Mr. Jim Dowdall:

It is a reality in the market. It is not a cartel. The issue is that there is a dominant player which sets the pricing in the market and there is a challenge. The other insurers find it difficult to negotiate with the private hospital providers and get rates that are comparable to a VHI rate because it has that dominant procurement effect.

There were a couple of points raised by Deputy Naughten. He asked would we cover all public hospitals. The same point applies. One potential issue is that in some cases the cost of the public hospitals is increasing and they may become much more costly than the cost of private hospitals. At present, all public hospitals are covered. If we see a continuation of the recent increases, it is questionable whether that is sustainable in the future.

On the issue of 200 people a day leaving, Deputy Naughten is correct that we need to find a way to correct that slide. The principal objective of the Health Insurance (Amendment) Bill 2012 should not be designed to prevent health insurers from attracting new members into the market or to restrict innovation. There are ways that we can drive more innovation in the market but the Bill is shaped to try to curtail that, and that does not make sense.

Deputy Naughten's last question related to smoking. Of course, there are opportunities to change our approach here and encourage people to take a healthier outlook on life. We believe there are. I do not think they are being considered. On lifetime community rating, the answer we received was that it was complicated. It has been complicated for many years. It is time to move this on and start implementing some of these mechanics that will make this much more viable and sensible.

I hope I addressed the questions raised.