Dáil Éireann Debate, Tuesday - 26 June 2012
524 Deputy Niall Collins asked the Minister for Health if bed re-designation will impact on the principle of community rating, particularly in terms of the numbers leaving private health insurance; and if he will make a statement on the matter. [30323/12]
Amharc ar fhreagraCommunity ratingmeans that the level of risk that a particular consumer poses to a private health insurer does not directly affect the health insurance premium paid. It also means that premiums for younger or healthier lives are typically higher than their expected claims would require, whereas for older or less healthy lives, premiums are typically lower than the expected claims would require.
I am strongly committed to protecting community rating, whereby older and sicker customers should pay the same amount for the same cover as younger and healthier people and can confirm that any policy decisions taken with regard to bed designation will not impact on the principle of community rating.
525 Deputy Niall Collins asked the Minister for Health if he has consulted with the Health Insurance Authority in respect of his proposal to re-designate beds in public hospitals, particularly in view of the authority’s statutory remit in relation to the functioning of the health insurance market; if so the views of the HIA on this issue; and if he will make a statement on the matter. [30324/12]
Amharc ar fhreagraI currently have no proposals in relation to bed designation. Furthermore, the Deputy may wish to note that the HIA has no role to play with regard to any decisions being made in the re-designation of beds in public hospitals. The Health Insurance Authority (HIA) is the statutory regulator of the private health insurance market and provides information to consumers regarding their rights and also on health insurance plans and benefits. The HIA plays an important role for customers, both in ensuring that they have accurate information, and in enforcing the implementation of the law protecting consumers in relation to health insurance and where appropriate it issues enforcement notices to enforce compliance with the Health Insurance Acts.
526 Deputy Niall Collins asked the Minister for Health if he will provide information in relation to the total amounts due to all public and voluntary hospitals in relation to outstanding health insurance claims which have yet to be submitted by such hospitals to private health insurers; and if he will make a statement on the matter. [30325/12]
Amharc ar fhreagraThe total amount due to all public and voluntary hospitals in relation to outstanding health insurance claims which have yet to be submitted to private health insurers amounted to approximately €96.6m at 31st March 2012. Hospitals have improved their submission performance by 21% on a cost neutral basis in the fifteen months from 31st Dec 2010. The HSE is continuing a drive to reduce the time taken to submit claims through implementing an electronic claims management system in its hospitals which will make the process more efficient for patients, medical staff, administrative staff and private health insurers. This system will reduce the time taken to submit claims. In addition, HSE Management continues to engage with Hospital Managers and Clinical Directors to stress the importance of increasing the timeliness of submissions.
527 Deputy Niall Collins asked the Minister for Health the level of income per annum that public and voluntary hospitals received from the private health insurers in 2008, 2009, 2010 and 2011 respectively; if he will provide a national average percentage figure on the level of private income raised from private beds in public and voluntary hospitals in 2011 and similarly the percentage figure for the best performing hospital in terms of private income raised from private beds in public hospitals; and if he will make a statement on the matter. [30326/12]
Amharc ar fhreagraThe level of private maintenance income for public and voluntary hospitals was:
2009 — €387m.
2010 — €382m.
2011 — €464m.
The increase in 2011 is mainly due to increased charges introduced on the 1st January 2011. The percentage of private maintenance income in acute hospitals as a percentage of total patient income is 86%. The hospitals with the highest percentage are the dedicated maternity hospitals as public maternity services are exempt from charges.
528 Deputy Niall Collins asked the Minister for Health his views on whether the increasing number of persons opting out of private health insurance will undermine the implementation of universal health insurance in view of the fact that the funding basis for UHI is being reduced by the numbers exiting private health insurance; and if he will make a statement on the matter. [30327/12]
Amharc ar fhreagraWhile there has been a decrease in the numbers with private health insurance, by 76,000 in the year to end-March 2012, it is important to note that the decline in private health insurance coverage is modest to-date, at less than 4% of the overall market. This leaves some 2.139 million, or 46.6% of the population, covered by private health insurance. Even in the current difficult financial climate, the vast majority of consumers holding private health insurance are choosing to retain some level of health insurance cover rather than allowing policies to lapse completely.
Under Universal Health Insurance (UHI), everyone will be insured for health care and the current unfair discrimination between public and private patients will be removed. The Government's clear objective is for the health insurance market to remain as competitive and affordable as possible, as we move towards a new system of UHI. The Government is committed to fundamental reform of healthcare in Ireland that will deliver a single tier health system, where access is based on need, not income. A new Insurance Fund will subsidise or pay insurance premiums for those who qualify for a subsidy. This reform programme is a major undertaking that requires careful sequencing over a number of years, to be supported by a number of key reform initiatives.
The Health Insurance Consultative Forum, which includes representatives from the country's three main health insurance companies, the Health Insurance Authority and the Department of Health, is tasked with examining how costs in the health insurance industry can be reduced. The Forum provides a vehicle for engagement and consideration of issues relating to the implementation of UHI. In addition, in February I established an Implementation Group on UHI which will assist in developing detailed implementation plans for UHI and driving implementation of various elements of the health reform programme. The Group will also assist my Department in preparing a White Paper on Financing Universal Health Insurance. The White Paper will outline the estimated costs and financing mechanisms associated with the introduction of UHI. Preparation of the White Paper is a complex process. It will involve significant financial modelling to support analysis of different design options and to estimate the cost of UHI. The White Paper will be published as early as possible within the Government's term of office.
In the interim, I am focusing on addressing the problems of the current private health insurance market, where insurers have a considerable financial incentive to cover younger, better risks rather than older, poorer risks. I am very concerned that any inefficiency in the management of claims is addressed before the introduction of UHI and am determined that measures currently being undertaken will have a significant impact in containing the cost of health insurance premiums, as we move towards the new system of Universal Health Insurance.
529 Deputy Niall Collins asked the Minister for Health his views on whether a system of co-payments by patients under universal health insurance will be necessary to fund all but the most basic treatment services under UHI, due to the fact that the likely funding base for UHI will be insufficient to fund all treatment services; and if he will make a statement on the matter. [30328/12]
Amharc ar fhreagraThe Government is committed to fundamental reform of healthcare in Ireland that will deliver a single tier health system, supported by universal health insurance, where access is based on need, not income. Every individual will have a choice of health insurer and will have equal access to a comprehensive range of curative services. A new Insurance Fund will subsidise or pay insurance premiums for those who qualify for a subsidy.
In February, I established an Implementation Group on Universal Health Insurance which will assist in developing detailed implementation plans for universal health insurance and driving implementation of various elements of the health reform programme.
The Group will also assist my Department in preparing a White Paper on Financing Universal Health Insurance. The White Paper will outline the estimated costs and financing mechanisms associated with the introduction of universal health insurance. Preparation of the White Paper is a complex process. It will involve significant financial modelling to support analysis of different design options and to estimate the cost of UHI. The White Paper will be published as early as possible within the Government's term of office.
The reform programme is a major undertaking that requires careful sequencing over a number of years. The Implementation Group will continue in existence throughout the health reform process and will oversee implementation of the reforms and consult widely.
530 Deputy Niall Collins asked the Minister for Health if his attention has been drawn to the fact that increasing costs of private health insurance is now a major concern for multi-national corporations and has the potential to negatively impact future foreign direct investment decisions and job creation; and if he will make a statement on the matter. [30329/12]
Amharc ar fhreagraI am not aware of any specific concerns raised by multinational corporations regarding the cost of private health insurance in this country being a significant factor for consideration when making foreign direct investment decisions. It is my understanding that the Deputy may be referring to any companies which pay health insurance premiums on behalf of employees, as an additional employment benefit. I refer the Deputy to a recent national consumer survey of the private health insurance market in Ireland commissioned by the Health Insurance Authority, a statutory regulator of the health insurance market in Ireland. The survey included an analysis of the effects of the economic environment on the attitudes and behaviour of consumers of private health insurance, part of which examined the issue of employer subscriptions.
The survey found that eighteen percent of Irish businesses operate an employee health insurance scheme and that the sectoral profile of those businesses is similar to the overall sectoral breakdown of businesses in Ireland. It can be noted from the survey that two in three companies review the provision of employee private health insurance yearly, or more often, and that three in four companies intend to keep private health insurance subsidies the same. In addition, the level of subsidy has been increased by 19 percent of companies in the past two years, with almost seven in ten companies stating that they have kept subsidies the same over the past two years. This suggests a high level of stability from the employers' viewpoint concerning the provision of employee private health insurance schemes.
It is also worth noting from the survey that the vast majority of companies intend maintaining the current private health insurance scheme for the considerable future.
