Paul Bradford (Fine Gael) | Oireachtas source

I welcome the Minister, and I am sure he is more than sufficiently robust to deal with the views of Senator Cullinane.

No topic comes up in the Seanad more frequently than the health service. It would be useful for both the Minister and the House, therefore, for him to come to the House early in the new year to discuss a broad range of health issues, when charges can be answered and the Minister can bring forward his own ideas and perspective.

We are speaking about the Health Insurance (Amendment) Bill. I have addressed the issues of risk equalisation and community rating on numerous occasions down the years. I will, of course, support the Bill, but probably with a heavy heart. Risk equalisation, while necessary in the short term, continues the system of health insurance we have had for many years but which is not sufficient to address the needs of the current generation. That is why I welcome the Minister's comments about plans for universal health insurance. A debate on that issue as soon as possible would be useful and worthwhile.

Universal health insurance sounds like good news. As the Minister and other speakers have said, however, some aspects of it will not be simple. They will be complex and very costly. Much of our thinking on universal health insurance is based on the Dutch model. In that country, it appears, the average premium is between ¤1,400 and ¤1,500, and increasing. The lesson we can learn from Holland or any country where universal health insurance is in place is that a top quality health service will cost money. There is no cheap option for solving the health crisis in this country, but the quicker the Minister can come forward with proposals and debate them with members of the Oireachtas, the better. We need to move beyond the current chaos in health insurance.

Over a decade ago, we saw difficulties with the first leading competitor to the VHI, namely, BUPA. The automatic response was to prop up the VHI, penalise BUPA and take whatever measures were necessary to save the skin of the VHI. The VHI has provided a top quality service to hundreds of thousands of people since it was set up by the late Tom O'Higgins when Minister for Health in the 1950s. It should have been more robust in dealing with the competition that arrived when BUPA and other companies came onto the market. The only response we got from VHI was, "Poor old us. We are looking after all the old people. The new firms are looking after all the younger healthier people and we must be protected". We have always responded to the requests of the VHI, whether for an increase in premiums, community ratings or risk equalisation. We have always said "Yes" to the VHI. It was necessary, politically, to do so but we must try to move on to new arrangements as soon as possible. It is with a heavy heart that I support this concept of risk equalisation, because it is a false concept.