Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

The Health Insurance (Amendment) Bill 2015 provides for the introduction of risk equalisation fund payments to health insurers for hospital day case in-patient admissions redefining the heretofore hospital bed utilisation credit, now to be known as the hospital utilisation credit, providing for a €30 payment for day cases and continuing the €90 payment for in-patient admissions on an overnight basis. Other amendments in the Bill apply to the principal Act, the Health Insurance Act 1994, and include definition changes, while others apply to the Stamp Duties Consolidation Act 1999. In the context of where health services are, Sinn Féin will not oppose the passage of the Bill.

There is an irony in the timing of Second Stage of this legislation in that it coincides with the Minister for Health’s memo to the Cabinet this week on the unaffordability “now or never” of the multi-payer model of universal health insurance, UHI, his party’s and the Government’s central plank of their health policy. Proposed by the Minister’s predecessor, Deputy James Reilly, the Fine Gael UHI plan was front and centre of that party’s manifesto in the run-up to the last general election in 2011. It was subsequently adopted as Government policy in the programme for Government adopted by Fine Gael and the Labour Party. From the outset I described it as unworkable and unaffordable in placing our health and very lives in the hands of for-profit insurance companies. While mine was not the only voice, we, in Sinn Féin, have been consistent opponents of this proposition for almost the past almost five years of the Government and previously.

The blind adherence of the former Minister, Deputy James Reilly, and the Taoiseach to the proposed funding model raises serious questions about their competence and suitability to hold high public office. It was not just me as an Opposition spokesperson on health who spelled out the dangers of the course the then Minister, the Taoiseach and their Fine Gael and Labour Party colleagues in government were planning to take. Their lauding of the multi-payer system in operation in the Netherlands attracted expressions of caution from within that country, including from less expected sources. The director general of Nefarma, the Dutch pharmaceutical industry lobby group, Michael Dutrée, in addressing the 2011 annual conference of the Irish Pharmaceutical Healthcare Association stated health care in the Netherlands under the multi-payer system was based on cost, not need.

The Dutch introduced their model of private-public health care, with private insurance companies competing to access public health services in 2006. By 2011 the cost of an ever reducing basket of services had increased by almost 10%, with the cost of unincluded, uncovered services increasing by 50%.

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