The country's largest health insurer has warned that the rising cost of claims is threatening the private system.
The VHI expects almost €3.5bn to be paid out in the next nine years - that is an 80% increase.
The state-owned insurer claims our aging population is likely to lead to extra payouts as chronic diseases rise.
It is also warning that many people are downgrading their cover paying less money for their policies.
The VHI says we need to shift as many patients as possible from acute facilities like hospitals to community care settings.