The position in regard to this matter is very much as Senator Stanford has told the Seanad. Since the Insurance Act of 1936, whatever doubts may exist one way or the other, the position has been accepted by the Minister for Industry and Commerce, who is the responsible Minister, and by interested associations, insurance bodies, that no form of health insurance—I am speaking only of health insurance—could be provided here except by those entitled to do so under the Insurance Act of 1936, and that meant licensed companies in accordance with the provisions of that Act.
It is also true that for the last 20 years, with one exception for a short period, none of those entitled to offer health insurance were interested in so doing. The position, therefore, has been over the last 20 years that our people here have not had available to them this form of insurance and it is precisely for that reason that this Bill is brought before the Oireachtas to meet that need and to provide this form of insurance for the people.
I am aware that different individuals have from time to time taken out forms of insurance which it was not legal or lawful for them to do. I cannot be asked to regard those people as being deserving of any privilege or special treatment. The plain fact has been that these British associations, which have been referred to here, under our existing law are not entitled to operate in this country and that goes for all. If some of our citizens have effected insurance with these people they did so knowing they were effecting insurance with an association, however well intentioned it may be, which in fact was not entitled to carry on insurance in this country.
It is suggested now that under this Bill these people who operated despite the provisions of the law should now be given a free pardon, if you like, and authority to continue with the insurance they have effected. That does not appeal to me. I do not think it is right. I do not think we should be asked to do so. As a result of the lack of initiative, if you like, by those entitled to do this for the last 20 years the State is now stepping in and setting up the appropriate machinery and endeavouring to provide, as economically as possible, a form of insurance to meet this need. In doing so I feel it is only right and proper that the board which will be charged with this duty should not be open to competition from outside because it would be very easy, as can well be imagined, for some outside association to make the work of the board completely impossible by offering for a period health insurance policies which would be uneconomic on Irish experience but which would be sufficient to make the work of this board a failure.
I said before, and I want my point of view to be understood, in relation to policies of health insurance at present on offer in England and which might, if the law were otherwise, be on offer here, that I do not believe that anyone can afford to disregard entirely the very carefully prepared report of the Advisory Body on health insurance. They have considered the facts and circumstances of this country and they have come to the conclusion that a scheme, roughly along the lines that they have set out here in the report, is the only scheme which will pay its way. That would entail that for the type of cover mentioned by Senator Sheehy Skeffington a premium, in the case of the individual, of £15 would represent the necessary premium, not for making a profit but to enable the scheme to pay its way. That is the view of the Advisory Body who have gone carefully into this matter and who have shown in the report the investigations they made and the very careful costings which they carried out and all the material which they collected. That is their view and I accept that view.
I think the report is an excellent one, excellently documented and represents a very careful appreciation of the situation. Accepting that view means this—that if the association that Senator Sheehy Skeffington mentioned, or any other outside association, offered a form of health insurance here, at the premiums which they offer in England, that association would go bankrupt very quickly. It could not carry on and it would be impossible for it to provide health insurance in this country at the premiums that they can offer in England, because our circumstances are quite different. The size of our families here is twice that in England.
In addition, in England there is a full national health scheme and people who effect health insurance only use it for particular purposes. They are content to avail of the State health scheme for a variety of calls which here, under our scheme, would become the subject of insurance expenditure. It is not possible to regard a premium based on English circumstances as being the premium which it would be necessary to charge here. I do not think it would be desirable, in any event, that any of the British insurance companies should, in effect, offer a form of health insurance here under which those paying the premium in England were, in effect, subsidising the market here in this country. That would not be desirable on any grounds and accordingly the prohibition contained in the section is one designed against the outside companies and associations from operating, or offering, health insurance here.
If there is any form of health insurance of a legal kind already entered into by any individual, that is not prohibited. That is the purpose of the saving clause to which Senator Stanford has referred. In sub-section (3) (b) (iv), any lawful contract of insurance entered into before this Act is not in any way interfered with or prohibited, but those who entered into contracts of insurance which they knew, and which the insurance company knew, were not in accordance with the law of this country, can expect no special treatment and they will be excluded. Up to this the Minister for Industry and Commerce, who probably was aware that these policies were on offer here turned the "Nelson eye" because, in fact, there was no alternative form of insurance. That alternative form of insurance will now be available, I hope, in the near future and I have no doubt that the Minister will see that the law in that regard is enforced.
Senator Stanford mentioned—and I must say he put it very well—the case of a person who in fact is accepted by one of these potential associations outside the country and who, no matter what the provisions of the law may be, has been covered and who found that in ill-health he and his family were safeguarded. Such a person was fortunate in having had that form of cover during his own illness and that of his family, but I am sure the Senator will find on inquiry that, if that individual is suffering from a particular malady or condition, the association concerned will continue the insurance but will exclude that particular condition. It may be that a person in good health takes out a form of health insurance and may develop a condition of coronary thrombosis. Such a potential association would continue the insurance, but it would exclude that particular illness and the effects arising from that particular condition. Such an individual, when our health insurance is on offer, will get precisely the same kind of cover that he would now get from the British associations or companies in relation to his condition. In other words, if he had a condition of coronary thrombosis, he would be insured in relation to anything else, but that particular condition would be excluded so that, in fact, precisely the same kind of cover will be offered here as would be available to a person who has been insuring for a number of years, however unlawfully, with British associations.
I should like to impress upon the Seanad that in excluding these British companies I am not, in fact, depriving our people here of any benefit. The premiums mentioned—and you can get a whole variety—are in no way realistic. Having regard to the circumstances of this country, there is no form of British health insurance scheme that could operate in this country except along the lines of the Advisory Body's report. The premiums suggested are based on individual premiums. In fact, the premiums in this report might be considerably different when groups of insurers are taken into account but, in so far as the individual is concerned, these premiums represent the premiums that would have to be charged by any insurance company here putting on offer health insurance for the people. If the aim is to meet costs from the premiums income, then the premiums will have to be along the lines suggested in this report.