Mr. Jim Dowdall:

We still have not been furnished with detail of the Bill.

I will move on to a number of other points. Senator Crown identified correctly that there is real risk now because we are in a very vulnerable stage in terms of migrating from one system to another, and I would fully agree. The Senator mentioned a number of important matters, that there is an equitable system and we do not support inefficiencies. There is a big challenge for us. There are inefficiencies inherent in the system. I will go back to my point in terms of not being able to negotiate the cost for public hospitals. We know in many cases today that the cost of procedures in private hospitals are cheaper than the costs in public hospitals and that private hospitals are more efficient and can have much greater throughput.

Senator Crown asked is there enough attention to the skill set in the public hospitals to address this issue. I do not believe there is the experience necessary to address this or that it is being utilised to the extent that it can. The issue is that 174,000 additional members have been driven back into the public health system and demand is increasing. There is an opportunity to alleviate the demand while the public system transforms itself and we have to find a way to do that.

I will take the Senator's questions on drugs, although some of the other insurers may hold a different view. The challenge in the market is that the VHI is still a dominant player, and coming previously from a monopoly position. It is an unfortunate reality that if the VHI decides not to cover a new drug, for example, then a much smaller competitor cannot cover the cost of that high cost drug because it would then be left to take all the risk and all of those who would use that new drug. Unfortunately, one cannot do so because it would make a smaller health insurer less viable. The issue of the VHI dominance-----