Mr. John O'Dwyer:

Senator Crown referred to smoking. My understanding is that we cannot in any way risk rate smoking. According to the current rules, that would be illegal. I am mildly asthmatic, so I do not like smoking. If it were capable of being implemented, I could not see it causing too much harm. It is difficult to implement. Conceptually, it is good but implementation is difficult. In life assurance, most people can be called for a medical examination. In health insurance, we do not have that cost. One wonders, therefore, which would be good. Conceptually, I fully agree with the Senator.

Senator Colm Burke referred to lengths of stay. In the context of Ireland's level of efficiency, an international report compiled a number of years ago showed that this country was lower than average in the context of lengths of stay. Lengths of stay for VHI customers are, on average, six days. In private hospitals, the length of stay is five days. In public hospitals, it is just over seven days. The Senator inquired as to which model is more cost-effective. There are per diem rates in respect of private patients in public hospitals. If a person who has had a hip replacement is released from a public hospital within a few days, it can, in comparison to the position with a private hospital, benefit the insurer. We do not have any negotiating power in the context of certainty. As stated earlier, we have a fixed-price package in respect of private hospitals. We pay a certain amount of money and it is clear there is no confusion. In the context of public hospitals, we do not enjoy that certainty.