Standing on the side of an Austrian mountain, there was feeling of pain in my chest, a pinching, pressing sensation. Pausing until it had passed, I skied on and said nothing, but felt it needed a doctor’s opinion.

Having already an appointment with a GP back in Ireland at 9 am on the following Monday morning, there was a ready made opportunity to casually ask what it might be. Following his comment upon the results of my blood pressure and cholesterol tests, I said, ‘Oh, by the way, I had a bit of pain in my chest last week’.

A cardiac stress test was arranged for the Wednesday afternoon, it did not go well. Two hours after the stress test, I was sat in the consulting room of a cardiologist. The following day, at three o’clock on the Thursday afternoon, I checked into a private Dublin hospital to have an angiogram that evening. The diagnosis was a build up of cholesterol that should be dispersed with medication.

It was an extraordinary level of health care – at a price. The GP appointment was €50, the stress test €150, and the consultant appointment €180. The consultant’s secretary advised that I clear the visit to the private hospital with my insurer. The pleasant man at the insurance company said, ‘Oh, that’s a high-tech hospital. I’ll have to check’. It was a couple of minutes before he responded to say that I would be covered, though advised there would be an excess payable of €125. The total for the week was €505, plus €80 for prescriptions, plus, of course, the cost of the insurance premiums that provided the chance to attend the hospital.

Opening the renewal notice from our health insurer, there was a sharp intake of breath: our annual premium had risen from €2,320 to €3,425, an increase of 48%. Much of the increase was due to the reduction of the upper age of cover for students from 23 to 21, taking the premium payable for our 22 year old student son from €478 to €982.

Is there a choice other than finding the extra money?

There is a public health system, but anyone who remembers the story of Kilkenny woman Susie Long will know how weak it was, and that was in the boom years. In October 2007, then Taoiseach Bertie Ahern admitted that the health system had failed. In a Dail debate on the case, then Opposition leader Enda Kenny accused the government of being engaged in a frenzy of closing services and stated there was a disconnect between the Government’s claims regarding the health service and what people experienced.

The health service’s failure of Susie Long came at the very peak of Ireland’s years of wealth. After the banking collapse, the IMF bailout of a bankrupt nation, the years of austerity programmes, the resources available in 2013 are considerably less than those six years ago. Anyone working in public health care can tell numerous tales of cuts in services. There is simply not the capacity in public facilities to deal with the country’s health care requirements.

In an ideal world, private health insurance would be an unnecessary luxury; Ireland is not part of an ideal world.