Marc MacSharry (Fianna Fail) | Oireachtas source

I welcome the Minister to the House. We will not support the Health Insurance (Amendment) Bill 2013. While we fully support the concept of risk equalisation and community rating, these policies will not work if we continue to undermine health insurance at every step. The market is becoming more unbalanced, as we have seen, with approximately 280,000, arguably younger and healthier, people leaving the market. That continues at a rate of approximately 5,000 per month. More of the under-50 age cohort are dropping out, thereby increasing the levy required for risk-equalisation.

Government policy on this is incoherent in terms of health insurance policies, such as the capping to tax relief. The Minister for Finance, Deputy Noonan, spoke on that earlier in our debate on the Finance (No. 2) Bill. The redesignation of hospital beds will arguably force more young people to quit, which will further exacerbate the imbalance in the market. I have substantially reduced the level of cover that my family of five has because of the cost. It was no longer affordable to continue with the levels we had, and we did not have a gold-plated policy, as the Minister for Finance, Deputy Noonan liked to call them.

The budget relief cut and the levy hike is expected to add €330 to the annual cost for two adults and two children. That applies to my family, although I have three children, and I do not know whether I can afford to continue with the insurance. Thankfully we are a relatively healthy family. It is possible that this time next year I will not be in the health insurance market and there will be an increased burden as a result because the relatively younger, healthier people will no longer be there to cross-subsidise those in the autumn of their lives requiring more health cover. At the same time we have taken medical cards from 55,000 over-70s over the last two budgets. More of them will presumably need to take out health insurance and will increase demand. This triple whammy will make the market even more unbalanced and will mean the Minister will be back here next year with another levy hike. It is a vicious circle.

The Minister mentioned the HIA a number of times and its report is due on Monday or Tuesday of next week. I do not know whether the Minister already knows what is in that and was able to draft this legislation accordingly. Last year the HIA made a series of recommendations to the Minister on what could be done to try to entice younger, healthier people into the health insurance market and he has done none of those things. I wonder why. He did the opposite. He increased certain things the HIA had recommended he decrease. Will the Minister act on any new recommendations in next week's report? The point was made in the other House when this was being discussed that we should have waited until the HIA report was published before debating this legislation. Again, the Minister may already be aware of what is in that report but the rest of us are not.

In the absence of the HIA report and in view of the cap on tax relief being reduced, we are unable to support this Bill. We have seen no indication of any effort or initiatives over the last number of years to get younger people into the market. I have grave concern that the Minister will be back next year to further increase this. With 5,000 people per month leaving he will have no option unless something is done to entice people into the market. The haemorrhaging of younger, healthier policy holders threatens the sustainability of the market and puts huge upward pressure on the likes of myself, as an example, and anybody who has private health insurance.

The debate in the Dáil has a lot of "remember what you said" in it. The transformation of people's opinion on these issues is interesting, particularly the Minister's opinion when, as Opposition spokesman, he spoke of not recommending the Bill going through the House at that time, how he was vehemently opposed to it, it was ill-advised and would put more pressure on our already pressurised health system. Those were all the Minister's words when we were imposing a levy of €160. This Bill will authorise a €399 levy. On that occasion, in what was a very good performance from the Opposition benches, the Minister proclaimed it to be the last straw that broke the camel's back.

One wonders how the mind has evolved since in the Minister's approach to this issue.

I could support the Bill if it contained tangible initiatives to encourage young people to enter the health insurance market, but, unfortunately, it reflects an acceptance that the policy is not working. The levy, therefore, will be ratcheted up and between 5,000 and 6,000 people like me a month will exit the market, which is not sustainable. This is many millions of miles way from the Minister's UHI vision.