Billy Kelleher (Cork North Central, Fianna Fail)
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79. To ask the Minister for Health the way he proposes to reduce the cost of private health insurance for consumers; the measures he will take to ensure a better age balance in the market; and if he will make a statement on the matter. [22955/13]

James Reilly (Dublin North, Fine Gael)
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I have consistently raised the issue of costs with health insurers and am determined to address costs in the sector in the interests of consumers. Last year I established the consultative forum on health insurance, which comprises representatives from the country's main health insurance companies, the Health Insurance Authority, HIA, and my Department. This forum was established to generate ideas that would help address health insurance costs, while always respecting the requirements of competition law. I have made it clear to the health insurers that I believe significant savings could be made which could contain the cost of health insurance premiums.

Given VHI’s very significant share of overall costs in the market, I will continue to focus strongly on the need for VHI to address its costs. At my instruction, VHI recently compiled a detailed cost containment plan, which sets out savings targets for 2013 and for the 2014-2016 period so as to minimise the need for any future premium increases. The savings targets over this period are to be achieved through a combination of initiatives, including rate reductions with private hospitals and consultants, utilisation management, expansion of clinical audit, reductions in high-cost drugs and prostheses, provider reviews and the continued transition of procedures to lower-cost and medically appropriate settings. I will continue to focus strongly on this issue as one of the measures to ensure the sustainability of the private health insurance market in the transition to a universal health insurance system.

The continued participation of younger customers is important in keeping the health insurance market on a sustainable path. In addition to the work of the forum, a subgroup of the consultative forum was established earlier this year to consider regulatory issues relevant to the health insurance market, including measures and proposals to encourage greater participation of younger, healthier people in the market. The forum and the subgroup provide a useful platform for continued engagement with the commercial insurers. It is envisaged that further work will be undertaken over the coming months, which will include consideration of any measures necessary to assist the maintenance of an appropriate age balance within the health insurance market.

Billy Kelleher (Cork North Central, Fianna Fail)
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At the outset the Minister stated that he has consistently raised the issue of health insurance, but I would say he has consistently raised the price of health insurance through his policies. What I cannot understand is the fact that this has been facing the Minister for the past two years. The Health Insurance Authority of Ireland made recommendations to him which he summarily dismissed. For example, there was the issue of non-advance payments, where the authority recommended there should be a reduction in the actual levy and the Minister decided to increase it by €5. It has made some other key policy recommendations which the Minister has also dismissed.

The simple point is that the health insurance market is in crisis. We all know that the reason for the difficulties in the health insurance market is the economic downturn. However, what cannot be explained is the spiralling cost to individuals of private health insurance. The only explanation I can find, which is being borne out by people who have examined the health insurance industry - such as Colm McCarthy in his recent report - is that the policies being pursued by the Minister are adding to the cost of private health insurance. It looks as though more than 90,000 people will stop paying for private health insurance between now and next year. The debt spiral will continue.

James Reilly (Dublin North, Fine Gael)
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This problem faced the Deputy and his Government for 14 years, during which time we saw year-on-year rises of up to 25%, so for the Deputy to come across, after two years, as concerned and wanting action on it is a little rich.

That is not the way his Government left the country. It was left in poverty and in tatters. His Government destroyed our financial sovereignty. It accounts for much of the reason why so many people are unemployed or cannot afford private insurance. Mr. McCarthy is right. Insurance will become unaffordable unless insurers take the issue of cost containment seriously. Why are we still paying for procedures on the basis that they take two hours when they only take 20 minutes with modern technology? Why are people still reporting to me that their bills listed procedures that were not carried out? Where is the audit and why is there no clinical audit by a group of doctors who could challenge the treating clinicians on the necessity of tests? Why are we still paying on a per diembasis instead of per procedure? That is what we have offered insurers and it is what we would like to see them do in private hospitals.

Billy Kelleher (Cork North Central, Fianna Fail)
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We can take the history lessons for as long as the Minister likes but I am only trying to get information on why the cost of private health insurance is escalating. Two and a half years ago he was apoplectic with rage in this House. He nearly fell over the benches at insurance increases of 3% to 5%. We are now speaking about increases of up to 30% on premiums for normal families.

James Reilly (Dublin North, Fine Gael)
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They are putative, not real. Where are they? The Deputy wants to confuse facts with supposition.

Billy Kelleher (Cork North Central, Fianna Fail)
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It is happening as we speak. The projection is that as young people continue to opt out of private health insurance, the burden will fall on fewer numbers of customers and it will cost them more. One does not have to be an actuary or expert in logarithmic expressions to realise that private health insurance is becoming unaffordable. The full-cost of private beds in public hospitals is one area and the levy is another. The Minister has refused to take on board any of the recommendations of the HIA. He dismissed them all.

Peter Mathews (Dublin South, Fine Gael)
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Deputy Kelleher has used his entire four minutes.

James Reilly (Dublin North, Fine Gael)
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I have to respond to that.

Peter Mathews (Dublin South, Fine Gael)
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The Minister has ten seconds.

James Reilly (Dublin North, Fine Gael)
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The HIA recommendations have not been refused. The Deputy is trying, as Fianna Fáil always does, to muddy the waters-----

Billy Kelleher (Cork North Central, Fianna Fail)
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I am not.

James Reilly (Dublin North, Fine Gael)
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-----and confuse fact with supposition and fiction. This will happen if no action is taken to address runaway costs of health insurance.

Peter Mathews (Dublin South, Fine Gael)
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We must move on. The rules of the House provide for two minutes for replies and four minutes for the interchange of supplementary questions and answers. They are not my rules.