Sir, – The Health in Ireland report, 2025, published this week, highlighting Ireland as having the highest self-perceived health status in the European Union demands critical scrutiny. While official reports show that almost 80 per cent of Irish adults rate their health as “good” or “very good,” we must not confuse subjective cultural optimism with a robust, accessible healthcare system. In reality, this statistic creates a false narrative that obscures systemic barriers to preventive medicine.As an Irish person living abroad, I see this contrast clearly. The country I now inhabit, Italy, has its own distinct problems across many fundamental pillars of society. However, healthcare here is genuinely considered a non-negotiable priority for the general population – a stark difference from the reality at home.Unlike many European peers, Ireland treats primary care as a private commodity rather than a tax-funded right. Citizens without a medical card face out-of-pocket GP fees often exceeding €60 to €80 per visit. This financial friction naturally deters people from seeking professional help at the earliest onset of an illness. Systemically, Ireland also lacks a culture of proactive, preventive medicine. Routine screening tools, such as annual baseline blood tests, are not systematically subsidised or encouraged for healthy adults in the public system. Proactive diagnostics are largely restricted to those who can afford private clinics or corporate wellness packages.When basic healthcare requires direct payment, individuals are disincentivised from seeking care until minor symptoms escalate into critical issues. Our high self-perceived health rating likely reflects cultural stoicism and a system that keeps people away from doctors, rather than a genuinely healthy population. If we want a truly healthy society, our policymakers must move past misleading self-assessments and fund a universal, preventive primary care system that matches our European neighbours. – Yours, etc,LISA KELLEHER,10060 (Torino),Italy.