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Universal Health Insurance

Dáil Éireann Debate, Wednesday - 13 March 2013

Wednesday, 13 March 2013

Questions (203, 204, 205, 206)

Maureen O'Sullivan

Question:

203. Deputy Maureen O'Sullivan asked the Minister for Health in view of the fact that, subject to eligibility and relevant charges, all persons in the State qualify for access to public health system currently, the way this might change with the introduction of the universal health insurance; if such a system would mean an up-front payment by all persons for health services that they may not use in a given year; and if he will make a statement on the matter. [13223/13]

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Maureen O'Sullivan

Question:

204. Deputy Maureen O'Sullivan asked the Minister for Health in view of the fact that universal health insurance payments will provide for equal access to a standard package of primary and acute hospital services, if health insurance providers will still be able to sell add-ons above the standard package; if so, the way he would see this as a change to a one tier system; and if he will make a statement on the matter. [13224/13]

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Maureen O'Sullivan

Question:

205. Deputy Maureen O'Sullivan asked the Minister for Health in view of the fact that the large number of persons that have ceased paying health insurance premia in recent years due to affordability issues, the way he envisages making universal health insurance an affordable option for people; and if he will make a statement on the matter. [13225/13]

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Maureen O'Sullivan

Question:

206. Deputy Maureen O'Sullivan asked the Minister for Health his views on the possibility that under a universal health insurance system different providers may have relationships with different acute services and insured persons may find themselves in a situation where the services nearest to them or best equipped to serve their needs may not be covered by their insurer's standard plan; and if he will make a statement on the matter. [13226/13]

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Written answers

I propose to take Questions Nos. 203 to 206, inclusive, together.

The Government is committed to a single-tier health service, supported by universal health insurance, which provides equal access based on need, not ability to pay, and which delivers the best health outcomes for Irish citizens.

Universal health insurance (UHI) will replace the current inequitable and inefficient two-tier health system. Under UHI, everyone will be insured for a standard package of curative services comprising primary and hospital care services, including mental health services. Health insurance will be mandatory, with a system of financial support ensuring affordability by paying or subsidising the cost of insurance premiums for all those who qualify. Insurance will be provided under a multi-payer insurer model with no distinction between “public” and “private” patients. The system will be founded on principles of social solidarity, including financial protection, open enrolment, lifetime cover and community rating.

The introduction of UHI will see the purchasing of primary and hospital care largely devolved to insurers. Health insurers will commission care for their members from primary care providers, independent not-for-profit Hospital Trusts and private hospitals. In doing this, they will have a duty to use their purchasing role to ensure that quality, continuous care is provided at the lowest level of complexity that is safe, timely, efficient and as close to a person's home as possible. Furthermore, in line with the fundamental principle of social solidarity, neither insurers nor providers operating within the UHI system will be allowed to sell faster access to services covered by the UHI standard package of care. While it is envisaged that supplementary insurance may be purchased for items not covered by the standard package, this may not interfere with the fundamental overriding principle of access to care being based on need.

The Department is currently undertaking detailed work in relation to the preparation of a White Paper on Universal Health Insurance. This White Paper will provide further detail on the UHI model for Ireland in addition to the estimated costs and financing mechanisms associated with its introduction. The work involved is both complex and technical and demands a wide-range of specialised legal and financial expertise. My Department has recently engaged specialised legal expertise to support work in relation to the design of the UHI model and work in this area is underway.

The reform programme is a major undertaking that requires careful planning and sequencing over a number of years and full implementation of UHI will take some time to achieve. I anticipate that by 2016 the necessary groundwork will be in place to enable us to phase in implementation of UHI, as promised in the Programme for Government. I should add that it is my intention to consult widely as part of the reform implementation process.

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