There is something irritating about the political reaction to the announcement of a 6 per cent rise in VHI premiums. This is not to say that a 6 per cent rise in health insurance is to be welcomed. It most certainly is not, especially given that it is a long time since many people have received a 6 per cent pay increase.
What is irritating about the reaction by opposition parties is that it is repeated every time the VHI raises its premiums. Yet what mechanism has been put in place by any of these parties, when in government, to satisfy the public that VIII increases are needed? The answer is that, when in power they do nothing about it, and when out of power they are glad to garner what votes they can by complaining when premiums go up.
VIII premiums have been going up for some years by more than the rate of inflation and the VHI has been saying that medical inflation rises faster than normal inflation. New medical technologies, new drugs and rising expectations are very, very expensive and must be paid for. In recent years the Department of Health has tightened up procedures to reduce the subsidisation of private medicine by the public system and this, too, has had its effect. The ageing of the population also means greater calls on the resources of the VIII as more and more of its members need hospitalisation. These developments drive VIII costs - upwards.
But if people wish to moderate this rise they should be pressing for moves to moderate the headlong rush towards ever more expensive medical technologies.
Politicians could note that the best protection against VIII rises would be a public hospital service more accessible than it is at present. A major motivation for VHI membership is speedy treatment. Traditionally the VHI maintained that people join so that they can choose their consultant. But how many know more than one consultant? How many know one?
The plain fact is that people join the VHI so that they will not be stuck on a seemingly endless waiting list a matter which, for those need heart treatment, could be one of life or death. If politicians wish to protect consumers against VIII increases an effective course of action would be to provide public services available within a reasonable period of time.
The money to pay for private hospital services comes from citizens of this country, many of whom would be happier to pay for good public health care if - and it is a big if, they could be assured of obtaining these services without undue delay.
Some VHI subscribers may hope for lower premiums when, as is expected, the British group BUPA enters the Irish market. But BUPA must follow the same rules as the VHI. That is, they must cover members for the same premiums regardless of age: they cannot charge a low premium to young, healthy people and increasingly higher premiums to older people, as they do in the UK. This will tie their hands in relation to premiums here unless they are prepared to subsidise their Irish operation until they gain a foothold in the market.
If, on the other band, BUPA can provide health insurance more cheaply than the VIII without such subsidisation, serious questions will have to be asked of the VIII about how it arrives at its charges.