Marc MacSharry (Fianna Fail) | Oireachtas source

I welcome the Minister to the House and I am pleased to have an opportunity to make a few points. The Fianna Fáil Party supports the Bill, albeit with some reservations. We support the principles of risk equalisation, having commenced the process in which the Minister is engaged in 2010, and community solidarity, under which those who have the misfortune of being unwell are supported by those who are well and the young support older people. Those of us who are young and healthy do not have any difficulty giving a little more to ensure that we will have the benefit of being looked after when we reach a certain age or become ill.

As the Minister will be aware, the Fianna Fáil Party, while in government with the Progressive Democrats, decided on a comprehensive set of actions to support older and sick people. We firmly support the position that the principle of solidarity should apply in private and public health insurance. The former has played an important role in funding and organising health care for the past 50 or 60 years. In 2010, for example, the private health insurance sector was responsible for health care claims totalling ¤1.7 billion.

The Fianna Fáil Party is gravely concerned about the number of people leaving the health insurance market and the spiralling cost of health insurance cover. The VHI, Laya Healthcare, Aviva Health and GloHealth are lining up increases in premiums of between 10% and 15% from the start of next year. This will bring the average plan for a family with two children to ¤2,300, an increase of ¤300. Families with three children, which include my family, face a significantly greater increase in premiums. The latest hike follows increases in VHI premiums of 23% in January 2009, 8% in February 2010, between 15% and 45% in February 2011, 2% in November 2011 and between 6% and 12.5% seven months ago.

The rises are to cover an increase in health care claims, spiralling health inflation, the cost of new drugs and procedures and the expected rise in the cost of the levy on private health care of up to ¤200 per family. I am also concerned that we are not carrying out any analysis of people presenting in hospitals who had health insurance. Such an analysis would be of use to us. One expert is quoted as saying that the average family can expect rises in premiums of between 10% and 15% but it could be higher. We may be lucky to get away with 15%. All this means that the costs of health insurance have doubled over the past four years at a time when general inflation has been very low. Everyone will be aware that we even had deflation for a time.

People are either giving up or downgrading their coverage. I did an analysis of it for my family and would advise others to the same. It is getting to the stage where if there is one income in the house and a number of children, it is not affordable even for people on what would be considered generous salaries. People are deciding that they can do without health insurance and are taking the risk of not having any cover. This is very concerning and we need to do more about it. I accept that the Minister said in his speech that a number of measures are being taken but the pace at which these things are happening is not quick enough. I ask the Minister to continue to explore ways to hasten the reforms he proposes to implement in this area.

In his speech, the Minister spoke about the universal health insurance model and the white paper as envisaged in the programme for Government. Is there any indication when that might appear? The Minister said there are many complexities and an analysis of financial modelling that must be taken into account but it all sounds a bit on the never never. We all want solidarity, universal health insurance and a one-tier system and we want them yesterday, as the Minister will recall from his robust commentary on these issues while in Opposition. The Minister should state whatever it is that he, the Department or the support network do not have to help bring this forward as quickly as possible. He should tell us what he needs to get over the line more quickly with regard to some of these issues and let us see as a nation whether it is possible to provide him with them.

The health insurance companies have a vested interest but they made a number of points with regard to this legislation. I am sure the Minister will have taken some of them into account. The VHI believe it is good news for community rating but feels that the most important element in the Bill is the level at which stamp duty paid in respect of health insurance contracts effected to provide health insurance cover would be replied. GloHealth is worried in that it wonders whether the new Bill will add factors that may be taken into account when setting the levy related to health status but that there is no requirement to ensure affordability for all customers in the market. If the ambition as stated in the legislation is to equalise all age and health costs within the market, the inevitable consequence in its view will be higher premiums for all, which is concerning. Laya Healthcare claims that the ability of consumers to avail of new innovative benefits has been squashed by the new Bill as insurers will only be permitted to alter benefits across its most popular range of schemes once a year.

All of the health insurance companies have an issue with the time afforded to them to react to it. Aviva has been expecting this legislation for a few years, is in the market and supports the introduction of risk equalisation. It has a genuine desire to work with the Department of Health and Children on the issue but it needs see more of a constant and timely dialogue. I am sure the Minister might be able to take those issues on board. Insurers do have a vested interested but they make some worthwhile points.

We will support the Bill but I have a concern in respect of attracting younger people. We mentioned all the people who have left health insurance schemes earlier. I know that while in Opposition, the Minister would have bemoaned the fact that so many people had left the health insurance system. The rate of people leaving has doubled since 2008 and 2009. I think the figure was 76,000 to March 2012. The Minister's view was that overall, this was a modest reduction. Those were the words he used, which are different to those he used in while in Opposition. It is difficult to identify measures here that will attract younger people into the market. We need young, healthy people to contribute and take part in this system if it is to be successful. We will support the Bill but the Minister might take some of those suggestions on board. As always, I thank him for taking the time to appear in person in the House.