David Cullinane (Sinn Fein) | Oireachtas source

I welcome the Minister to the House. My party will support this Bill but only because it brings some level of equity to the health care system and retains some equity in the delivery of health care in the State. The Bill continues a necessary system of community rating, which ensures that all consumers are charged the same premium for a particular plan, regardless of age, gender or health status, thus preventing price discrimination against those more likely to require medical treatment. It amends section 1A of the Health Insurance Act 1994 by making the provision for community rating more specific, extending the cost subsidy currently between the young and old to include the more healthy and less healthy.

This is necessary and valuable, as equity and solidarity within the health care system is important. However, the necessity illustrates effectively to me and those who use the health care system that there is inequity in the system because of the existence of private health insurance companies. That is one of our problems but the Minister wants to open the future of our health care system to the private health insurance market. We are trying to regulate the system and work against the worst excesses of what happens because we allow our public health system and patients to rely on the private health care system. It is only a sticking plaster solution to the problems we have in the system. Without legislation, the unregulated market would discriminate against the old, the sick and any other group that individual insurance companies decide is at greater risk. The necessity for this legislation is evidence that the Government accepts this issue.

The Bill is part of a long-standing but complex system of risk equalisation to support the community rating principle, which compensates those who carry heavier risk burdens as against those with lighter risk burdens. It provides against a raw profit motive and protects our elderly, unwell people and the vulnerable. That is a positive step. The current position is farcical and we need the safeguards in this legislation to protect against the sharp practice of private insurance firms while at the same time subsidising heavily the private insurance industry. We would hardly have a private insurance industry - if it can be called as much - without State support. That is ironic. We subsidise the private, for-profit health system with private beds in public hospitals and fast track treatment for private patients. Meanwhile, the bottom is falling out of the market, with 60,000 people forced to drop their insurance in the past year. It would be laughable if it was not so serious; we are subsidising the private health care system with the public system, which is itself at breaking point.

Based on the figures from the Government, if we applied the full cost of private beds in public hospitals, it would save ¤432 million per year, and that money could be spent on dealing with the problems we have in our public system by reducing waiting times and ensuring genuine equity in the system. I want a world class public health care system to be funded through progressive taxation and based on need alone. There should be no charge at the gate when people receive treatment.

The reform strategy of the Fine Gael and Labour Party Government will be based on competing private health insurance companies and will represent the effective privatisation of health services. The strategy has no basis in rights as it contains no commitment that patients will be guaranteed in law by the State to receive basic and essential health care. The Minister is relying on a profit motive and hoping the edges will be softened with regulation. We must wait to see how that works out. I note with interest the concerns that IMPACT has tabled about the future of health care in Ireland and the Minister's plans for the health care system. The union believes this will lead to a more inequitable system and we will not get value for money, quality or universal access to health care.

I am not one of the two-faced politicians or public representatives in this State. I have the courage to say to the Minister's face what many people in this room have been saying over the past number of weeks. There have been many calls from Senators for the Minister to come before us and explain issues relating to site locations of primary health care centres. Many people have said the Minister should resign as Minister for Health, and I am one of them.

I take the opportunity, while the Minister is in the Chamber, to call on him to resign.