The shock that the 1.3 million VHI subscribers felt when they learned the scale of the price rises for health insurance cover is turning to real anger.

There is anger, of course, at the magnitude of the rise and the fact that it hits older people particularly forcefully, a direct contravention within the VHI itself of this government's own health insurance strategy of community rating in which the strong support the weak.

There was no sign whatsoever of that policy underpinning the VHI's attitude to the 600,000-odd older customers who make up the greater membership of Plan B and Plan B Options who were effectively shown the door with a brutal 45% increase. A health insurance policy that was just about affordable last week has now gone into the stratosphere in terms of family budgeting.

But there is also rage at the lack of any meaningful explanation from either the VHI itself, or from the government, about why hammering vulnerable older middle-class people was the only option open to the semi-state insurer as it strives to build its capital base before it is sold off.

Only last July, chief executive Jimmy Tolan (salary €412,000, some €160,000 above the €250,000 set by Brian Lenihan for semi-state chief executives in the budget) was predicting that increases would be of the order of 6-8% over the next 10 years. What suddenly changed?

The VHI's announcement has devastated a huge number of households, but it is the behaviour of Mary Harney herself that has left the country appalled. The Dáil rose for its Christmas break on 16 December. It is not back until this Wednesday, 12 January. Is it too much to expect that the minister organises her holiday so that she is at her departmental desk in time to deal with this announcement and give hundreds of thousands of extremely worried people some direction? The politicians' Christmas holidays are already very generous by every other country's standards. It was surely within Harney's power to book hers so that it did not clash with a time period that is notorious for health service mayhem.

She would have known from previous experience that last week would prove a difficult one for accident and emergency departments. The rise in swine flu cases was entirely predictable.

If the minister knew that, as well as these crises, the VHI announcement was planned for last week, it speaks volumes of her arrogance that she chose to be out of the country at this time.

This government has made much of its desire to complete the unfinished business of the Finance Bill and other "urgent", mostly Green, legislation before the election is called in March. But if they want to hang on, then they should govern effectively. Instead, as minister after minister announces his lucrative retirement, they are succeeding only in feeding the perception that most of the cabinet have already mentally signed off, effectively leaving this country on auto- pilot for three months.

Harney's absence is unacceptable, the more so given the stress people are already under. Last week, unemployment figures went up another 5,200. A rake of further relatively small-scale job losses hit the news, including the loss of Celtic Bookmakers and a large Super­quinn store. People are only just coming to terms with the impact of higher taxes and the new universal levy (supposedly to support our dysfunctional health service) in their pay packets, though most won't find out for sure just how badly they will be hit until the end of the month. Transaction charges at Bank of Ireland are going up and even though we own over 95% of the institution, the minister for finance insists he can't interfere. Further mortgage increases are inevitable for those not on tracker packages. Other financial landmines are strewn across the 2011 landscape.

People hoping that the new year might mark a tiny improvement in the economic depression we are living under have been shaken to the core by this VHI announcement.

Yet the minister's only pronouncement ? from a luxury 5-star hotel in Thailand ? is to advise people to shop around.

To tell people they are free to change when they have paid into the VHI all their lives is to completely misread the motivation behind their sticking with the semi-state insurer in the first place. The massive number who pay for private health insurance is and always has been a measure of the working citizen's complete and utter lack of confidence in the public health system.

The fate of the late Susie Long serves as a very recent reminder of just how badly public patients are treated. The scandal over the GPs' letters of referral to clinics lying unopened for months in Tallaght hospital was another reminder of the contempt with which public patients are regarded in terms of access to public diagnostic services. The record numbers in A& E – the only point where public and private meet in the health care system – and the chaos that reigns there, underscores how incapable the system is of coping when private insurance is taken out of the equation.

If Mary Harney, who won't be minister for health in four months, can't be bothered to be here to manage any of this, perhaps it would be better that she go now.