Cheaper health insurance ‘on way’

THE termination of a long-standing deal whereby consultants collectively negotiated their fees with health insurance providers will mean lower costs for two-million subscribers, according to the Competition Authority.

The authority said consultants are set to pull out of the “total cover” scheme after an investigation found it was illegal.

Under the agreement, doctors received a higher-than-normal fee for each procedure from the insurance company as long as they did not send a balance or top-up bill to the subscriber. Doctors receive up to €200 million each year from the VHI as part of its fee agreements.

According to sources within the authority, the practice, established since the Nineties, is a breach of Section 4 of the 2002 Competition Act as the consultants are effectively self-employed when doing private work and so it is illegal for them to collectively bargain.

“The problem is the relationship between the insurer and the consultant. These prices should be worked out individually and then we could potentially see a situation where premiums could fall. For instance, should a consultant with two years’ experience be paid the same as one with 30 years’ experience? This is happening under the current system,” the source said.

The Irish Hospital Consultants Association has warned that an end to the current practice could mean that inpatients and day cases will have to pay “top up bills” as under the current scheme, patients were assured that their premiums would fully cover all surgical treatments.

“The system was driven by the health insurers and not the consultants,” said IHCA assistant secretary general Donal Duffy.

A spokeswoman or the VHI said they would hold talks with the consultants’ representative bodies on all issues surrounding a new schedule of procedures with the exception of price.