James O'Connor (Cork East, Fianna Fail) | Oireachtas source

The Health Insurance (Amendment) Bill is somewhat akin to the Finance Bill or the Social Welfare Bill, as it arrives in November every year. The measures within are designed to support risk equalisation and to sustain community rating in our health insurance market so that older citizens and people with illnesses can afford health insurance and are not penalised in favour of younger healthier people.

There is no increase in the risk equalisation levy this year. Risk equalisation and community rating have many merits. Our values as a people are to support older people and the sick. This is not just out of a sense of obligation but because we respect and value our older people and the dignity of each person in their illness, medical condition or disability. We are firm in our view that the principle of solidarity should apply in private health insurance as well as in public health services. However, I ask the Minister of State what are the potential costs of maintaining this system over time and what are the implications on competition. The maintenance of a community rate causes a barrier to entry for outside providers. I understand the balancing act needed to ensure adequate access to care for all of those paying to get value for money but I am also conscious of the rising unfunded liability over time, which has the potential to collapse the private health insurance system. Ireland has had a murky past in private health insurance provision and I want to flag that, if left unchecked, the current set-up would lead to similar outcomes.

While I recognise the current measures in place are interim in nature until the full roll-out of Sláintecare, the values executed through the risk equalisation scheme are those we should uphold in the provision of our healthcare systems, specifically, equal access for all. I want to ensure everyone is working towards a system that will enable us to continue to uphold these values and provide care in the most cost-effective manner.

At an individual level, some of the most challenging issues facing all Deputies, including me, are those arising from people's health insurance. Some very difficult and desperate cases have come through our offices, whereby people may have gone as far as getting insolvency practitioners involved as a result of healthcare bills. It is critical that the State continues to legislate in this area.

I have a significant concern for the many families in the squeezed middle for whom the cost of private healthcare may be just beyond their means. As a Government, we have to try to do more to assist these families because getting access to a medical card or an emergency medical card can be quite a challenge in some cases, where there are issues with regard to the eligibility criteria. This causes major issues with private health insurance and people trying to get access through the public system. It is an area on which we need to see greater emphasis placed by the Government. It is a significant issue. I take this opportunity to raise this matter while speaking about health insurance.

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