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Written Answers. - Health Insurance Act, 1994.

Wednesday, 8 May 1996

Dáil Éireann Debate
Vol. 465 No. 1

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 67. Mr. Lawlor Information on Liam Lawlor Zoom on Liam Lawlor  asked the Minister for Health Information on Michael Noonan Zoom on Michael Noonan  if he will amend the Health Insurance Act, 1994, regulations regarding companies such as BUPA, which are entering the Irish market, by stipulating the minimum level of in-patient cover that health insurance companies must provide, either as a sum insured or for the duration of in-patient stay and to ensure that discrimination does not occur affecting groups such as the psychiatrically ill. [9023/96]

Minister for Health (Mr. Noonan,: Information on Michael Noonan Zoom on Michael Noonan Limerick East): The Health Insurance Act, 1994, and the regulations made pursuant to it, comprise the regulatory framework for the operation of a competitive health insurance market in this country and apply to all undertakings wishing to carry out health insurance in this country.

Given the unforeseen nature and extent of costs arising under indemnity health insurance, I do not consider that providing for a minimum level of in-patient cover as a sum insured would constitute a satisfactory minimum protection as it could give rise to the individual being significantly under-insured in the event of prolonged and expensive [103] treatment resulting from serious illness or injury.

With regard to duration of stay, the regulations provide to all insured persons a statutory minimum entitlement in respect of levels and periods of indemnity cover under all health insurance contracts. These provisions are intended to meet our obligation to provide for competition in the health insurance market; to safeguard the principles of community rating, open enrolment and lifetime cover; and to offer a significant protection to the general public in an open competitive market.

Prior to finalising the regulations I met with representatives of the two major private psychiatric hospitals. The proposals on minimum benefit in respect of psychiatric in-patient and day-patient services were acceptable to them in the context of an open competitive health insurance market.

The regulations provide that the minimum period of guaranteed cover in respect of private psychiatric in-patient care is to be 100 days in a year. Furthermore, I am committed to making provision, at an early date, for a further period of 20 days day-patient care in private psychiatric hospitals. The level of cover now provided as a statutory minimum compares very favourably with the position taken by insurers elsewhere who specifically limit, in some cases extensively, their exposure to risk in the area of psychiatric illness or do not cover it at all.

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