Michael Fitzmaurice (Roscommon-Galway, Independent) | Oireachtas source

I welcome the opportunity to speak on the Bill. For people who have health insurance, we hear on a regular basis that there is a threshold of €100 or €150 and after that the health insurance kicks in. When they arrive in a hospital they are asked to sign a form. The reasoning behind this needs to be looked at, even though it might be good for the person going into the hospital. There might be a lot of people in a public ward and they might be charged for semi-private or private. If we heard two or three people saying it, we might not take notice, but a good few people have been speaking about this.

On risk equalisation, some people have gone to different companies. People are moving from VHI to Laya and to all the other providers. Will this continue? We need health insurance for elderly people. With demographic changes in a few years' time, a large percentage of our people will be over 60. Risk equalisation obviously increases the price of health insurance cover.

During the recession people walked away from health insurance for a while but it is welcome to see them take it out again. We looked at the situation in the United States at one time and what people were paying for health insurance in that country was phenomenal. For what one would call average, not gold star, cover here families are paying exorbitant fees. When does the Minister of State believe the cost of health insurance will settle because if it continues to increase at the current rate, it will be out of the reach of many people. Unfortunately, a large number of people gave up their health insurance. Some have taken it up again but I am worried that there are people who are chancing it in that they do not have health insurance and are not entitled to a medical card. If something goes wrong with their health and they have to remain in hospital for a while, they would not be fit to pay some of the cost. The first thing hospitals get people to do when they are admitted is sign a form. As rightly explained earlier, one is vulnerable when being admitted to hospital. One is not running around the place when one goes in the door of a hospital. There is a bit of panic. It might be difficult to get through the accident and emergency department but, in fairness, once one is admitted a great service is provided. The problem is getting admitted.

If someone who has health cover needs an operation they will be able to get it done fairly quickly. I see that with people who need treatment for cataracts. Another problem involves people who need scans. I know of someone who had a medical card and was told that they would have to wait six months for a scan but if they paid for it they would be through the system in a week. That is not the way to look after patients.

I refer to some people with health cover who are admitted to a public hospital, perhaps on a trolley, but in terms of the rates they are charged, one would swear they were in the best hotel in the world. Everyone will acknowledge that the doctors and nurses do great work. However, in terms of these people who are paying health insurance, some hospitals - I cannot talk about every hospital - may be abusing the type of cover that allows them to get in more money. They have to get what they are entitled to or whatever but some hospitals will do that.

Another issue came up in the HSE west in the Saolta Hospital Group. We were at a meeting in Galway and there appears to be a problem in drawing down money. I believe approximately €6 million or €7 million was not recouped by the Saolta Hospital Group or it was finding it difficult to recoup it. The financial controller said it does not write that off but goes after it. However, it seems to be struggling to get it. Is it the case that people are paying health insurance but there is then a big battle between the health insurance companies and the hospitals to cover their bills? Some of the prices charged for a night in a hospital for a minor operation are phenomenal. Is there any adjudication body, similar to the Taxing Master in the Four Courts, that examines that because the costs seem to be only going up? If that continues, health insurance will be out of the reach of most people because many people currently struggle to pay it. We need to be mindful of that and keep an eye on it to make sure that the problems and abuses we hear from people are addressed.

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