Seanad debates

Tuesday, 21 November 2017

Health Insurance (Amendment) Bill 2017: Second Stage

 

2:30 pm

Photo of Maire DevineMaire Devine (Sinn Fein) | Oireachtas source

I welcome the Minister of State to the House. I question whether health insurance is fair, the extra burden that is carried by citizens given their PRSI contributions and that they are trying to keep the health system going. We deal with a Bill like this one every year and it is about taking the risk away from insurance companies. It aims to be Exchequer-neutral but I wonder why are we involved in discussing, meddling and assisting the private sector. The health system is on its knees and it has been bled dry. Some 46% of thereabouts of the people who struggle to afford private health insurance are thinking it is better to have a safe clause for themselves and their families than none at all. That is the reality. They are held by ransom as the health system buckles under the weight of demand and need.

We still need to talk about systematic change. It is the elephant in the room and should be prioritised. We are discussing this legislation when the health sector is on its knees with an absolute health emergency and discussing the future of health care should be prioritised.

Last year, when speaking on the risk equalisation Bill, the Minister stated "We need to encourage our insurance companies not to use this as an excuse to hike up insurance premiums" and I sincerely hope he does more than encourage good behaviour.

I would appreciate an outline of how the impact of risk equalisation is conducted in Ireland. Has it been conducted and what has been found since this policy was brought forward? If the Minister of State cannot provide that or does not have those statistics, I will need to consider tabling an amendment on the impact of assessment. I urge her to seriously consider this as encouraging private health insurance is not enough. We need transparency, oversight and value for money, especially if it is coming out of the public purse.

The social justice issue of health insurance is not about equity of premium but is about the inability to pay. That is what we should be discussing here today. I imagine the argument would be that risk equalisation benefits the ordinary person who may be more sick or more at risk than their neighbour but we would not need this benefit if all our citizens had access to a properly functioning public health system. That is the real risk we should be reviewing and managing today.

I want to pick up on a point highlighted last week, which other Senators may also have raised even thought it is not directly related to this Bill. A person may be on a waiting list for a particular investigation, scan or whatever it may be, but if one has the required €600, one can get it down within 48 hours. In one case in St. Vincent's hospital, there is only one machine to do a particular investigation. Why is it that if one has €600, one can have the investigation done within 48 hours, but it will take up to three years to have it done if one goes on the public waiting list? There is a small number of medics who seem to use our public property, our public machines, whatever they may be, for their own gain. I find that disappointing, which is a polite word to describe it.

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