Marc MacSharry (Fianna Fail) | Oireachtas source

I offer many thanks to Senator Gilroy for sharing one of those copies so we could have a quick preview of the closing pages of the speech.

We will not be supporting this legislation and I have several questions in this regard. Mr. Colm McCarthy prepared a report on health insurance but it would seem that not much cognisance has been taken of its findings. There is very serious concern that an increase in health insurance premia will inevitably result from this. I have heard a suggestion from the Department that the Minister has actuarial data to show this will not happen, so I would be most interested that he publish this information given independent economists such as Mr. Colm McCarthy are saying it is inevitable we will have an increase. All of the insurance companies are also saying this, with some suggesting there will increases in premia of over 20% and as much as 40%, and they are collectively agreed it will be close to a 30% increase across the board.

As somebody who has private health insurance with VHI, I have found that, with a family of five, I have had to adjust the kind of cover I have. We were paying in the region of €3,200 per annum and we have had to cut back on a number of items to leave it now in the region of €2,000. That is against a backdrop where approximately 1,100 people a week have pulled out of health insurance, which is greatly upsetting the sustainability of our community rating system. This is the forgotten generation - people like Senator O'Brien, myself and those of that age group - who are struggling to nurse mortgages and so on, and are now asking: "Will I stay in the health insurance market or not?"

The Minister in his commentary on this issue has pointed out that health insurance claims are up, but that is hardly a good sign. Of course they are up, given the people who are still in there are the ones who are older and less healthy, regrettably, and it is the younger people who are pulling out. This is what the data that has been made available to us seems to suggest. In the recent figures, we see that 79,000 customers under the age of 40 left the market while the number of insured people over the age of 50 increased by 14,000. That is simply unsustainable.

I am sorry the Minister has to leave and I thank him for taking the time to attend.

No doubt, the Minister of State with responsibility for disability, equality and mental health issues, whom I welcome, will pass on all of my sentiments and listen as intently as ever.

I have just spoken about how I inquired about what data were available in the Department to show that we were not going to have an increase in premia of 30%. The Minister has said the health insurance companies are scaremongering. However, it stands to reason that if I, as a taxpayer with health insurance who contributes to the same public health system through my taxes, must now be charged €900 or whatever the figure is per night for a bed in a non-teaching hospital as opposed to €75, or €80 following the passage of the Bill, it will inevitably affect the solvency of the insurance companies. That is borne out by a number of issues that have been raised by Mr. Colm McCarthy in his report. Inevitably, there will be fewer people in the health insurance market and those who stay will be over 50 years in the main. They are more likely to be sick and a heavy burden on the system and those who leave will put increased pressure on the public system, creating additional costs. It does not seem to add up and is very woolly. We do not know how it will pan out. In terms of the basic economics and if we are to listen to those involved in the system, this will not play out very well, which is a major concern for us. For that reason, we cannot support it.

There appears to have been no consultation with the insurance companies. Perhaps there is a line of communication with VHI, given its connection to the State, but in the case of the other companies, there seems to have been no formal contact to ask them what they think could be done and how we should respond to the financial challenges in the health service. I gather the insurance companies made a submission on a collective basis a month ago containing suggestions about how savings could be made. It is our information that there was no response to that submission. Is that the case because if it is, it seems like a very bad practice to come up with a plan and then consult after it has been implemented?

Yesterday the Minister announced a new health forum, which will aim to lower the cost of health insurance. Who announces such a forum the night before legislation is published? It is like saying, "This is the new car that we are selling into the market and we plan to test its performance after we sell 50,000 units." It is just ridiculous; it is planning in reverse and haphazard. If there is a master plan behind this, the Minister of State should share it with us because it looks very haphazard and loose. Regarding the announcement of a new health forum that will aim to lower the cost of health insurance plans and "knock heads together", based on what the insurance companies which contacted us stated, it seems that they were available to talk for a long time.

Is the Directorate-General for Competition in Brussels in any way concerned about this measure? On the one hand, the private insurers negotiate directly with private hospitals, whereas the Minister of the day sets the price in the case of public hospitals. Is there a competition issue? There might be. The Minister should look into the possibility that some insurance company will refer it to the Directorate-General for Competition.

The Bill was to provide for the roll-out of free GP care, but we do not see anything in it about this. That was our understanding of the position. The measure seems to have been pushed out further and further.

There is an adjustment being made to the fair deal scheme whereby a higher proportion of the elderly person's estate will be sought. Age Action Ireland has made its views very clear on this and other budgetary measures announced before Christmas. The other measures such as trebling the prescription fee are being interpreted by Age Action Ireland and quite likely the elderly as a further attack on them.

What are the Government's plans to attract young healthy people to the health insurance system? At its peak, 2.5 million or more people had health insurance across the full system. This figure has been substantially reduced and it has been predicted that 300,000 will leave as a result of this Bill. What measures will the Government introduce to entice people to take out health insurance because I see nothing in the Bill to that end? People in Senator Darragh O'Brien's age group and mine - what the ESRI called the forgotten generation - pay between €2,000 and €3,000 per year if they have a few children; therefore, it is a no-brainer. That figure must come down or other measures will have to be put in place because it is simply unsustainable.

While I appreciate that the Minister of State is deputising for the Minister, I ask that she try to answer some of my questions. In terms of the figure of €75 which is to increase to €80, we are supportive, but we cannot support the other measures proposed. If they come to pass which they clearly will because the Government has a majority, a universal system of health insurance will be even further away because the Bill will inevitably bring down the numbers already with private health insurance. As Mr. Colm McCarthy said in his report, the lower the number with private health insurance, the more difficult it will be to implement a universal system of health insurance.