need.

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The second main way to finance universal healthcare is........

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