'Penalise late entrants to health cover’
The report recommends measures be taken to encourage young people to enter the market and that the action would be in line with the principles of lifetime community rating.
It says health insurers should prove their commitment to retaining and attracting persons in the 18-29 age group by discounting premiums for full-time students up to the age of 23, which is already allowed under health insurance legislation.
The independent report is the first in a two-phase report, the second of which is to be prepared within a further three months.
James Reilly, the health minister, said the Government’s objective was for the health insurance market to remain as competitive and affordable as possible as the country moves towards a new system of universal health insurance.
Last year, private health insurers paid out almost €2bn in claims, a 9% increase on the previous year and at a time when almost one in five of the insured population was aged over 60.
The report makes 32 recommendations to try and reduce costs, including the need to tackle abuse in the system.
The report says the industry should fund a whistleblower initiative to encourage reporting of abuse.
It says all hospitals should submit claims within an agreed timeframe. Failure to do so should result in insurers only paying a specified proportion of the value of the claim.
It says it should be open to the HSE to suspend the admitting rights of consultants who repeatedly fail to complete and sign claim forms for private insurance within a reasonable period
It recommends public hospitals be responsible for ensuring consultants adhere to their contract type.
And it says patients should be given an opportunity to confirm the treatment received and the names of the treating consultants.
Dermot Goode of healthinsurancesavings.ie said the exit of young people was destabilising the market. “If that is not addressed, then there won’t be a private health insurance market in years to come,” he warned.
Vhi Healthcare said it was continuously identifying ways of reducing costs and promoting efficiencies.
A new cancer cover insurance plan, with monthly premiums from €3.50, is expected to appeal to those who can no longer afford private health insurance.
Dolmen Insurance Brokers have linked with AIG Europe to provide the plan that pays up to €64,400.
On diagnosis, there is an immediate cash payment, followed by income payments for 12 months, with additional payments after surgery and during hospitalisation.
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