Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

Members will hold different opinions on how to fund our health services and provide equality of access based on need as opposed to financial means. We could be accused of having establishing a two-tier health system, in that there is private health insurance and a publicly funded system. Until we reach the point that the Minister is aiming for, though, funding health services will pose a major difficulty. Nothing in the Bill provides me with confidence about what we will try to do or, rather, what the Minister will try to do, as I do not fully support the idea of universal health insurance in the form that he has proposed. The White Paper remains to be published and I would have expected a broad discussion on that to be critical. This is not just a policy shift. Rather, it is a major Government decision. The Minister claims that he has a mandate to do so, but the difficulty is that universal health insurance will cost money and the Government does not have a magical funding system.

The market for private health insurance is diminishing, since even those who are taking out private health insurance and funding the sector are only doing so under considerable stress. Inter-generational solidarity, community rating or risk equalisation, whatever one wants to call it, is falling on the shoulders of fewer people. While this continues to be the case, insurers will increase their premia. It is a vicious circle. Does any provision in the Bill ensure that there will be no inflationary pressures on health premia over and above the norm? A diminishing pool of people are funding inter-generational solidarity. If the insurance market collapses because people exit the system or reduce their coverage, from where will the Minister get the inter-generational solidarity fund to support those who need it most? Section 2, the critical component in terms of risk equalisation and amending the principal Act, contains no provision in this regard.