Patricia Ryan (Kildare South, Sinn Fein) | Oireachtas source

I welcome the opportunity to speak about this Bill. It is an issue that is dealt with every year around this time, in a similar Bill to provide for risk equalisation. Risk equalisation is a mechanism designed to give effect to the objective of a community-rated health insurance market, where customers pay the same premium for the same health insurance plan, regardless of age, gender or health status.

The Health Insurance Act has provided for a risk equalisation scheme for the market since January 2013. Under the scheme, insurers receives risk equalisation credits to compensate for the additional cost of insuring less-healthy or older members. This year’s scheme will differ from the current one by introducing high-cost claims credits. Treating these claims separately will mean that the risk equalisation subsidised provided to insurers will be more accurate and effective by removing distortive high-cost claims.

As a result of lower claims activity due to Covid-19 a surplus of around €100 million has built up in the risk equalisation fund. The Health Insurance Authority has recommended the return of this €100 million to consumers by the way of a reduction in stamp duty for contracts commencing or renewing in the period of 1 April 2022 to 31 March 2023. This is likely to be a once-off reduction because of Covid-19 imposed restrictions on access to public and private hospitals, which resulted in lower credits being paid out of the fund.

Some 45% of the population is covered by private health insurance and pay out more than €2.5 billion in premiums. For many workers and families, health insurance is a necessary evil. They make great sacrifices to pay for it, hoping that they will never have to use it. The only reason they pay is that our health system is so bad and they fear the long waiting lists in public hospitals. There are hundreds of thousands of people languishing on long waiting lists and this Government has no credible plan to address this. We need to fix the imbalance in healthcare to remove private healthcare from our public hospitals and our public healthcare system.

It is time we moved away from a two-tier health system. There are many people falling through the cracks, who earn too much to qualify for a medical card, or too little to afford health insurance. This is wrong. Ability to pay should have no bearing on how we are treated in the healthcare system.

People are languishing on waiting lists and are getting sicker, while those with health insurance are fast-tracked to the front of the queue. In some cases, they are treated by the same doctors and, in some cases, the same hospitals. For those who have to wait, their mental health is suffering and in some cases their life expectancy will be lowered. The Minister of State is aware that we have discussed our elderly many times. This is not good enough and health insurance exploits a failed public health system. It is a public health system that is being killed off by successive Governments to favour a private health system. As with the commodification of housing, the commodification of our health service is hurting those who need it most, like our elderly and like those on low income, in other words, the working poor.

I spoke to a lady last week who has been waiting for more than three years for a tonsillectomy appointment for her child. She was initially told that the wait would be 18 months. If the family had health insurance, it could be done within a week. Instead, the child endures pain of recurring sore throats - six in the last year. Children are suffering and it is a disgrace. Sinn Féin in government will deliver an all-Ireland health system that is free at the point of delivery and one that is based on need and not on income.

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