Mr. John O'Dwyer:

On behalf of VHI, I am very pleased to have the opportunity to talk about our ideas on universal health insurance. We fully support universal health insurance, which probably represents the single biggest change in the area of health in this country in decades. We are committed to playing our part in the successful implementation. We sent the committee a letter with slides giving more detail. I will pick a few key points from those slides.

We believe the key objective of universal health insurance is to get away from the two-tier system and have a one-tier system with equal access to our health care system for all citizens. We need to have an efficient high quality health care system that rewards good outcomes. For universal health insurance to work many things must be in place and I will highlight three. The annual budget concept that takes place in many of our public hospitals must stop. The Minister has mentioned many times that the money must follow the patient. Patient activity and the outcomes for those patients must define where the money goes.

There must be competition between providers. Clearly we believe there must be very tight rules in the marketplace to ensure there are no incentives for risk selection. We all believe in community rating; it is Government policy. For community rating to work we must have good goalkeepers and good policing, which means a very comprehensive risk-equalisation scheme.

I joined the VHI a few months ago and-----