Ireland’s two-tier health insurance system
Question
How do you get pre-existing conditions and waiting periods waived when getting health insurance from Vhi in Ireland?
Answer:
You start working at a multi-billion dollar American Big Tech company like VMWare.
We’re all equal…
In Ireland, we are told that by law everyone has access to the same health insurance plans, including company plans negotiated by Big Tech and other multinationals.
In reality, however, we have a two-tier system where the gentry who work at our Silicon Valley corporate overlords don’t have to put up with petty annoyances like waiting periods or pre-existing conditions while the rest of us hoi polloi do.
So, I can sign up for the same PMI 18 11 plan a VMWare employee can sign up for but with one crucial difference: the VMWare employee doesn’t have pre-existing conditions or waiting periods to worry about as they’re both waived.
…but some are more equal than others.
I first noticed this when, overwhelmed by trying to get my head around the sheer number of cryptic company plans, I started procrastinating by researching which companies they belonged to.
Using search engines, I was only able to uncover two: PayPal and VMWare. But it was on the VMWare healthcare benefits page (archive.org backup)1 that I came across the following blurb:
Waiting Periods & Pre-Existing Conditions
Pre-existing conditions and waiting periods have been waived which provides you and your eligible dependents with coverage from your enrolment under the Company policy.
So I called Vhi’s group memberships team that deals with corporate accounts to find out how the two of us working on Small Tech for the common good at our tiny two-person not-for-profit could get the same deal as folks working to increase the profits of a multi-billion dollar US Big Tech company.
The answer, in short, was “you can’t.”
With apologies to Orwell, I basically learned that we’re all equal but that some of us are more equal than others.
What follows is a transcript of the relevant parts of that call2, the most poignant moment of which was hearing the lovely person I was talking to express her resignation that nothing’s perfect and life’s not fair.
I truly hope, from the bottom of my heart, that we do whatever is in our power to change that. Because it doesn’t have to be that way.
We created this messed-up world.
We can create a better one.
Transcript
Me:
VMware, for example, has waiting periods and pre-existing conditions waived on their plan so how would we add something like that to ours?
Vhi representative:
I’ll be honest, Aral, it wouldn’t normally be a concession that we would give to, say, members in general. It may be a concession that we give but it depends really, to be honest, on when we’re negotiating with the group, per se, it’s not something that we would normally give on an individual basis, to be honest, so in terms of [inaudible] joining
Me:
Right, ’cos I thought you said that by law you’re required to give the same terms…
Vhi representative:
We are required to give you the same offer of cover, which is the element of cover, in terms of, say, whether we give concessions in joining and, even if we have corporates, you know what I mean, we might still have a corporate group scheme… it isn’t always a given that you would get concessions unfortunately, Aral.
Me:
Right, but I mean it’s not necessarily the same plan then, is it? If, for example, I have to wait – I don’t know how long, is it 26 weeks? – but someone at VMware doesn’t have to wait 26 weeks… that doesn’t really sound like the same plan. Does that make sense?
Vhi representative:
I hear what you’re saying and I do know what you’re looking for but unfortunately in terms of, say, our offer like absolutely… um… this is I suppose where we stand; that it’s not a concession that we would always give… it’s not a concession that is maybe given all the time… I do hear what you’re saying about particularly maybe VMware and maybe that’s been an experience, perhaps, I’m not sure but in general it’s not always a given.
Me:
Okay, so basically, like, if you do want to have no waiting periods you really do need to be working for like a multinational American company of some sort of like a Big Tech company, is that correct?
Vhi representative:
[pause] I can’t say when we might give that, you know what I mean, as I said…
Me:
[interjecting] Right,so I can’t pay you any amount of money to…
Vhi representative:
[laughing] No… there’s a set price on the policy… we can’t, you know what I mean, we’re not gonna be changing it up to, you know, that is where you get into the realm of, say, I suppose… I suppose… it’s the opposite of community rating, you might say, you know what I mean. It’s risk rating, you know what I mean… and you’re paying extra to reduce the risk, you know what I mean, it’s not risk rating.
Me:
Right… so, I mean, it’s just not even an option for an everyday person?
Vhi representative:
It isn’t.
Me:
No.
Vhi representative:
It isn’t an option in terms [inaudible] cover, unfortunately.
Me:
Okay, all right, well that’s good to know… that’s good to know, alright… well I will… thank you for your time, I’ll definitely review the programmes that you have… the various options…
It is interesting, though, I mean it does kind of create a two-tier system doesn’t it? I mean, I guess… are you are you Irish? Do you live in Ireland?
Vhi representative:
I do live in Ireland, yes [small laugh]
Me:
Yeah, how do you feel?…
Vhi representative:
And I am aware of the… I’m, well… it’s not so much how I feel, you know what I mean, because obviously I just have to respect that I work here. These are the rules that we go by…
Me:
Of course, of course, yeah… but I mean just as a human being, like, how do you feel about that living here? Like that, someone who works for a US corporation has almost more rights…?
Vhi representative:
[pause]
I… you know, to be honest, in life there’s nothing perfect and there’s nothing fair…
Me:
[laughs] …that’s true…
Vhi representative:
…and, you know what I mean, that’s going to be, you know, it’s “how long is a piece of string?” is the answer to that, you know what I mean… so where do we start and where do we stop?
Me:
Indeed, indeed… well thank you so much for your time… I will review the plans, I guess we’ll have to sign up with one of them after all… And, yeah, but thank you, it’s been enlightening.
Vhi representative:
Okay, Aral, nice to speak with you today and thank you for your call.
Me:
Likewise… yep, take care
Vhi representative:
Have a great day.
Me
You too.
Vhi representative:
Bye-bye.