Frank Feighan (Sligo-Leitrim, Fine Gael) | Oireachtas source

I thank Deputies for their contributions to the debate on this Bill. Health insurance is held by a large proportion of people in Ireland relative to other countries, as has been stated by many Deputies. It is important that we took the opportunity to discuss this Bill and the positive effect that community rating and other aspects of health insurance regulation have on people's daily lives. The voluntary health insurance system in Ireland operates on the basis of community rating, meaning people who are old or sick do not have to pay more than the young and healthy. Community rating is a fundamental cornerstone of the Irish health insurance system and in other health insurance systems. The level of risk presented by an individual directly affects the premium paid. The objective of community rating is supported by a risk equalisation scheme which aims to keep health insurance affordable for older and less healthy members. Under the scheme, all the money raised on levies from insurers is paid into a fund for the sole purpose of supporting the market in the forms of credit payable.

The purpose of this Bill is to specify the revised credits and corresponding stamp duty levels to apply on health insurance. I thank the Deputies for the issues they have raised. Deputies Cullinane, Patricia Ryan, O'Rourke and Shortall talked about Sláintecare. I hope that Sláintecare will eventually impact on implementing the removal of private healthcare. It will happen progressively. Anyone with health insurance can continue to receive private care in public hospitals for the foreseeable future. After that, anybody with private health insurance will still be able to receive private care in private hospitals. When there is certainty about the timeframe for the implementation of Sláintecare and a public-only consultant contract, a broader discussion on the role of private health insurance will follow. We are committed to introducing Sláintecare as soon as possible.

Deputies Ó Murchú and Gould talked about addiction services. I would be concerned that the €90 cost for an assessment for treatment is a barrier. I ask Deputy Gould if he could raise that again because we want to support recovery, especially for people in addiction services.

Deputy Naughten talked about Irish Life Health, and how one major insurer was not supporting level 2 hospitals such as Clonmel, Louth, Roscommon and many more. There is no obligation for insurers to cover all the hospitals in the manner outlined because it limits the commercial decisions of the insurers. We would be concerned that this would increase the cost if legislation tried to oblige insurers to cover all hospitals for treatments, procedures etc. I agree with Deputy Naughten and I am familiar with Roscommon University Hospital. It is a level 2 hospital and much great work has happened there. We need to try to talk to the GPs and many other stakeholders, to say that there is better, quicker treatment available at level 2 hospitals than at level 3 or 4 hospitals. They have a role there and Deputy Naughten has a point.

Deputy O'Connor talked about cost systems and outside providers. We keep an eye on it.

Deputy Michael Collins talked about a young child in Cork. If he writes to me and the Department, we will follow up on that serious issue and try to sort it out or see exactly what is happening.

Although the private health insurance market has demonstrated resilience and remained reasonably stable amid significant uncertainty in 2020, the longer-term impact of Covid-19 on the health insurance industry has yet to be determined. Against the background of some uncertainty about the potential impact on market profile and membership, the credit and levy rates for next year strike a fair balance between the need to support community rating and maintaining the sustainability of the market.

Deputy Pringle has some interesting points about health insurance. He made an interesting point about credit unions and we must have a discussion about that in the future.

The Bill allows us to maintain support for the core principle of community rating, which is long-established and well-supported Government policy for the health insurance market. The Bill will ensure that we can continue to provide the necessary support to ensure that the costs of health insurance are shared across the insured population.

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