Colm Burke (Fine Gael) | Oireachtas source

I welcome the Minister. It is always difficult to introduce changes such as this, but we must respond to what the market requires and provide equal access to health insurance. This is, unfortunately, the way it has to be dealt with. More than 530,000 people are aged over 65 years, many of whom, thankfully, have health insurance. That cohort will continue to increase in the coming years and it is estimated that 900,000 will be in this category by 2030; therefore, we must engage in careful planning in this regard. The long-term plan for the health service will take a number of years to implement and the Government is working on it. In the meantime, the Minister must deal with the market as it stands.

VHI has 89% of the over 80s market. It is interesting that the number of people in this age category has increased dramatically in recent years, with an increase of 20% in the past six years alone. That reflects how the market is changing and the Minister has to introduce legislation to make sure people have equality of access and that there is an equal health insurance contribution.

The cost of health care went unchecked for a long period. The Government parties have made a significant effort in the past two and a half years to address increasing costs in health care and that effort will continue. It is not easy, but we need to achieve greater efficiencies. In the past few weeks an area was highlighted in which there was still no scrutiny. The Minister and the HSE are dealing with this issue of the 25% of the health budget going to non-Department and non-HSE controlled organisations. It is being tackled to make sure taxpayer's money is used in a proper manner. In fairness, the vast majority of organisations provide a good service in the areas in which they specialise and comply in full with the regulations, but a few have not and the Minister and the HSE are right to scrutinise them to ensure moneys are not being used for a different purpose than was intended.

The health insurance market is under pressure and the numbers who have cover have decreased, but the only way to reverse the trend is by improving the economic outlook and getting more people back to work. The Government has succeeded in reversing job losses. At one point, more than 7,000 people a month were losing their jobs, whereas now almost 5,000 new jobs a month are being created. There are 58,000 more people at work than at this time last year and I hope that number will continue to improve in the next 12 months. This will help people to return to the health insurance market. The level of health insurance coverage has reduced from 50% of the population to 44%, a substantial reduction, but given the pressure people have come under financially, it is good that many of them have been doing everything possible to stay in the market. That should be encouraged.

In dealing with the health service it must be ensured the insurance companies carrying the older age cohorts are not penalised. The demands they place on health services are greater than those of younger people, which is why the adjustment is being made. The Bill is comprehensive in that it sets out clearly what the strategy is for the next three years. This is important to provide security.

Further efficiencies will have to be generated in the health service and we must continue to work towards reducing the cost of medical care. A major change in the cost of drugs was introduced in the past year. Payments for drugs had increased from €570 million to more than €2.3 billion annually. The Minister introduced legislation to deal with the use of generic drugs because only 18% of drugs prescribed were generic, whereas in other countries the figure was as high as 70%. In addition, the cost of drugs was much higher than in other countries and changes are being made in this regard. This can contribute huge savings also. By tackling these issues, the cost of health care can be reduced and I hope more people will then re-enter the health insurance market and the cost of insurance will not increase. That is the long-term plan we want to work towards. This legislation is a step that must be taken at this stage to stabilise the cost of insurance and make sure the companies providing insurance cover, especially for older age cohorts, can continue to provide the requisite level of care. I support the Bill.