Written answers

Wednesday, 9 November 2016

Department of Health

Health Insurance Data

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
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161. To ask the Minister for Health his plans to review the legislation in view of claims data submitted by insurers (details supplied) and the negative impact on the affordability of private health insurance; and if he will make a statement on the matter. [33994/16]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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Insurance companies operate as commercial providers and make their own decisions about the price of their health insurance plans. The cost of private health insurance is influenced by a number of factors such as the number of persons in the market, the age profile of those holding private health insurance and ongoing medical innovations. Each of these are contributors to the cost of care, the cost of claims and therefore the cost of premia payable.

While everyone is entitled to use a public hospital, some people choose to be treated privately, in which case they have chosen to pay the consultant and the hospital. Prior to the Health (Amendment) Act 2013, private in-patients in public hospitals were, in the case of an emergency admission where a private bed was not available, accommodated in a public bed for which they were charged €75 per day (to a maximum of €750 for 10 nights per annum) although they continued to pay the fees of their hospital consultant. The Comptroller and Auditor General pointed out in his 2010 Annual Report that almost 45% of in-patients being treated privately by consultants were not paying the designated charge to the public hospitals in which they were being treated, because they did not occupy a designated private bed. This represented a significant loss of income to the public hospital system, to taxpayers and was an indirect subsidy to private insurance companies, who cover most private patients.

On the basis that users of private services should pay for the costs of providing these services even when they are provided by a public hospital the previous Government introduced legislation in 2013 to amend Section 55 of the Health Act 1970 to provide for the charging of private in-patients whenever they have opted to be treated as a private patient by their hospital consultant. The charging regime as introduced was intended to decrease but not eliminate any gap in providing services to private in-patients and that target is being reached. There are no plans to reverse this policy.

It should also be noted that under the 2013 Act, all private patients are charged in a similar manner, and this enabled the legislation to provide for an average reduction of 9% in the daily charges for private patients in public hospitals. The private in-patient charge goes not only towards meeting accommodation costs but also towards meeting part of the cost of providing the hospital's services to private patients, for example, the cost of non-consultant doctors, nursing, administration and support staff, diagnostic services (such as x-rays and other scans), medical and surgical supplies, operating theatres, laboratory services (such as blood tests etc) and capital costs.

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