James Reilly (Dublin North, Fine Gael)
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This issue relates to health insurance, the VHI in particular, but not solely. At the beginning of the week one of the national newspapers reported there was a plan to increase fees and private health insurance by 62% for the elderly population. This comes hot on the Government decision to remove medical cards from the over 70s. I would like some clarity on the situation.

The country is well aware that a High Court challenge was made against the Minister's interpretation of risk equalisation. The Minister lost that challenge and risk equalisation is now out of the equation. However, the principle of community rating is still with us. I want to ascertain today what plans or legislation are proposed to allow for community rating to continue. Failing that, what plans are in train to deal with the situation if private health insurers increase their insurance premia?

People are already suffering the shock of the loss of their medical cards. Over 280,000 people over the age of 60 are insured with the VHI alone. The proposed increases have huge ramifications for them. The figure of 62% of an increase is in the media, but from where did this figure come? Many older people have had their premia paid by their children, as an adjunct to their medical card. Any increase will hurt them hugely. With regard to those who left the VHI and who now want to rejoin it, what criteria will be put in place for them? Will they have to pay the premia for the years they lost? That would amount to a sum most people could not afford.

On top of all this, there has been a rumour circulating that the Government will reduce the tax rebate from the higher rate to the lower rate for medical expenses and that instead of being able to claim back 41% of the VHI insurance premium, people will only be able to claim 20%. Many of the people concerned are just over 60 and many are still working, like many 60 to 69 year olds. Many of these people also tend to use the public transport system. These people will also be hit by the €200 per person per car, a sum that before tax is the equivalent of €800 a year. People are being hit on every side. They want certainty with regard to their health insurance.

I wish to ascertain if the Minister for Health and Children will make a statement on the Supreme Court ruling with regard to the risk equalisation and its implications for health insurers.

I want to know the Government's view on reports that health insurance companies are preparing to increase the premium for the older population by up to 60% and its plans to relieve this burden.

Michael Kitt (Galway East, Fianna Fail)
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I am taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney. I thank the Deputy for raising the matter.

Community rating is a fundamental principle of the health insurance market in Ireland. Following the liberalisation of the market in 1994, political parties and successive Governments have supported the maintenance of community rating. It is an inescapable fact supported by international evidence that community rating cannot be sustained without schemes to support the higher costs of claims of older or sicker people, in other words, a risk equalisation mechanism. There may be differences of opinion on how such a mechanism will work but few dispute its need.

A primary objective of Government policy on health insurance is that it should be affordable to the broadest possible cross section of the community, including older people and those who suffer ill-health. This policy objective has been implemented through a substantial body of primary and secondary legislation providing for open enrolment, community rating and lifetime cover.

Although the Supreme Court found our risk equalisation scheme to be ultra vires, it did not strike down the principle of risk equalisation and other important elements of the regulatory framework for private health insurance. However, the decision gives rise to complex issues which need to be addressed. The Minister is at present assessing all available options. Since the judgment was delivered, she has engaged in consultations with officials, the Attorney General and the Health Insurance Authority. She has also received submissions from insurers. Complex financial, legal and policy matters are involved, however.

It is the Minister's intention to bring forward measures at the earliest opportunity to ensure health insurance remains affordable for older and sicker people. Deputy Reilly will appreciate that it would not be appropriate for me to discuss the details of such proposals at this time.

Charlie O'Connor (Dublin South West, Fianna Fail)
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I would love to let Deputy Reilly speak again but Standing Orders do not provide for it.

James Reilly (Dublin North, Fine Gael)
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I just want to make a quick comment.

Charlie O'Connor (Dublin South West, Fianna Fail)
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I ask him to be quick because he is out of order.

James Reilly (Dublin North, Fine Gael)
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I am sure the Acting Chairman will forgive me on this occasion, given the understanding nature of people who come from Tallaght.

Charlie O'Connor (Dublin South West, Fianna Fail)
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The Deputy should not worry about me.

James Reilly (Dublin North, Fine Gael)
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The Finance Bill 2008 is being brought before us on 28 November, which gives us a short window of opportunity. The work would need to be completed by 25 November.

Michael Kitt (Galway East, Fianna Fail)
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I will bring the Deputy's comments to the attention of the Minister.