Mattie McGrath (Tipperary South, Independent) | Oireachtas source

The main purposes of the Bill is to specify the allowable rate of net premium payable in respect of young adults; to provide for the transfer of an insured person from a restricted membership undertaking to another registered undertaking without the application of any additional initial waiting period; to specify the amount of risk equalisation credits in respect of age, gender and level of cover payable to insurers from the risk equalisation fund from 1 March 2015; to specify the amount of the hospital bed utilisation credit applicable from 1 March 2015, and to make consequential amendments to the Stamp Duties Consolidation Act 1999 to revise the stamp duty levy required to fund the risk equalisation credits for 2015.

The term "hospital bed utilisation credit" means the relevant amount payable in respect of each hospital stay, on or after 31 March 2013, involving an overnight stay in a hospital bed in private hospital accommodation by an insured person. Goodness knows, we need some of these issues. The prices health insurance companies are charging for beds are astonishing. There has to be a serious examination of these costs.

I am happy to have this brief time to contribute to the debate on an aspect of our health-care system that is crying out for a more equitable application of regulations governing health insurance. In that sense I welcome those aspects of the Bill that seek to help tackle increasing health insurance premiums. The Bill aims to freeze stamp duty for public hospital cover, introduce young adult rates and reduce the Health Insurance Authority levy from 0.12% to 0.01%. That was greatly needed. Something had to be done to reduce premiums.

Earlier, Deputy Finian McGrath referred to some figures. I wish the Minister well in his new portfolio. The figures indicate that people have fled or rather were forced to flee by economic circumstances. No breadwinner in a household would want to give up health insurance, but it is a sad choice. I have a large family and we are at the pin of our collar to continue paying the health insurance. Thank God, they are all healthy. People, including elderly people, who have been paying for years, have been forced to give it up because of exorbitant increases in premiums. Other industries have taken repeated cuts in the past five years since the recession came, but this industry has increased its premiums every year.

The figures were already on the record, but I will refer to them again. Some 250,000 persons dropped out of the private health insurance market in the five years to the end of 2013. Those are working people, small businesspeople and ordinary people who want to be able to pay to go to a private hospital. They do not want to put huge pressures on the public health service and are willing to pay but it has become impossible for them to pay because the prices have been hiked.

The increases in premiums ranged from 7.3% in 2011 to 12.1% in 2012. In 2008 the average premium paid per insured person was €729. In 2013, this had risen to €1,150, representing a 58% increase in the period from 2008 to 2013. That is madness. That any industry or insurance company could be allowed to get away with it indicates that the HSE and the Minister did not have their eye on the ball. It is reckless and puts huge pressure on already overcrowded and pressurised accident and emergency departments, and many other departments.

I compliment the newly elected Deputy Fitzmaurice, who is still in the Chamber, on his novel ideas about trying to get young graduate doctors and nurses to stay. They and their families have made huge efforts to put them through college to become qualified. I salute them for going into that noble profession. It is a pity that so many have to move abroad for work. There must be some clawback based on giving some service, giving something back. Loans could be provided for their education and maybe have a sensible payback system there.

The Minister has made the right sounds. The jury is out, but I wish him well. He should be given a chance to look at some ideas. The HSE and the whole system have failed us. Any industry with premiums increasing to that extent over the past five years without action is not fit for purpose. I am a small businessman as is the Deputy behind me. No businessperson could even dream of getting those increases in profits. The economy has gone the other way but those operating in this area have been reckless. I have many more figures but I will not quote them because the Minister has heard some of them already.

As the Minister said, regulation of the health insurance market should occur in the interest of the common good. We are all here to serve the common good. If we cannot serve the common good maybe it is time we packed our bags and stopped being public representatives. We are all elected in our own right by the people who expect us to work for the common good. I agree that central to any conception of the common good is a health insurance market in which intergenerational solidarity between all insured persons old and young exists in a fair and just manner. Community-rated health insurance systems across the world use risk equalisation as a mechanism to achieve such fairness. There are many examples across the world. I would not want to see us advocating the use of an American-style experience-rating model over the preferred community-rating model. What happens over there is not all good. A person over there with insurance is fine, but a person without insurance is in a very poor situation.

This is especially true given the dangers that exist for members of experience-rating schemes where the common practices of insurance companies is one of denying applicants insurance based on pre-existing conditions. If that was to happen in my business or that of Deputy Fitzmaurice, we would not be in business because there will always be accidents and incidents. Businesspeople generally have a goodwill relationship with an insurance company - they strike a deal and carry on.

Experience-rating schemes also require a waiting period before pre-existing conditions are covered and drop members when they suffer an accident or get sick, which are not fair or in the common good. It is just another form of bullying. If the Bill sets out to counteract some of these kinds of outcomes then I welcome it even if I am uneasy about some of the provisions.

I hope the Acting Chairman will not mind me straying slightly from health insurance to general health issues. I agree with what the Minister said earlier about certain people demanding his presence this morning and stopping the work. We then wasted another hour back and forward with other issues which is not good enough. I had to put back by an hour an appointment in my constituency - some of us have further to travel than others.

The fair deal waiting list is putting pressure back on the system. There are people in hospital beds at €1,000 a night in my hospital - I do not know how much it is in bigger hospitals. They could be in a nursing home for €750 a week or less. The cap must be lifted there. The latest thing is charging for medical card patients if they spend more than 30 days in any hospital, whether it be respite, accident and emergency or a rehabilitation unit such as the one we have in St. Patrick's in Cashel. If they reach 30 days they are charged €25 a day. They do not have €25 a day. These are people who are sick and vulnerable. They would not owe €25 to anyone - they would not owe €2. They are getting sicker because they are getting these bills. I accept the hospital managements are doing their best to pay it at €2 a day, but if they are in for seven days a week they owe €175 out of the €200 payment. It is not possible.

I beg the Minister to show some humanity and address that issue because it is not fair. These are people who do not walk away from hospitals without paying their bills. They were born, reared and lived on the basis of paying their way. They would not buy something in a shop if they did not have money to pay for it. They never had holidays. They are not reckless people. It is not right to penalise them and frighten them. Spouses of patients have contacted me to say they cannot pay it. They would take their spouse, partner or sibling out of a hospital rather than accrue a bill they could not pay. That is not the way they operate. Their modus operandiis honesty and integrity, and to support the State and pay their way. To be threatened and intimidated, and get these bills is very hard and crude. Add that to the beds that are delayed the figures add up totally on the fair deal. It is nonsense and bad value for money to have bed-blockers in hospitals and also have that issue to contend with. It is just not acceptable.

We are hammering the working man and hammering the old. These are the people along with the small businesspeople that we need to regenerate our economy, to kick-start it and work to get us out of recession.

May I continue?

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