John Gormley (Dublin South East, Green Party)

I am sharing my time with Deputy Ó Snodaigh and Deputy Connolly.

This is a complete mess and not the way to legislate. I was in my constituency this evening trying to explain to people the reason for Government confusion about the proposed incinerator when I received a telephone call. I now see its confusion about this issue. Has so-called competition worked? It was suggested that when VHI had a monopoly, prices were much higher. However, in the past six years premiums have increased substantially, by up to 80%. Competition has not worked. In the Canadian model there is a natural monopoly, with one insurer providing universal health insurance. Surely, that is a model we need to examine. If there are a number of insurance companies in the market, we need the community rating model, with risk equalisation. However, what model of risk equalisation is the Minister talking about? Various models have been brought forward. Mr. Seán Barrett and even representatives of BUPA have spoken about sharing the patient load proportionately to ensure every single insurance company has the same proportion of high risk patients.

Under EU directives, one company can have a monopoly if there is universal health insurance. We know VHI is trying to increase its reserves as it is fattening itself up for privatisation at some future date. What we have is false competition. There is no real competition in the market. The bottom line is what is best for the patient. That is what we, as policy makers, need to ask ourselves. If we continue along these lines, the two-tier health service will continue.

Many people have told me stories about private primary care services. My next door neighbour dislocated his shoulder and was told that it would be fine if he paid €200. The situation whereby people who have health insurance continue to have a significant advantage over those who are uninsured cannot continue. We need to engage in a detailed examination of the manner in which we are proceeding. We are introducing legislation at 10 p.m. to close a loophole, but we will have to revisit this matter on many occasions to sort out this mess. The Tánaiste needs to examine the system thoroughly. On that basis, I cannot support this legislation.

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