Martin Daly: Supports Bill, Warns on Private Insurance Shortfalls
Martin Daly spoke in support of the current bill, arguing it is vital to maintain community rating through a risk equalisation scheme funded by stamp duties. He raised concerns about affordability, market transparency, rural access to private beds, and productivity in the public health service.
The speaker said he fully supports the bill and emphasised the importance of maintaining community rating through a risk equalisation scheme funded by stamp duties, describing that mechanism as absolutely vital to fair premiums.
Drawing on his experience as a practising GP and involvement in medical politics, he said about 46% of people hold private health insurance and outlined a three-part breakdown: roughly a third cannot afford private cover and rely fully on the public system, a third will always insure, and a third would not if the public system had the capacity. He argued many take out cover because they lack confidence that the public health service will deliver care when and where needed and noted that some families fund insurance for older parents who cannot afford it themselves.
He criticised the multiplicity of around 336 plans in the market as a source of confusion and a lack of transparency for consumers. He described examples of patients discovering at critical times that particular procedures were not covered and said he advised them to seek help from the Health Insurance Authority.
The speaker warned that public capacity is insufficient to meet demand if nearly half the population feels compelled to insure privately. He argued that increased public funding has not been matched by productivity gains, called for digitalisation to improve hospital and clinic efficiency, and warned against simply "throwing money" at an archaic HSE structure without productivity improvements. He also acknowledged the minister's role in increasing public funding while noting productivity has not kept pace.
He raised concerns about geographic inequality, saying urban investment by insurers in large, year-round centres does not help rural residents who lack access to private beds. He emphasised that acute and hospice care are underpinned by the public hospital service, which he said underpins everything that happens in the state and provides very good value for money.
Support for the bill
The speaker said he fully supports the bill and emphasised the importance of maintaining community rating through a risk equalisation scheme funded by stamp duties, describing that mechanism as absolutely vital to fair premiums.
Affordability and reasons people buy insurance
Drawing on his experience as a practising GP and involvement in medical politics, he said about 46% of people hold private health insurance and outlined a three-part breakdown: roughly a third cannot afford private cover and rely fully on the public system, a third will always insure, and a third would not if the public system had the capacity. He argued many take out cover because they lack confidence that the public health service will deliver care when and where needed and noted that some families fund insurance for older parents who cannot afford it themselves.
Private insurance market and transparency
He criticised the multiplicity of around 336 plans in the market as a source of confusion and a lack of transparency for consumers. He described examples of patients discovering at critical times that particular procedures were not covered and said he advised them to seek help from the Health Insurance Authority.
Public hospital capacity and productivity
The speaker warned that public capacity is insufficient to meet demand if nearly half the population feels compelled to insure privately. He argued that increased public funding has not been matched by productivity gains, called for digitalisation to improve hospital and clinic efficiency, and warned against simply "throwing money" at an archaic HSE structure without productivity improvements. He also acknowledged the minister's role in increasing public funding while noting productivity has not kept pace.
Rural access and emergency care
He raised concerns about geographic inequality, saying urban investment by insurers in large, year-round centres does not help rural residents who lack access to private beds. He emphasised that acute and hospice care are underpinned by the public hospital service, which he said underpins everything that happens in the state and provides very good value for money.
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Transcript
Thank you for your indulgence and to the Minister as well. I just wanted to make a couple of reflections on the current bill. I want to say that I fully support it. It is absolutely vital that we maintain community rating through a risk equalisation scheme through the stamp duties that are paid. But I also want to ask and reflect why do people feel they must ensure in this country 46% of people. It is my view as a practicing GP and being involved in medical politics for many years that a third of people can't afford it and are covered fully by the public system. A third of people may always ensure no matter what public system we have in place and I think that experience is borne out in other countries and a third of people are the people who feel if they had a choice and the capacity in the public health service was there that they wouldn't ensure and they're certainly very hard pressed to ensure themselves and they do so because they don't have confidence in the public health system to deliver health care for them when and where they need it and I think that that's what we need to reflect on. We also need to reflect on slaughter care. I am a public funded doctor. I have worked mainly in public practice with medical card system. I believe in a public health service but I do believe we need to reflect on slaughter care. The capacity isn't there and it's difficult to see how we are going to create a capacity for 46% of the population who feel they must ensure themselves and I have to also reflect that many sons and daughters are funding private health insurance for their older parents because they can't afford it and they want access. I'm also concerned about private health insurance companies. There are 336 plans in or about and to me that represents a lack of transparency. I've had multiple patients coming in to me to find out at critical times of illness that they don't have insurance cover for particular procedures in private hospitals and it wasn't that clear to them when the policy was being sold. I have sent them to the health insurance authority and advised them to go and seek help there but 336 policies means plans means to me that people are being confused by what they're being offered and it doesn't serve the consumer well. On the public side productivity remains an issue and one of the issues around productivity is we can keep throwing money at an archaic structural organisation like the HSE and unless we get to digitalisation and really improve productivity in our hospitals and in our clinics we are not going to get value for money and I think in fairness to Minister Carol MacNeill and you have said this as well Minister that there has been a significant increase in public funding but without the commensurate increase in productivity. Also I just want to reflect quickly because I am running out of time and I do appreciate this time is that the major health insurance companies are now investing fortunes in advertising and in these big centres in urban areas offering all sorts of services and that is fine but there is no risk equalisation for the rural person who is living in a county like Roscommon or East Galway where there is no access to private beds and are they subsidising access for people who are living in urban areas to these super duper 365 day centres run by various health insurers and just finally to reflect on it the private health insurers and people say that private health insurance is so efficient the public health service provides the bulk of health care in this country let's get that straight if you have a stroke in this country in the morning there is no private there is no private facility that will admit you to hospital and the same applies for hospice care so people need to remember that they need to remember that our public hospital service it underpins everything that happens in this state and is exceedingly good value for money for what we get thank you thank you deputy dairy minister