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

I move amendment No. 4:

In page 11, between lines 20 and 21, to insert the following:

“9.—Section 7A of the Principal Act is amended—

(a) in subsection (6), by deleting “may by regulation” and substituting “shall introduce by 1 January 2014 regulations which shall”, and

(b) in subsection (7), by deleting “Regulations under subsection (6) may” and substituting “Regulations under subsection (6) shall, inter alia,”.”.

This relates to an amendment I tabled on Committee Stage and tries to incentivise the provisions in the 2001 Act following the introduction of universal health insurance where we will have lifetime community rating implemented as per the provisions in 2001. I put forward an amendment as an alternative option. It comes back to the argument we had on amendment No. 1. Health insurers no longer announce premium increases on an annual basis, but perhaps three or four times a year. The concern is that premium inflation will continue. At the moment an adult will pay a health insurance levy of approximately €285 and a child pays approximately €95. That will increase significantly on foot of the legislation before us. At the same time nearly 200,000 people have left the health insurance market. The reality is that the best way to protect the community-rated system is to ensure that more young people come into the system.

However, the opposite is happening because with the increase in the cost of private health insurance, young people and young families are leaving the system. We have a bizarre situation where the numbers of older people within the system are increasing. If we look at a comparison between 2009 and 2010, the number of people over the age of 65 has increased from 40.9% to 43.4%. In real terms, between 2009 and 2011, an extra 5,500 people over the age of 80 joined the health insurance system. The number of people aged between 70 and 79 in the system has increased up by 9,500, while the number of people aged between 60 and 69 in the system has increased by 5,000. Older people are joining health insurance later in life, while younger people are leaving the system. If this trend continues, the only people who will be able to afford health insurance in this country will be the wealthy or people who have no other choice but to remain in the system in order to access vital health care. I have huge concerns that the trend will undermine the principle of universal health insurance, in which most of us in this House believe.

I tabled an amendment to get around the logjam of lifetime community rating on Committee Stage. I have tabled a different amendment here on Report Stage but it is based on the same principle and would encourage the Minister to sign the 2001 regulation, implement lifetime community rating and introduce some type of incentive or give an indication that there will be an incentive built into the new universal health insurance system for people within the health system whenever that happens. The Minister sees where I am coming from in respect of this and acknowledged that in his original contribution this evening. What is crucially important is that we have a timeline in respect of that. I hope that when he responds to me he can give a timeline for the implementation of lifetime community rating. Based on the evidence we have received from the health insurers and the HIA, the only mechanism that is not being used to reduce the cost of health insurance is lifetime community rating. This could have an impact on the rate of increase of health insurance costs and hopefully see a curtailment of them. This could then be followed by a reduction in the rate of health insurance costs and could encourage even more people into the system. This would then take pressure off the community rated system and allow for the implementation of universal health insurance, a principle with which we all agree in this House.

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