Dáil Éireann Debate, Wednesday - 26 February 2014
7. Deputy Richard Boyd Barrett asked the Minister for Public Expenditure and Reform if he will report on his examination of the likely cost implications of universal health insurance and potential implications for sustainable public expenditure overall; and if he will make a statement on the matter. [9312/14]
Amharc ar fhreagra19. Deputy Dara Calleary asked the Minister for Public Expenditure and Reform to set out his view on views expressed by his Department on the affordability of universal health insurance; and if he will make a statement on the matter. [9446/14]
Amharc ar fhreagra29. Deputy Richard Boyd Barrett asked the Minister for Public Expenditure and Reform to outline his views on reported concerns within his Department regarding the potential cost implications of universal health insurance. [9313/14]
Amharc ar fhreagraThere has been quite a public spat, it would appear, between the Minister's Department and the Department of Health over the possible costs of universal health insurance. There have been suggestions that the Minister's Department believes the proposal could potentially threaten the financial stability of the State. There is talk of vast costs for people who would be brought into what is, essentially, obligatory private health insurance for prescription costs and so on. Figures have been bandied around of €1,000 or more per year for what would be, essentially, extra taxes to fund this proposal. Can the Minister tell us what he knows about the proposals that are being floated and their cost implications? When will the Minister pronounce on whether this scheme is actually a disaster? Some of us, as the Minister is aware, are strongly opposed to this model and believe we should go for a national health service model, not what is essentially mandatory private health insurance.
I propose to take Questions Nos. 7, 19 and 29 together.
The Deputies are referring to the White Paper, which is in draft form, on universal health insurance that is being developed by my colleague, the Minister for Health, Deputy James Reilly. Universal health insurance is a priority policy area for the Government. My Department, given its central role, is always engaged constructively with other Departments to ensure that policy development takes account of the impact on the economy, the Exchequer and the taxpayer. Universal health insurance is no different to any other policy area across any other Department. I am committed to working with the Minister, Deputy Reilly, and all the other members of the Government to ensure this policy is progressed. I understand that the Minister's paper will be submitted for Government approval and publication shortly. It will stimulate a debate on universal health insurance. That debate will be necessary and valuable and I look forward to contributing to it and to it determining the future for health delivery in the country.
As the Minister is aware, those of us who are opposed to this way of delivering health care have made the point that universal health insurance is mandatory private health insurance organised via the State imposing the system. It is similar to the United States or the Netherlands. Things that have to be factored in to the system include profit for the private health insurance companies, billing costs, administration costs, legal costs and advertising costs. Is it the case that the leaked White Paper and the associated comments from the Minister's Department indicate an awareness on the part of the Minister's Department that when we add in all these costs, the proposal will cost us an absolute fortune and that it is a mad project to embark upon? As much as universal health sounds wonderful, when we add in the word "insurance" and we mean private health insurance companies, then the costs blow up out of all proportion.
Those costs will be borne either by the services that are delivered or through extra taxes imposed on ordinary citizens who are already burdened with massive amounts of austerity taxes and cuts.
Quite clearly the Deputy will have a contribution to make to the debate when the paper is produced by my colleague the Minister for Health. Let us wait and see what the paper proposes. Let us then have that debate and consider the proposals from all sides, as we work together to form a health policy that will serve all the people properly.
As a former Minister for Health, I know the challenges facing every developed country to provide an affordable, quality health service. We all have a contribution to make to that debate.
There is more to it than that. Leaked documents suggest that, even though the paper is in draft form and the details are sketchy, it could cost €5 billion. We could be talking about an annual cost of €1,672 per person. There is even talk of €700 per year in drugs costs for medical card holders. These are terrifying figures. Will the Minister comment on them? From where do they come from and what does the Minister have to say about these costs? Is this an assessment of the potential cost of the scheme the Minister for Health, Deputy Reilly, is proposing? If so, it is terrifying.
I ask the Deputy not to terrify people.
That is what is being reported.
Do not believe everything that is reported.
So there is no substance to it.
The Deputy should wait until the paper is produced. He can then ask the questions and contribute to the debate, but let us work together to have an answer to one of the most intractable, difficult and challenging policy issues facing the governments of every developed country - that is, to provide an affordable, efficient, quality health service for a population that is ageing. We now enjoy longer life expectancy, thankfully, and while medicine is becoming more expensive it is capable of treating more conditions. Advances are being made in drugs and medical treatment generally.
We need to have an affordable system so that everybody can enjoy equal access to it. Let us have a debate about how that system can be constructed, but the Deputy should wait until the proposals are published. Leaks and comments will be made by all and sundry. I know people sometimes approach these matters with a partisan political axe to grind, but this is an important and fundamental issue for us to get right. Let us hear a frank and clear debate on the proposals once they are published.
