Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance) | Oireachtas source

I will be brief as we have had this discussion at length on earlier Stages. As I said before, I fundamentally reject the basis on which this entire Bill is constructed and the emphasis of this Government's policy on the private health insurance industry playing a useful role in developing a universal health system. The reason the Government used the term “universal health insurance” prior to the last general election is because it knew that is what people wanted. People want something that is available to everybody. Whatever about our ideological and philosophical differences on a range of issues, such as markets and whatnot, everybody believes health care provision should be universal. Everybody should get the same treatment because they need it as human beings, particularly when they are ill, disabled or whatever. That is what the majority think and Fine Gael used that term prior to the last election because it knew that is what everybody wanted. Everybody rejects the two-tier health care system. If we listen to what people say they want and if we are moving towards providing quality health care to everybody, regardless of income, position in society or whatever, then we must move to a universal system.

The Minister has now acknowledged that trying to deliver universality, while incorporating the private health insurance industry, just does not add up.

After five years of saying we will have universal health insurance, what the public heard was "universal" but what the Government smuggled in was "insurance". The second bit undermines the first. We all know it. The international evidence is absolutely clear. Once private health insurance companies are brought into the equation, hierarchies come into play straight away. Some people can afford to buy better packages than others. We do not get equality or universality. We get something else.

We also get a massive waste and drain on resources. Money which is paid out of the Exchequer and the pockets of those who take out health insurance is wasted on things which have nothing to do with health care. Millions of euro are wasted on advertising. On a worldwide scale, billions of euro are wasted on private health insurance companies competing with one another. It is not spent on nurses and doctors or on building hospitals or primary care centres but on advertising and it is a waste. We see and hear the advertisements every day on the television and the radio, including one telling people to go to the Blackrock Clinic as it is much better in an emergency. People should know that there is an accident and emergency department nearby which they can access on a 24-hour basis, that they will not be left for days on trolleys and that money is not an issue. It should be paid for through central and progressive taxation. That is what people want.

I have made the point before but there is something wrong when a debate on health starts with phrases such as "risk equalisation" and "lifetime community rating" and lots of technical babble which has nothing to do with health. When we hear these terms, we know we have done something wrong and are on the wrong track because that is not what health care is about. That is not what hospitals and sickness are about. It is techno babble and it arises from the fact that there are external, profit-seeking bodies that have nothing to do with delivering health care thrown into the mix. Massive billing operations, administration and all that kind of stuff has nothing to do with health care. The cost of providing health care is greater wherever this model exists. It will always be greater because it is necessary to add profit-seeking, advertising, administration, billing costs and all the rest of it into the equation.

The Government has sort of had to acknowledge that those are the facts because it has more or less abandoned a promise it made on this issue. The Government should listen to what people are saying and what all the evidence is saying. Let us have a national health system and let us fund and finance it because in the end, it will be cheaper, more efficient and fairer.

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