John Gilroy (Labour) | Oireachtas source

I welcome the Minister to the Chamber to debate legislation that has passed all Stages in the other House. I watched the debate with some interest but it took me a little while to assimilate the necessity for the Bill. It is technical and complex legislation. When I gave it a lot of thought, I realised it is a fundamental part of the transition to the universal health insurance system we have long awaited and hoped for. The Minister's colleague, Deputy Alex White, talked about medical cards during the week and he has often talked about the building blocks required in advance of establishing the long-awaited reforms of the health system. Nothing is as complex as the health system. The role of setting the rate of stamp duty involves the Minister for Finance along with the Minister for Health, which demonstrates the level of complexity.

Policy change in one area automatically leads to policy change in other areas so that we can have a coherent policy across all areas. Risk equalisation and community rating are the core issues at stake. How we achieve them is the fundamental part of social democracy and we are all social democrats. The rising cost of health insurance is the bugbear of everyone and we must balance access to affordable health insurance with a need for equity in access to health services. The current system is the cause of the two-tier health system. Access to health must be based on medical need not on the depth of one's pockets. While I welcome this aspect of it, we have a long way to go.

Second Stage of any Bill is time to ask whether the legislation is good. I think this Bill is good and it is something we can support. I hope everyone can support it. Senator Barrett referred to cost containment and how he would like to see efficiency achieved in hospitals. This also applies to how health insurance companies do their business. One example concerns a woman whose 15-year-old son developed chest pains while playing a match. He could not play until he had the problem sorted out. On the public system, it would take 12 months to get an appointment to see a cardiologist. Because they had a health insurance plan, they decided to go privately and went to a private hospital in Dublin. The minor surgical procedure required a two-night stay before being discharged, being admitted the night before and discharged the day after the procedure.

She showed me the bill which was for €17,000. It was shocking at every level. It was also shocking that when she telephoned VHI, her service provider, it could not adequately explain the reason for such a bill. One might even have said it was excessive at €1,700. Is it not strange that people feel they have to go to politicians? Is there not something wrong with the system when a member of the public must go to her local Senator to explain something rather than her health insurer? Is it any wonder Senator Marc MacSharry is complaining that the cost of his health insurance is becoming so exorbitant that he will not be able to afford to pay it next year?

Is there any mechanism, as Senator Sean D. Barrett asked, to ascertain whether health insurance companies are getting good value in the private sector? I would be all in favour of health insurance companies paying as much money as possible to the public sector, but we are looking at exorbitant prices which are being passed on to customers. Is it any wonder that we see super profits about which Senator Sean D. Barrett talked? I am happy to see section 7(4) introducing a requirement to make a payment into the risk equalisation fund if a company has made more than a reasonable profit. That is progressive. It is a big change in many policy areas, not only in health but other areas also.

I look forward to teasing out these and other issues on Committee Stage. Obviously, we support the Bill, but there are many questions I would like to ask on Committee Stage which would be more appropriate than loading the Minister with many technical questions to which no doubt he does not have the answers now. However, I might not be in a position to assimilate these answers.