Joan Collins (Dublin South Central, Independents 4 Change) | Oireachtas source

There is no justification for the subsidising of private healthcare by the State. The two-tier system of healthcare and, in particular, the mingling of private and public care in our public hospital system is the key obstacle to equity of access and a fit-for-purpose national health system open to all and free to use.

In the 1950s, the VHI was established as a not-for-profit State insurance company to provide health cover for the top 15% of income earners who were then not able to access the public hospital system. A key factor then, as now, was the determination of consultants to protect private practice and the lucrative nature of it.

The public hospital system, on paper, is open to all today, yet we know approximately 50% of the population buy private health insurance, which is one of the highest levels in the OECD. The question has to be asked why people on moderate incomes would take out expensive private health insurance when they are entitled to public care. They are not doing so because they can have luxury treatment in a private hospital. Much of the private care takes place in public hospitals. The reason is simple - waiting lists. The VHI helps people to jump the queue. That is inherently unfair and the fact that it is subsidised both by tax relief and the use of the public system by consultants to treat private patients defies all logic, unless one believes that the profit motive comes before people's health.

I have not been able to get a figure for the cost of tax relief on health insurance but the average premium is around €2,000. Twenty per cent tax relief on that is €400, and with half the population covered, it must be a cost to the Exchequer.

In terms of risk equalisation, my understanding is that the VHI dominates the market and that no transfer funds between companies has ever taken place. We need an end to this nonsense and a properly funded, single tier health service available equally to all and free at the point of use.

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