James Lawless (Kildare North, Fianna Fail) | Oireachtas source

Deputy Naughten makes a good point.

Prevention is the best cure. The elective procedures of the type Deputy Naughten mentioned and the prolificacy of urgent care centres for such admissions, which are springing up nationwide, is an important part of the health service.

The point on model 2 hospitals is well made, particularly in regard to the minimum benefit regulations. The Deputy has talked about community rating, which is the pillar underpinning the health insurance system we have had for decades. It is important that it is protected. The point has been made that whether one is eight or 88, one pays a common price regardless of health status, age or other factors that may be priced into a risk market where that would be brought to bear in a competitive pricing model. We do not have a competitive pricing model for reasons of public policy. For that reason, we cannot discriminate against those insurers that apply the principle properly, equally and fairly across the country and across all benefits.

The minimum benefit regulations were introduced at a time of the minimum benefits legislation. Health insurance policies initially were extremely comprehensive and covered almost every ailment under the sun. With the advent of competition in part and of risk pricing and of the greater risk profile, it was becoming far more expensive and health insurers were put to the pin of their collars to fund those. Even with community rating, they could not afford to keep paying for all benefits all the time and they began to scale back the plans. It was in response to that scale-back, in which benefits such as outpatient cover were removed from health insurance plans, that the minimum benefit regulations were introduced to provide that there is a certain bar below which an insurer cannot drop in terms of provision of cover. If one is an insurer providing a health insurance plan, one must have a certain minimum level of cover. There are certain anomalies in that cover but at the same time, the principle is good. The principle of community rating is good. Deputy Naughten's point is well made. That applies to the universality of cover geographically as much as it applies to the benefits themselves and to the procedures covered.

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