James Reilly (Dublin North, Fine Gael) | Oireachtas source

Go raibh maith agat. The principal objective of this Bill is the general statement of policy on the line of the health insurance Acts, including the amendments to be made by the provisions of this Bill. It is an aid to interpretation of the Acts. The health insurance Acts regulate how private health insurance is provided to ensure it is available to those who choose to purchase it on a fair and equitable basis. It relates therefore to the 46% of the population who have chosen to take out private health insurance and the need for those individuals to be protected from any discrimination in that context. Insurers are free to offer products and to set prices at any level they want subject only to compliance with certain minimum benefits outlined in the regulations made under the health insurance Acts.

The principal objective sets out the purpose of the legislation and from this principle the other provisions of the Act flow. It sets out in clear terms that insurers must offer the same product at the same price for each individual who wishes to purchase it. No differentiation can be made between individuals on the basis of the status of their health, their age or their gender. Of course all residents of the State, those with or without health insurance retain eligibility at different levels for health and personal social services via the public system. The principal objective relates only to those who have chosen to avail of private health insurance cover. The issue concerning the basis on which access to health services is available, whether that is on the ability to pay or health need does not arise in this case. Therefore I reject the amendment.

The Deputy mentioned some assessments of the Dutch model of care, where there is a multi-payer system. I do not accept what the IMPACT trade union report states. Let me point out that we looked at a number of models, including the Dutch model from the point of view of the multi-payer system; the UK model from the point of view of trusts for hospitals; and the North of Ireland from the point of view of the special delivery units. We also looked at the way they ensure patient safety in Denmark and Canada. We have taken from the different systems what we feel is appropriate and best for our service to patients.

On the overlying issue, the Government's intention is to bring in insurance that is universal and available to all our citizens, so that nobody needs to worry about ability to pay as a barrier to receiving services that are based on fairness. The service is based on medical needs and not on ability to pay. It does not matter how much money one has, or whether one has a higher level of insurance cover; all one will get for the higher payments are cordon bleu cooking and five star hotel accommodation. One will not get a colonoscopy or a hernia repaired more quickly. That is critically important but it is not relevant to this Bill.

I am not in a position to accept the Deputy's amendment.