Written Answers. - Medical Cards.
Noel Ahern
Question:
518
Mr. N. Ahern
asked the
Minister for Health and Children
the procedures applied by the health boards in relation to provision of sleep apnea devices approved and prescribed medically which are hired by patients individually who then claim the cost from health boards; and if he will reconsider and have devices hired directly by health boards which should reduce bureaucracy and so on.
[13247/02]
Minister for Health and Children (Mr. Martin): Arrangements for the provision of items such as sleep apnea devices to individual patients are a matter for the relevant health board to decide.
Noel Ahern
Question:
519
Mr. N. Ahern
asked the
Minister for Health and Children
the position in relation to VHI or other health insurance and the reason credit or reduced rates cannot be given to persons who qualify for medical cards of public health hospital provision; the fundamental principle involved which prevents this; and if the philosophy behind this matter can be outlined.
[13248/02]
Minister for Health and Children (Mr. Martin): There is no relationship between the criteria for eligibility to hold a medical card and the rates applicable to the purchase of private health insurance. The former relates to a statutory based social protection provision, while the latter involves the voluntary purchase of commercial insurance against the risks associated with the cost of illness and is solely a commercial arrangement for the insurance provider, primarily guided by business considerations.
In terms of health insurance considerations, there are no grounds to require insurance companies to provide cover to persons with medical cards at more favourable rates than the insured community at large. From a regulatory perspective, such a measure would not be compatible with the core principle of community rating in our health insurance system. A broad range of factors could be put forward as justifying reduced premiums for certain categories of persons, for example, a no claims bonus. However, such an approach would be detrimental to community rating.
Having regard to consumers, the existence of community rating represents a broad protection to the community as a whole in terms of individual insurance rates applicable, particularly for the elderly and the sick. It is based on intergenerational solidarity where young healthy people contribute to the system, which facilitates the insurance of older, sicker people at premium rates that would not otherwise be affordable.
Noel Ahern
Question:
520
Mr. N. Ahern
asked the
Minister for Health and Children
if he has received complaints of general practitioners encouraging persons over 70 years of age who always had medical cards to surrender them and re-apply for the over 70 scheme which is more lucrative for general practitioners; if there is a complaints procedure for such complaints; and the action which could be taken against a general practitioner if a case is proven.
[13249/02]
Minister for Health and Children (Mr. Martin): My Department has not received any complaints of this nature. If the Deputy has evidence which suggests that doctors are encouraging such behaviour in an attempt to enhance their own remuneration, I would be obliged if he would forward it to me and I will have the matter investigated. Complaints of any sort against a GMS contract holding doctor may be made to the local health board, in the first instance, and any remedial action deemed necessary can be taken by the chief executive officer. A code of behaviour and conduct forms part of the GMS contract.
