Colm Burke (Fine Gael) | Oireachtas source

I welcome the Minister of State to the House and thank her for bringing forward this legislation. I agree with my colleague. We are concerned when any levy is increased. That is the challenge we face over the next 15 or 20 years. If one looks at the growth of the population over 66, it will continue to increase. Pensions alone will cost an extra €200 million per annum because of the increase in the number of people who are reaching retirement. There will be an average of 20,000 people per annum added to the number of people entitled to draw an old age pension. That is also reflected in the change in the health services. The one frightening figure we find in health services is that 51% of all hospital beds are occupied by people over 66 years of age. We will have a growing problem over the next ten to 15 years.

My understanding is that the number of people over 66 will be approximately 1 million by 2030. It is around 600,000 at present. Therefore, we will face a major challenge in this area. It is something we need to look at. We also need to look at the fact that, per head of population, the cost of health care in this country is higher than in other EU countries. How can we continue to improve and increase the level of services we provide while at the same time ensuring we get cost efficiency? We will have another debate later on about the cost of a particular drug but we seem to have a major problem in this country with the overall cost of pharmaceuticals. That is part of the huge costs in our health service. If one looks at the Department of Health and the HSE budget, it is €14.5 billion this year. There is another €3.5 billion to €4 billion for private health care across a whole range of areas. We are talking about over €18 billion per annum in health care. That will continue to increase. In order to keep people paying for insurance, there has to be risk equalisation. This is the fairest way of doing that. While no one welcomes any increase, unfortunately because of the changing demographics, it is likely to continue. I note where the changes have come in. The other area where it is increasing is in the over-85 age group, which has increased by over 20% over a very short time period of six to seven years. In the Bill, the contribution for someone over 85 is €3,700 per annum. It will obviously be a growing figure each year. I welcome the Bill. We have to continue with this equalisation process.

While we welcome that an additional 100,000 people have begun paying for private health insurance in the past 12 months, that will probably level off. Other challenges such as the cost of renting and buying housing will have a knock-on effect when trying to increase the numbers of young people who have private health insurance. If we do not increase the numbers, the problem is that risk equalisation will have to continue and will increase the cost. That is one of the challenges we face. We need to look constantly at how we can make the system more efficient and deliver a top of the range service while at the same time not increase additional costs.

I will touch on one other issue with people paying private health insurance which I came across as recently as yesterday. It is in respect of eye care and involves a person who has insurance but requires a particular treatment in order to prevent them from going blind. The cost of the operation for each eye is around €4,000. They are now being advised that their policy does not cover them for this particular type of operation. One of the things that is happening is that people sometimes buy into insurance thinking they are covered for a whole range of areas and then find when the issue arises that the cover is not there.

The other issue I have come across is where a particular treatment is not available in Ireland but is available in the UK, for instance. The treatment recommended to the person is in their best interest, yet there is reluctance on the part of the insurance company to get involved in providing cover. We have ended up going in and battling with the insurance company to try to bring it on board. There is a huge long-term saving for the individual and also for the company because if the particular procedure recommended is not completed, the person will end up spending longer in our hospital service. Sometimes when we look at problems, we look at the here and now but do not look at the long-term issue of how to save costs at a later date. I welcome that we are now progressing with this matter. We need to have an overall discussion on this matter in the long term. How will we face the challenges over the next five to ten years on this issue? The age profile is continuing to change. In order to make sure we do not have the same increase next year and the year after, we have to increase the numbers who are paying private health insurance. Otherwise we will have to continue to increase the levies that apply in each category. I thank the Minister of State. We will support the Bill.