Denis Naughten (Roscommon-South Leitrim, Independent) | Oireachtas source

I will make two points. The Minister is correct, in that a great deal of unnecessary cost seems to be built into the health insurance system. I will provide three brief examples. Caesarean sections account for 36% of all privately insured births. In the public system, the figure is 27%. The HSE's target is 20%. There is a major cost in this regard. In the UK, most cataract operations are done under local anaesthetic. In Ireland, we are still using general anaesthetic. Similarly, many hip replacements are being carried out under general anaesthetic. These types of costs must be removed from the system.

The Health Insurance Authority, HIA, which appeared before the committee recently, has a responsibility. We must examine its role in encouraging older people to consider their levels of cover and insurers. Approximately 50% of people and the majority of older people are on the wrong health insurance schemes because they have not altered them over the years. Anyone who has been on a scheme for the past ten or 15 years and has not reviewed it is probably paying significantly more than should be the case. Naturally, older people are risk averse and are not prepared to change their schemes or insurers. The HIA has a responsibility to drive this discussion and encourage people to examine their policies. It has a kitty of €8 million, a small portion of which could surely be used to work with Age Action and other organisations in driving an effective information campaign targeted at the group in question. If older people shop around and drive down the cost, it will reduce the overall cost of the health insurance levy and risk equalisation. Young couples are subsidising this inefficiency, overcoverage and overpayment of premia.