Ireland
This chapter provides an extended look at health politics and the largely tax-financed health system in Ireland. It traces the historical development of the Irish healthcare system, characterized by the institutionalization of a health service that obliged and incentivized the middle classes to pay for their healthcare, out-of-pocket or through voluntary private health insurance. Since the late 1980s, the hospital sector has become more privatized, while universal coverage has been partially introduced to the primary sector. While center-right government legislation which institutionalized the treatment of private patients in public hospitals elicited strong parliamentary opposition from across the political spectrum, the fiscal incentivization of private hospital development, introduced by a center-right coalition, was subject to little debate. The most significant turning point in healthcare policy since 1989 has been the removal of means-testing and provision of free general practitioner care to the under-6s and the over-70s. Cross-party consensus on a plan to move towards a universal tax-based healthcare system was reached in 2017.