David Cullinane (Sinn Fein)

The Bill arrives in that context and in the context of a declining health insurance market. VHI has said it expects up to 200,000 people to give up private health insurance by the end of 2012 as a result of rising unemployment. The proportion of the population with health insurance declined from 49% in 2007 to 47% in 2010. The numbers qualifying for and receiving medical cards have increased. Some 30% of the population have a medical card, while 23% have neither a medical card nor health insurance and must pay as they go through every part of the health care system. A total of 53% of the population depend entirely on the public health system, from which the other 47% also benefit - for example, through the use of private beds in public hospitals, which I spoke about earlier. Data from the OECD shows that the largest proportion of funding for health care in the State - 80% - comes from the public finances.

In light of these facts, how does our existing structure make sense? This Bill simply addresses one aspect of that structure, which I welcome - the need for what is called societal and intergenerational solidarity in the health insurance sector. It does this by continuing up to the end of 2012 the arrangement whereby the burden of the costs of health services are shared by insured persons through a cost subsidy and age-related tax credit funded by the collection of a levy on all insured lives. There is a need to protect our health system from a predatory approach by health insurers, which would see older people and those with illnesses being forced to pay higher health insurance premiums. This Bill seeks to achieve that for another year. However, it is a stop-gap measure, and I hope many of the changes the Government has promised will be implemented, although I do not accept all of them. I do not like the fact that the response to the health care situation is based on health insurance because I am opposed to health care being driven by market forces. I would much prefer if the Minister was to move towards universal health care, because health is a right and it should be provided at the point of access for all and funded through progressive and just taxation.

I support the Bill in what it does. There is a problem in the market at the moment whereby some health care providers are discriminating against older people and others in the market, and the Bill corrects this. That is why I support it.