Mr. Jim Dowdall:

If I am not responding correctly to the Chairman's question, I will try again.

There is an opportunity to redistribute VHI customers and have a look at redistributing equal proportions of the company's book. That would create the paradigm shift to which I referred earlier to a competitive market, which is essential to ensuring we have affordable health insurance in the long term.

The issue currently is the health insurance levy, which has increased annually over the past five years, has driven up the cost of health insurance. We need to call a halt to that now. I suggest we strongly look at, as Deputy Creighton said, the report from Goodbodys and find ways to structurally change this market in order that it is viable and sustainable in the long term and there is an opportunity to do that. That will address VHI's issue in terms of having a predominance of older people in the market.

Deputy McNamara asked what we are doing to force costs down. GloHealth negotiates with all the private hospitals on an ongoing basis and we find ways to keep our costs competitive. The one entity we cannot negotiate with is the public health system, for which rates are set unilaterally by the Minister for Health and we have no ability to take those costs down. In many cases, it is more expensive to get some treatments carried out in the public health system than in the private health system. We would welcome the opportunity to negotiate with public hospitals to ensure we have competitive rates. That would make a significant difference in the market.

Deputy Creighton asked how we will get people back into the health insurance market, which is critical for universal health insurance. We have lifetime community rating. VHI referred to the opportunity to introduce discounts for younger people. We need to look urgently at those mechanics and find ways to encourage younger people to enter the market but the critical issue that needs to be addressed is the affordability challenge. If we can find ways to make health insurance affordable, we will encourage people back into the market, which will deliver a huge benefit for the older and sicker people who pay higher prices for their health insurance than they need to.