Eamon Gilmore (Dún Laoghaire, Labour) | Oireachtas source

The recession has been very tough on working families. The last thing families need now is an increase in the cost of private health insurance. At a time of increasing competition in the market and with new players seeing the opportunity for themselves, I share the wonder expressed by many people as to why prices are going up and not down. The Deputy will be aware that the Government has no legal power to intervene in the pricing set by VHI or any other insurer. However, we are very concerned about the cost of standard health insurance for hard-pressed families. That is the reason the Minister for Health, Deputy James Reilly, set up a consultative forum under an independent chairperson, Mr. Pat McLoughlin, to work with health insurers, the Department of Health and the Health Insurance Authority on the issue of containing costs. Mr. McLoughlin's report on the first phase of this work was published on 26 December 2013. He has started on the next phase of the work which is a study in greater depth of the key drivers of rising costs and how these can be addressed. He will report within three months.

The first McLoughlin report on costs made recommendations in a number of areas, including adopting a co-ordinated approach to identifying and tackling fraud in the industry. It published data on funds recovered from hospitals and consultants. The report also calls on the industry to fund a whistleblower initiative to assist in uncovering fraud. The report acknowledges the important role of clinical audit in identifying unnecessary claims. It is vital the industry makes best use of this tool to address rising costs. The report calls on insurers to make better use of existing information sources to challenge payments, in particular in respect of the most appropriate places for providing treatment, to ensure patients receive quality treatment at the lowest possible cost. Implementation of the policy of money following the patient will support this action by replacing daily charges with case-based charging.

Addressing the age structure of the private health insurance market is also important. The Minister for Health, Deputy Reilly, is considering measures to encourage more young people into the market, including the introduction of lifetime community rating to encourage younger people to take out private health insurance. The industry can make better use of existing legislation by discounting premiums for full-time students under the age of 23. The report also makes a number of recommendations about the processing of claims and admission and discharge procedures. The Minister is committed to progressing these recommendations in consultation with stakeholders. The Minister supports Mr. McLoughlin's recommendations and is committed to making progress in this area.

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