Share the cost of health care across the board

23rd October 2008

One of the 15,000 to protest outside Leinster House yesterday

Prior to the unprecedented events we witnessed outside Leinster House yesterday, I raised the matter of Medical Cards and the health system as a whole at the Order of Business in the Seanad. Below is an edited transcript.

 

We need to have a debate on the medical card for the over-70s issue today. Everyone in the country is talking about these issues while we seem to be the only body that is not, apart from the opportunity to raise it on the Order of Business. We should amend the Order of Business to allow a debate with the Minister for Health and Children on this issue today.

There is nothing short of chaos in the entire budgetary process. Yesterday I made the point that people do not believe what they are being told. That is a very serious matter for a government. It is one thing to disagree with a government but another not to believe it. There is a credibility gap with the figures behind yesterday’s reversal and many other issues. The Government needs to engage seriously with the people, giving them the information and clarity they require and deserve.

Over the summer holidays, the Supreme Court brought in a serious judgment which involved criticism of the Legislature in respect of the health insurance scheme and BUPA. I am very critical of the ideology espoused by the Minister for Health and Children regarding the health services. This is one area, however, in which I agree with her. I supported her position in the BUPA case in which she argued in the Supreme Court that the important principle of risk equalisation was a fundamental prerequisite for the effective operation of community rating. In other words, it is to spread the cost of health care across the board by charging younger and healthier people the same cost for health insurance, in order to support those who are older and more in need of services.

It is a very noble communitarian principle which I would extend. The entire community, in particular those well able to pay more for health services, should be called upon to pay their fair share for a truly universal system of health care.

The communitarian ideals the Minister argued in the Supreme Court in the BUPA case should be extended across the board. For once and for all, let us face up to the need to have a proper health service with the same minimum standard of health care for all citizens, irrespective of income.

The risk equalisation scheme was interrupted in 2005 and has not yet come into place. When will the legislation be introduced for dealing with the effects of the Supreme Court judgment in the BUPA case? Will the Leader invite the Minister for Health and Children to debate the risk equalisation issue and allow us an opportunity to consider the wider question of universal health care which arises from this case?