Brendan Smith (Cavan-Monaghan, Fianna Fail) | Oireachtas source

I am not suggesting that. I suggest that at times people are concerned about a change in the particular drug they take.

The 2010 Dutch Health Care Performance Report discusses the fact that insurance companies mainly compete to limit the cost of health care services, with quality of care being of limited influence. This is a worrying feature of an insurance company-dominated health service. These are not the only issues with the Dutch model but couple these problems with major questions about how the system would be financed and how much extra burden would fall on individual patients and one must ask oneself whether this is really the right model for us to follow.

This is the question Fianna Fáil asked approximately one year ago when Dr. Brian Turner, an economist in University College Cork, prepared an independent assessment for us on what universal health insurance would mean for our citizens. In his report, Dr. Turner concluded it is far from clear the introduction of universal health insurance, as envisaged by the Minister, Deputy Reilly, would be of benefit to the Irish health system.

He went further, and stated, "There is simply insufficient evidence from international systems to suggest a change in the funding mechanism would produce benefits sufficient to justify the disruption that such a change would cause, and indeed there is some evidence to suggest that such a move would lead to higher costs for the Irish public without significant improvements in health outcomes."

Like all of us, he supports the goals of creating a single-tier health system, removing financial barriers to accessing GP services and reducing waiting times for hospital treatment but, like Fianna Fáil, he fears that what the Minister proposes will not alone fail to achieve these objectives but that radically redesigning the funding mechanism would entail additional costs. This fear of massive additional costs would seem to be borne out by estimates from the Department of Public Expenditure and Reform that this new charge could cost up to €1,600 a year per person.

According to the White Paper we are discussing, every member of the population will purchase a universal health insurance policy from his or her preferred insurer and this policy will provide cover for a comprehensive package of health care services. The package or basket of services is not outlined in the White Paper. It will be the subject of consultation. Neither are their costs as these will not be provided this year. The White Paper states that over the coming 12 months the Department will undertake a major costing exercise to ensure a full and comprehensive analysis of the estimated costs involved is available. However, the Minister, Deputy Reilly, claims we cannot know the costs because we do not know the tax rates which will prevail in 2019. This is fairly clear to all of us.

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