Vol. 451 No. 7
9 Mr. Moynihan asked the Minister for Health if the proposed draft regulations for the operation of medical insurance will restrict consultants' rights to admit some patients to hospitals; and if he will make a statement on the matter. [7002/95]
(Limerick East): The draft health insurance regulations provide that, in respect of non-emergency treatment for a psychiatric condition, alcoholism, drug or other substance abuse, an insurer may require a hospital consultant to provide a statement outlining the proposed treatment programme for the insured person prior to admitting the insured person to hospital. It will be a matter for each insurer to decide whether it wishes to require such a statement. The draft regulations set out the framework within which competition can operate in the health insurance market.
A requirement for pre-certification of non-emergency psychiatric treatment by health insurers is a common feature in countries outside of Ireland and it would not be appropriate to deny insurance companies the means by which they can control their costs. Many health insurers abroad either no longer offer cover for treatment for these illnesses or, if they do so, offer greatly reduced level of cover.
Does the Minister agree that we should not facilitate insurers who want to opt out in terms of their responsibility to provide health cover at a time when there are high levels of alcohol and drug abuse?
(Limerick East): The question relates to the draft health insurance regulations on which I have invited observations. They will not be promulgated as statutory regulations for some time. The reason regulations have been drafted is that the health insurance market is being opened up in accordance with EU law. Consequently, it would not be appropriate to impose restrictions on insurance companies which would prohibit them from controlling their costs. If the practice is substantially different elsewhere it would be difficult in the context of a unified EU insurance market to have practices here which are not in line with those in the rest of the Union.
