Fiona O'Malley (Progressive Democrats)

I would welcome one. When the Minister of State was Chairman of the Oireachtas Joint Committee on Health and Children we dealt often with the health insurance market, which is fascinating. I took a strong interest in this area as we watched the evolution of competition in the sector. We heard that the VHI would decide how many days a patient would stay in hospital and the terms of that stay. It did not matter if the patient came out after three days or did not need to stay in for three days. That is a total abuse of power. That is why I welcome the arrival of companies based in other countries.

Our system is good in so far as we have a high rate of people on private health insurance, although that is declining in the present economic situation. One hears that the first thing people cancel when they can no longer afford it is health insurance, but intergenerational solidarity and risk equalisation is a good principle. That is why the insurance Bill and changes in the insurance market are necessary.

There is, however, a contradiction in this Bill because the Minister of State uses the term intergenerational solidarity and states that nobody should pay any more, but he proposes a levy which eliminates the notion that everybody pays the same. I am not a fan, if that is the correct word, of health insurance. I do not really believe in it. I believe the public system should be good enough for us to have faith in it. I do not have health insurance. If one decides to take out health insurance later in life one will pay a penalty for doing so. That may well be because one will not have cost the health insurance company any money at that stage and therefore it is entitled to get more money out of one. That flies in the face of the notion of true risk equalisation and fairness. I see this as an interim measure to deal with the legislation as it is. It is an area that needs a great deal of change where litigation has been pending for many years and, as we all know, BUPA took the State to court. It is not over and it is not a level playing field.

The Minister of State will know from his time as Chairman of the Joint Committee on Health and Children when we dealt with this matter that it is a very uneven playing field. The committee tried to make the playing field more level but we were somewhat restricted from doing so, largely because of the dominance of the VHI and its construction in terms of its financial obligations. I wish we were introducing legislation to deal with that because it is far more important. We need regulation in this area, but we need light-touch regulation. We need to be able to encourage many more insurers into the market.

I note this interim measure is to deal with the specific issue of the judgment and to provide a degree of certainty to older people in particular because they are at risk of facing higher premiums. We need a once and for all health insurance Bill to deal with the dominance of the VHI and I would welcome it into the Oireachtas. I understand what this Bill is trying to do but there is this inherent contradiction and I am interested to hear the response of the Minister of State on this.

We need to encourage more participants and health insurance providers into the market. That is the best way of ensuring competition and getting greater efficiencies and better value for money for the patient and the State in terms of what it pays for health insurance, which is after all what we want. The monopoly has interfered with or damaged much practice and bad practices were allowed to develop. As I mentioned before, competition now exists in the aviation sector and is much to the benefit of the consumer. This could be replicated in the health insurance area. I seek changes in the ongoing regulation of the health insurance market because we need to keep competition alive in it.