Róisín Shortall (Dublin North West, Independent) | Oireachtas source

I agree with Deputy Michael McGrath. This is a ticking time bomb. Vast numbers of people are leaving private health insurance or downgrading their cover and it is not sustainable. We have come very close to a tipping point and action is required. While we all subscribe to the principle of community rating and risk equalisation, the fact is that the system will collapse unless there is a dramatic change in the model of care. To suggest that the introduction of universal health insurance will address the problem is incorrect. In Holland, when universal health insurance was introduced, costs went through the roof. There must be a cost containment policy and the model of care must be switched so that the bulk of health care is provided at primary level. The programme for Government provides for that but, unfortunately, it has not happened yet. I accept the Minister of State's point that these are serious policy matters for the Minister for Health.

A side issue in the section relates to concerns that have been expressed by the health insurance industry about potential unintended consequences of the legislation. There is an amendment to section 125(a) of the Stamp Duties Consolidation Act, subsections (10) and (11) of which provide that people can be required to pay a levy only once per calendar year. There is a concern that an unintended consequence of the legislation may be that a levy will have to be paid by a person any time he or she changes his or her cover. People are being encouraged to shop around, and to switch if it is to their benefit, but the concern is that on switching they may be required to pay a new levy. Industry representatives have been in touch with the Departments of Finance and Health, both of which have been very helpful in this regard and suggested that guidelines could issue to ensure this unintended consequence does not occur. However, it would comfort the industry if the Minister were to commit on the record to issuing those guidelines.