John Crown (Independent) | Oireachtas source

I move amendment No. 5:

In page 6, between lines 9 and 10, to insert the following:“Amendment of section 21 of Principal Act
6. To insert a new subsection after subsection (1) of section 21 of the Principal Act:

“(2) Where a complaint is made to the Authority by a medical practitioner, to review whether any changes in coding, or payments structures, used by any health insurance undertaking, has the effect of restricting access to care for those who have health insurance contracts, or whether such changes result in services no longer being provided outside of the public system, and to notify the Minister, and the Competition Authority, if they form the opinion that any such change is likely to have such a consequence in the health insurance contract market.”.”.

This is a very particular issue brought to my attention. I do not wish to personalise the matter or make it too readily identifiable but an entire category of medical treatment has effectively become unavailable throughout the private sector in Dublin recently because of a decision made with respect to the reimbursement for a group of procedures by one of the major players in the insurance market. It is a little hard for me to escape the conclusion that a major engineering decision was made by the company in an attempt to corral this particular treatment back into the public sector and deciding that this is not a treatment to be covered in the private sector at all. This has the potential to cause chaos for the solitary unit in Dublin which currently provides this type of treatment, as there will be a major increase in demand and waiting lists for a procedure that is already over-subscribed and under-provided. It is very neatly allowing the insurance company off the hook in this regard. It has struck me that perhaps a little bit of Government oversight into some of the secondary and unanticipated consequences of certain reimbursement procedures could be brought to bear.