Martin Kenny (Sligo-Leitrim, Sinn Fein) | Oireachtas source

When it comes to the political differences between the Minister and l, they are probably most acute when it comes to private healthcare. We see legislation of this sort every year and with each year we are reminded of the body of work that progressive parties have ahead of them to address the imbalance in healthcare and remove private healthcare from public hospitals.

The question of health insurance is fraught. On the one hand, it facilitates the skipping of queues and the bypassing of waiting lists while, on the other, it represents a large number of people who go without other things because they are afraid that without it they will end up waiting two years for a colonoscopy or some other procedure. The health insurance market exists because the Government champions it and because people are afraid of having to enter the public system and being left to wait for months or years for treatment.

The de Buitléir report stated that insurers said one of the main reasons people choose to buy private health insurance is to access healthcare services quicker. We find ourselves where we are because successive Governments have driven as a matter of policy the privatisation and commodification of the health service. When I speak to those involved in healthcare, I am told that diagnostics is the hard part of healthcare and that is left to the public sector and the easy part, namely, the treatment, when one has discovered what is wrong, is where the private sector steps in and does the part which is somewhat easier to cost. The taxpayer is paying for the more difficult end while the private end is taken up with the part where it can quickly make a profit. We must ask whether that is the best way to run the health service; I think it is not. We must also ask whether health insurance in this country is fair, given that much of the cover is driven by fear and it constitutes an additional burden to be carried by citizens, and given how much is contributed to the health budget by taxpayers. Private healthcare preys on the fears of people about the prospect of being ill and needing care and the inability of the public health system, for which they pay through their taxes, to provide them with that care.

Then, the saviour to that is the private side of it coming in. There is something to be looked at and a close examination needed as to where vested interests play a part. Certain vested interests make a lot of money from the private side of it. They are the same people who are in charge of providing the public side of it and who are ensuring, many would say, that it does not operate as efficiently and effectively as it should in order that they can step in on the other side of it.

One group of people who must take out insurance and have no choice in the matter are international students. Recently, the Health Insurance Authority, HIA, made a decision that non-EEA students studying here on courses of more than one academic year are considered not ordinarily resident in the State for the purposes of the Health Insurance Acts. Because the Irish Naturalisation and Immigration Service requires these students to hold medical insurance, if either the HIA decision stands or the relevant legislation is not amended, then these students will be compelled to purchase community rated insurance which may not fit their needs. I wish to ask the Minister if he has any intention to keep the availability of non-community rated student medical insurance for international students studying in this State and if he will bring forward amendments to that end on Committee Stage.

The Oireachtas deals with this Bill every year. It is about taking away the risk from insurance companies to equalise risk for certain policyholders. If only the Government was as quick to intervene in the market in other areas, we would have a much better country. While we will allow the passage of the Bill in order for older people and others to be protected, we do so with serious reservations about a health service that buckles under the weight of demand and we point out that fear is what drives many people to take out health insurance across the State.

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