Vol. 494 No. 6
6 Mr. Dukes asked the Minister for Health and Children the steps, if any, he will take to facilitate persons of 65 years and over obtaining health insurance from the Voluntary Health Insurance Board or BUPA; and the consideration, if any, given by him to proposing amendments to the relevant provisions contained in the Health Insurance Act, 1994. [18868/98]
98 Mr. Shatter asked the Minister for Health and Children the steps, if any, he will take to facilitate persons of 65 years and over obtaining health insurance from the Voluntary Health Insurance Board or BUPA; and the consideration, if any, given by him to proposing amendments to the relevant provisions contained in the Health Insurance Act, 1994. [18987/98]
I propose to take Questions Nos. 6 and 98 together.
The business of private health insurance in this country is regulated by the Health Insurance Act, 1994, and the Health Insurance Regulations, 1996. The legislation provides for "open enrolment" which obliges insurers to make cover available to persons under the age of 65, regardless of whether they were previously covered; "community rating" which requires that insurers must charge the same premium for a given level of cover, regardless of a person's age, sex or health status; and "lifetime cover" which provides that cover made available cannot be cancelled by the insurer, except in limited exceptional circumstances.
The position regarding first time private health insurance cover in the State for over 65 year olds, as set down under the legislation, mirrored the circumstances obtaining in the market prior to the enactment of the Health Insurance Act, 1994.
In particular, the present framework reflects the fact that our system is based on community rating. As there is a correlation between age and the utilisation of hospital services, a community rated system cannot work effectively if individuals wait until they get to an age where they know they are more likely to avail of the benefits provided under health insurance cover before deciding to contribute to the system.
It is a matter for registered insurers to decide whether to provide cover for a person of or over the age of 65 years who is seeking access to our community-rated private health insurance system for the first time. Insurers are not prevented from offering cover to persons aged 65 or over. However, if an insurer decides to make available such cover it must do so on the basis of community rating and lifetime cover. It may be that this is regarded by insurers as a disincentive to giving cover in such cases.
My Department is exploring all the options relating to our current regulatory framework in the context of the preparation of the White Paper on private health insurance and the specific issue of first time private insurance cover for persons over the age of 65 will be fully considered in this context.
In the context of increased life expectancy, does the Minister agree that the age of 65 is too low a cut-off point for the insurance companies to operate? Does he accept it is unreasonable and unfair to young insured people to operate a community rating system for those over age 65 who seek health insurance for the first time, but that there is a need within the health insurance context to provide a mechanism that will give an opening to people over 65 who seek health insurance to obtain it at an appropriate rate, in so far as they would need to pay it?
The Deputy will appreciate that if there were an obligation to give automatic cover to people over 65, the VHI would find it difficult to proceed because people would delay entering the scheme until illness became apparent or more foreseeable. Submissions have been made on the White Paper and we have received inquiries about, for instance, people returning to Ireland on retirement and seeking access to private health insurance, or cases where improved economic circumstances allow a son or daughter to purchase health insurance for a parent then aged over 65. I would like the White Paper to examine what could be done in those and similar cases; these are not incentives to defer membership but instances which are becoming more prevalent in present economic circumstances.
When can we expect the White Paper and will it be published?
It will be published by the end of this year, I hope.
