As regards lines 35 to 40 of the Bill relating to the question of loading, will some regulation take account of that? The section refers to people over 65 years.
Health Insurance Bill, 1994: Committee Stage.
Sections 1 to 4, inclusive, agreed to.
SECTION 5.
Question proposed: "That section 5 stand part of the Bill."
The principle of rating means that one cannot load. There will be circumstances where people entering for the first time may have to pay an increased premium. The notion of community rating is that there is a single package of benefits available to everybody regardless of age without loading so everyone pays the same.
Question put and agreed to.
Section 6 agreed to.
SECTION 7.
I move amendment No. 1:
In page 7, subsection (2) (a), line 29, to delete "or sex" and substitute, "sex or sexual orientation".
I made the substance of this argument on Second Stage and I am pleased, but not surprised, that the Minister accepted the trend of the argument and declared himself to be sympathetic. He said he believes this might be covered in other elements of the Bill. The amendment has been circulated but I believe it is useful to spell it out, to make it explicit rather than assuming that it is there by implication for the very cogent reasons that I put on the record of the House on the Second Stage, particularly with regard to HIV status and the question of patients with AIDS and the insurance risks involved in being part of what is defined as a high risk category.
I support the amendment. When we were discussing the Industrial Relations (Amendment) Bill, we added that as a reason against unlawful dismissal. This House has a good reputation in that area.
I have no difficulty with the spirit of the amendment and I have asked my officials to look at it in the few minutes we have had. They have assured me that under the global non-discrimination aspect of the Bill, sexual orientation is covered already. They are a little concerned that if somebody is specified then others not specified might be adversely affected. Sections 7 and 8 of the Bill already ensure that a person cannot be discriminated against by virtue of sexual orientation or other lifestyle factors. Section 7 (2) is a form of clarification of section 7 (1) but does not purport to form a definitive list of circumstances in which discrimination is prohibited.
The fear is there — and we have not had much time to think about this — that if a specific list of groups or people who cannot be discriminated against is inserted, we might leave somebody out, for example, sportsmen or some other high risk group and it could be argued subsequently that since this is a list of people who are excluded, the Bill allows insurers to exclude that lifestyle or activity. I am assured that to use a global brush and simply prohibit discrimination is the more effective way of doing it. I hope that is acceptable to the Senator.
Not really. This is the same argument that has come up on every occasion we put forward sexual discrimination clauses, including the first ones which were in the Incitement to Hatred Bill and the video Bill. That argument does not carry any conviction for me, particularly because if that was true the Minister would not include age or sex. It would just say you cannot discriminate. Age, sex and sexual orientation have become a linked group which are almost invariably spelled out. I have had this argument before, it is on the record of the House when we were discussing the Incitement to Hatred Bill and the video Bill, but it does not wash as far as I am concerned. I am not convinced that it is covered; it seems extraordinary that it is not covered. It did not arise directly from myself, I was alerted to it by senior people in the insurance industry.
I share the Minister's compliments to his advisers they have done a very comprehensive job and it is a pity they cannot be complimented by name. I know it is a tradition of the House, it probably spares other less efficient servants of the State from being excoriated by name in other circumstances but on this occasion I do not accept the advice they have proffered to the Minister.
A related question was asked about the VHI's current treatment of people with HIV. I am informed that the VHI deals with HIV on the same basis as other pre-existing conditions under rule 1.6. This position will be copperfastened in the regulations which I will make under section 8 of this Bill. Those affected by HIV will have to be accepted by insurers subject only to the normal period governing any pre-existing condition. That will be a significant advance for HIV sufferers generally.
I ask the Minister to look at my amendment again because the Bill obviously will not be passed before 6 o'clock.
An Leas-Chathaoirleach
We have to deal with the amendment now. Is this amendment being pressed?
I wonder if I would have the opportunity to reintroduce this amendment at Report Stage.
An Leas-Chathaoirleach
If you so decide.
So it is better not to vote on it now.
On reflection, I have decided to accept the Senator's amendment.
I am very grateful.
Amendment agreed to.
Section 7, as amended, agreed to.
SECTION 8.
Question proposed: "That section 8 stand part of the Bill."
Under section 8(3) the Minister may prescribe a maximum waiting period for eligibility of payment. Could people get left without cover for some weeks if they are moving from one health scheme to another? Maybe this will be dealt with in the regulations.
Section 8 (3) (b) states"... is suffering from a medical condition when the contract is effected". What if they do not know about it? Will that be dealt with in the same way as life insurance? If you have an examination by a doctor and something is not picked up, the life insurance still holds. Will it be the same with this or is there any question that a subscriber could be in trouble about it? I am anxious about genetic screening in this context.
The whole issue of genetic screening and new technology generally is a cause of concern. It is something we will address in the regulations. We are most anxious to ensure that any genetic or other mechanism to decide whether somebody is predisposed to a particular illness will affect their insurance cover. That will not be allowed for. The other points made by the Senator will certainly be picked up in the regulations.
Question put and agreed to.
Section 9 agreed to.
SECTION 10.
Question proposed: "That section 10 stand part of the Bill."
What is the purpose of engaging a person under this section? The Minister paid tribute to his staff and I concur with that view. Surely some member of his staff would be in a position to advise him on this matter?
There are two reasons. It must be somebody at arm's length from the Department of Health, that is, somebody who is contracted in rather than somebody who works for the Minister or the Department of Health. Second, a particular skill will be required. I envisage the person doing this will be working in the area of risk equalisation, a very complex issue, and they will probably need actuarial skills. That is the sort of person we will require.
Question put and agreed to.
SECTION 11.
An Leas-Chathaoirleach
Amendment No. 2. Amendments Nos. 3, 4, 5 and 6 are cognate and all may be discussed together.
I move amendment No. 2:
In page 10, paragraph (a), line 3, after "person" to insert "or member of such person's family".
This section of the Bill relates to inducements being offered by certain people so that people who would be entitled to benefit would terminate their contract or cease payment. I ask the Minister to amend this section to include a member of that person's family because the person could be very old and some member of their family could be offered an inducement to encourage the holder of the insurance to terminate the insurance. I ask the Minister to consider this very carefully. It is very reasonable from my experience with older people, they are sometimes put under pressure from relatives.
These amendments are unnecessary because the term "a person" as used in the Bill will include any member of a subscriber's family. I do not, therefore, propose to accept the amendments.
Amendment, by leave, withdrawn.
Amendments Nos. 3 to 6, inclusive, not moved.
Section 11 agreed to.
Sections 12 and 13 agreed to.
Progress reported; Committee to sit again.