Warning of health insurance ‘debt spiral’

Legislation to charge health insurers for the use of public beds by private patients will be introduced before the Dáil summer recess.

Tánaiste Eamon Gilmore said that if a hospital "can charge for the private bed it ought to be able to charge for the public bed rather than having the entire cost of that fall on the taxpayer".

The charge would raise €60 million out of a total payout by insurers of €2.2 billion. Mr Gilmore said “€60 million does not amount to a 15 per cent increase in premiums even if it were passed on”.

Those who suggested the move would result in a 15 per cent insurance cost rise “are exaggerating the impact of charging the insurance companies for the use of public beds”.

Fianna Fáil leader Micheál Martin had referred to media reports that people with private health insurance faced a further 15 per cent rise from July 1st, and he claimed repeated increases were not sustainable.

'Centre cannot hold '
"The centre cannot hold," he claimed, citing analysts suggesting "we are in the beginning of a cycle that could spell the death-knell for the private health insurance market".

Mr Martin said the Health Insurance Authority had issued a warning about this. Something had to be done to "stop what is in essence a debt spiral in the health insurance market".

Mr Gilmore said the increases in health insurance premiums for families were “staggering” and this was a major issue.

There were other issues insurance companies needed to address relating to their cost base and the “very high level of other charges that are charged to the insurance companies, including hospital charges and charges by professionals”.

Their proposal was that public bed costs in a public hospital should be charged to the insurance company.

“The private health insurers charge for everything – the consultant, the anaesthetist and if it is a private bed, the bed – but at present the hospital cannot charge for the public bed.”

Major reform of the health services was under way to “reduce the cost of delivering them” and they were doing this while having to reduce the health service budget.

Mr Gilmore pointed out that private inpatients in public hospitals face maintenance charges of between €586 and €1,046 daily and this was separate to consultant fees. About 20 per cent of public beds were designated for private use, he said. “The change being proposed, which is in draft legislation coming forward, is to provide for charging for public beds.”

Mr Martin said 6,000 insurance subscribers were leaving every month. "Some 90,000 will leave between now and 2014, and 68,000 left last year." The Government promised the "Dutch model" of universal health insurance but "there hasn't even been a white paper in that regard". Younger people were leaving in "droves" and not there to "cross-subsidise" older members.

Medical card
He asked "where do the 20 per cent stand who have neither health insurance nor the medical card?

Mr Gilmore said a policy paper was published recently and progress was being made on the policy to implement universal health insurance, which “will take time to achieve”.