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Health Insurance (Amendment) Bill 2012: Report and Final Stages (Continued)

Tuesday, 4 December 2012

Dáil Éireann Debate
Vol. 785 No. 1

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(Speaker Continuing)

[Deputy Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin] With all respect the Health Insurance Authority is a quango of little proven worth. That was emphasised and underlined by its representatives' recent appearance before the Oireachtas Joint Committee on Health and Children.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I will deal with the last point. I would not have been greatly impressed with the role the HIA had in the past. It is intended to beef it up considerably so it can act as a regulator. One is nearly afraid to use the word "regulator" in this country, having seen all the failures of regulation in the past.

Deputy Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin And continuing.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly However, it will be independent and will protect the consumer, define the standard policy to be available and monitor very closely any products created by the insurance companies to ensure there is no attempt at cherry-picking and segmenting in the market. By that I mean trying to encourage younger people into certain products and to discourage older people. I would be the first to accept that we need to beef it up.

I emphasise there will be competing insurers, with at least one public in the new arrangements. Ultimately the amendment has no relevance to the Bill, which relates to the current market and to those who chose to have private health insurance. It does not relate to the future universal health insurance system that we plan. The paper on universal health insurance will be available later this month as promised. As the amendment is not relevant to the Bill I decline to accept it.

Deputy Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin As I have another amendment and as Deputy Naughten is also waiting to move amendment No. 4, I will not make any further contribution.

  Question, "That the word proposed to be deleted stand", put and declared carried.

  Amendment declared lost.

Deputy Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin I move amendment No. 3:

In page 6, to delete lines 12 to 14.

It is quite obvious that this will suffer the same fate as my previous amendment. As I explained on Committee Stage, the effect of section 4 as it stands would be to remove the requirement to lay regulations before the Houses of the Oireachtas in draft form. I have explained that by reference back to the principal Act of 1994, which provides that a draft of the regulation shall be laid before each House of the Oireachtas and the regulation shall not be made until a resolution approving of the draft has been passed by each such House. I believe that is a very important provision and is as it should be.

  As I recall, in his reply on Committee Stage, the Minister said that another provision, as yet not before us, would eliminate or make redundant such a requirement. I have no doubt he will explain this again in a moment. Regardless of what is to present, at this point that requirement exists. I believe it should remain unless and until a better methodology is presented and no such is offering in this Bill. We are simply being asked to remove a requirement for both Houses of the Oireachtas to have sight of the draft regulations. That should stand and Members of this House should be prepared to argue for and defend it. It is clearly not only in the interest of the Members of these Houses, bearing in mind our role and responsibility, but also in the wider public interest that the earliest scrutiny should take effect. I commend the amendment to the Minister.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I thank the Deputy and while I share the sentiment, as I explained on Committee State, the previous risk equalisation scheme in 2003 was mainly set out in regulations. The new scheme, including rates for risk equalisation credits and stamp duty levies, is strengthened in future by being set in primary legislation. The Houses will have ample opportunity to discuss amendments now and in the future. To put it another way, the Bill puts all these things that were in regulations into primary legislation, which makes them much more robust. They cannot be challenged in the courts in the way that regulations can be. As I will not be making regulations to provide for a risk equalisation scheme in the future, these subsections are no longer valid.

As I explained in my Second Stage contribution, I will make regulations to deal with the administration of the scheme, rather than the scheme itself, as provided for in the Bill. The regulations, which will not be introduced until the Bill is passed, under section 11F will include, for example, the making and determination of claims. The other set of regulations to be made by the Health Insurance Authority under section 11E will allow for the categorisation of products.

Deputy Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin I am disappointed the Minister has not accepted the amendment. I am sure he understands why I focused on the matter and why I believe it to be important. I am not entirely convinced by the explanation he has given that this is no longer a requirement and a protection. There lies the difference between us on this matter, as with so many other matters. I will not prolong my contribution.

  Question, "That the word proposed to be deleted stand", put and declared carried.

  Amendment declared lost.

Deputy Denis Naughten: Information on Denis Naughten Zoom on Denis Naughten I move amendment No. 4:

In page 11, between lines 20 and 21, to insert the following:

“9.—Section 7A of the Principal Act is amended—
(a) in subsection (6), by deleting “may by regulation” and substituting “shall introduce by 1 January 2014 regulations which shall”, and

(b) in subsection (7), by deleting “Regulations under subsection (6) may” and substituting “Regulations under subsection (6) shall, inter alia,”.”.

This relates to an amendment I tabled on Committee Stage and tries to incentivise the provisions in the 2001 Act following the introduction of universal health insurance where we will have lifetime community rating implemented as per the provisions in 2001. I put forward an amendment as an alternative option. It comes back to the argument we had on amendment No. 1. Health insurers no longer announce premium increases on an annual basis, but perhaps three or four times a year. The concern is that premium inflation will continue. At the moment an adult will pay a health insurance levy of approximately €285 and a child pays approximately €95. That will increase significantly on foot of the legislation before us. At the same time nearly 200,000 people have left the health insurance market. The reality is that the best way to protect the community-rated system is to ensure that more young people come into the system.


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