Mary Harney (Dublin Mid West, Progressive Democrats)

A primary objective of Government policy in health insurance is that it should be affordable for the broadest possible cross section of the community including older people and those who suffer ill health. This policy objective has been implemented through a substantial body of primary and secondary legislation providing for open enrolment, community rating and lifetime cover.

Although the Supreme Court found the particular risk equalisation scheme to be ultra vires, it did not strike down the principle of risk equalisation or any of the other important elements of the regulatory framework that supports private health insurance in Ireland. However, the decision of the Supreme Court gives rise to some complex issues that now need to be addressed.

I have yet to hear any argument made against the continuing need for community rating. It is a fundamental principle of the health insurance market in Ireland. Following the liberalisation of the market in 1994 every political party and successive Governments have supported the maintenance of community rating. It is an inescapable fact, supported by international evidence, that community rating cannot be sustained without some scheme to support the higher costs of claims of older or sicker people, effectively a risk equalisation mechanism. There may be differences of opinion in how such a mechanism must work, but few dispute the need for one.

I am currently assessing all available options. Since the judgment was delivered, I have engaged in consultations with officials, the Attorney General, advisers, the Health Insurance Authority and with the companies operating in the market. I also received submissions from all the operators in the market and we are in dialogue with them on an ongoing basis. There are complex financial, legal and policy matters involved. It is my intention to bring forward measures to ensure that health insurance remains affordable for older and sicker people at the earliest opportunity. I will be bringing such proposals to Government shortly.

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