Keith Swanick (Fianna Fail) | Oireachtas source

Fianna Fáil supports the Health Insurance (Amendment) Bill. These types of Bills, which amend health legislation, are somewhat akin to the Finance Bill or the Social Welfare Bill in that they seem to arrive at this time every year. The measures set out in the Bill before us are designed to support risk equalisation and sustain community rating in our health insurance market so that older citizens and people with illnesses can afford to take out insurance and are not discriminated against in favour of younger healthier people. Risk equalisation and community rating are principles we have always supported. No increase is being proposed for advanced cover levies next year, which is welcome, as is the reduction in the levy for non-advanced cover. The limiting of lifetime community rating loadings to ten years is also welcome, Fianna Fáil having previously tabled amendments seeking such a change. We are also pleased the lifetime community rating rules will exempt members of the Permanent Defence Force.

I cannot count the number of people who have come into my surgery to express concern about increased health insurance premiums in a context where they were already struggling to afford their plans. Many of these people were worried about buying school books or putting diesel in their car. In those circumstances, health insurance is one of the things people may have to give up. In 2009, Fine Gael expressed fears that the introduction of a health levy of €160 by the then Fianna Fáil-Green Party Government would make private health insurance unaffordable and that it amounted to an anti-competitive measure which would serve to prop up the dominant State player in the market. Fast forward to 2018, however, and Fine Gael in government has approved a levy of €444 for 2018. In fact, the levy was effectively doubled by the then Minister for Health, now Senator James Reilly, when it increased during his tenure by 178% for adults and 179% for children.

The Health Insurance (Amendment) Bill 2017 seeks to amend the Health Insurance Act in order to change the risk equalisation credits payable to insurers in 2018. It also seeks to maintain the main rate of stamp duty levy on health insurance contracts next year and decrease the amount of stamp duty levy on lower level health insurance contracts. The Bill will also make some amendments arising from the review of lifetime community rating which led, two years ago, to the introduction of measures to encourage people under 35 years of age to take out private health insurance. The lifetime community rating provisions sought to address the inequity in the system whereby persons who wait until they are older to take out health insurance were paying the same as those who were health insurance consumers for decades. A system of loadings, or additional costs built into the price of insurance policies, were introduced in 2015 to encourage people to take out a policy at a younger age. Those who signed up for health insurance later in life were slapped with penalties and increased price points while those who signed up before a certain age were spared the additional charge. We absolutely do need to encourage young people into the health insurance market, but we also must acknowledge that a person coming in at 30 years of age should be given some credit relative to the person taking out a premium at 55 years of age, when he or she is more likely to need to access health care.

Can the Minister of State offer us any insight into the Taoiseach's confusing remarks when, as Minister for Health, he said that lifetime community rating is a step on the way to universal health care? That is simply not true. As we move to universal health insurance, where insurance will be compulsory, the issue of lifetime community rating will no longer arise. In fact, it arises only in circumstances where one has a choice as to whether or not one takes out insurance. If everyone is insured, there is no need for lifetime community rating. Is this a case of wrong information coming from the Taoiseach? It would not be the first time we have seen evidence of confusion within Fine Gael in respect of its policy on health insurance. In 2006, for example, the Sunday Independentreported that the then Fine Gael leader, Deputy Enda Kenny, had signalled his opposition to the introduction of risk equalisation. However, for the seventh year running, Fine Gael in government is legislating for something to which it was apparently opposed in the past.

Will the Minister of State provide clarification on the section of the Bill setting out provisions for breaks in health insurance cover of at least six months for persons living in the State, up to a cumulative total of three years, without incurring loadings on resumption? What is the rationale for this change?

We in Fianna Fáil have been firm in our view that the principle of solidarity should apply in private health insurance as well as in public health services. Our values as a people are to support the elderly and the sick, not just out of a sense of obligation but because we respect and value older people and wish to safeguard the dignity of every person in their illness, medical condition or disability. It is sometimes observed that the moral test of any Government is how it treats those who are in the dawn of life, those who are in the twilight of life and those who are in the shadows of life, including the sick, the needy and the disabled. We should always be mindful of those principles.