Denis Naughten (Roscommon-South Leitrim, Independent) | Oireachtas source

I support Deputy Kelleher's amendment. He has made a valid argument, which we raised with the Minister on Committee Stage, regarding the challenges we face. The reality is that unless we can encourage young people to go into the health insurance market we will continue to see the haemorrhaging of individuals and families out of the system. It is estimated that by the end of this year approximately 200,000 people will have left the health insurance system since 2008. Something must be done to incentivise people to take up health insurance and encourage others to join up for the first time.

The difficulty is that the Health Insurance Authority has said that is a pointless exercise at this stage in that universal health insurance will be introduced in four years' time and therefore it will not make a huge difference. The reality is that it will take a period of time to implement universal health insurance in its totality. It will not happen in four years' time. Hopefully, it will commence at that stage, but it will take a period of time to roll out. There was a contribution by the health insurers at the Oireachtas committee recently and, according to their evidence, it will take ten years to implement universal health insurance. If we are talking about up to 14 years for the full implementation of universal health insurance, many people will have leaked out of the system in the intervening period. Some type of incentive must be built in.

The argument is being made by the Health Insurance Authority that once universal health insurance comes in everyone will be legally obliged to sign up to health insurance and therefore we will not have to try to incentivise it. The difficulty is that we must try to get new people into the system now if we are to make the health insurance system sustainable in the short term. The argument I made to the Minister on Committee Stage was that some sort of incentive must be put in place, and not just for young people coming into the health insurance market. Why should someone who has continuously paid his or her VHI subscription year in, year out for the past 40 or 50 years have to pay the same amount for the same benefits as someone of the same age who is signing up for the first time?

In the past, when the Minister articulated the view on universal health insurance, he said there would be an incentive for insurers to improve the quality of health of the cohort of people they have insured. They would encourage people to give up smoking, lose weight and so forth, but how do we encourage that? Some incentive must be given to the individual for them to lose weight or give up the cigarettes and if that is not built into the price of the policy some other added bonus must be offered. I have suggested to the Minister that whatever carrot, so to speak, is looked at under universal health insurance, it should also be offered to people currently in the health insurance system in advance of the introduction of universal health insurance here. It is a fair proposal that is being put forward because incentives will be built into the universal health insurance system. Regardless of what they are, they will be decided by the insurers in many cases. Surely we can make some provision, as part of the roll-out of universal health insurance, that people already in the system get some additional benefit on foot of others coming into the new system in the future.

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