Michael Kitt (Galway East, Fianna Fail)

I am taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney. I thank the Deputy for raising the matter.

Community rating is a fundamental principle of the health insurance market in Ireland. Following the liberalisation of the market in 1994, political parties 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 schemes to support the higher costs of claims of older or sicker people, in other words, a risk equalisation mechanism. There may be differences of opinion on how such a mechanism will work but few dispute its need.

A primary objective of Government policy on health insurance is that it should be affordable to 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 our risk equalisation scheme to be ultra vires, it did not strike down the principle of risk equalisation and other important elements of the regulatory framework for private health insurance. However, the decision gives rise to complex issues which need to be addressed. The Minister is at present assessing all available options. Since the judgment was delivered, she has engaged in consultations with officials, the Attorney General and the Health Insurance Authority. She has also received submissions from insurers. Complex financial, legal and policy matters are involved, however.

It is the Minister's intention to bring forward measures at the earliest opportunity to ensure health insurance remains affordable for older and sicker people. Deputy Reilly will appreciate that it would not be appropriate for me to discuss the details of such proposals at this time.

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