Vol. 512 No. 1
185 Ms Shortall asked the Minister for Health and Children his views on the large increases in private medical insurance in recent years; if his attention has been drawn to the fact that, for many older people in excess of the medical card income guidelines, medical cover is becoming progressively less affordable; and the steps, if any, he will take to address this problem. [25637/99]
Subject to the requirements of community rating, which ensure that premiums are not increased because of the insured person getting older, the setting of premium charges is a matter, in the first instance, for the insurers concerned. Premiums are set having regard to such business considerations as anticipated claims payments, administrative expenses, and the maintenance of adequate reserves. Health care costs are increasing at a rate ahead of general inflation as they include a range of unique factors, including increasing utilisation of services and high cost technologies.
The Government considers that the private health insurance regulatory framework should enable the development of practices between insurers and service providers which address the standard, efficacy and cost effectiveness of the services being purchased. Current cost containment approaches include negotiation of scheduled professional fee payments, length of stay agreements and a shift towards day care activity. There are other measures, such as greater use of fixed price procedures and development of treatment protocols, which it may be possible for insurers and service providers to develop to ensure the optimum use of available resources. It is also considered that a greater emphasis on primary care in the development of insurance packages may, over time, be beneficial as regards early detection of disease and intervention or obviating the need for more costly hospital care.
The health insurance regulatory framework should not impede such development, should not be inflationary and should safeguard the broad rights and interests of insured persons. This is the approach to be pursued by my Department on foot of the recently published White Paper on Private Health Insurance. Ultimately, in the competitive market in voluntary private health insurance, cost containment measures are essentially a matter for agreement between insurers and service providers, having regard to the need to provide a quality service at lowest possible cost for insured persons.
