Health insurance proposals to be re-drafted to reinforce controls on cost

The controversial draft White Paper on the introduction of universal health insurance is to be amended to reinforce arrangements to control costs, following a meeting of the Cabinet subcommittee on health yesterday.

Highly placed sources said the redrafted document would be circulated within the next few days with a view to bringing it before the full Cabinet within the next week or so.

It is understood that some of the proposed architecture for controlling costs under the universal health insurance initiative, such as the establishment of a new healthcare pricing office that would act as a national price-setter – would be fast-tracked.

Expenditure cap
As expected, there is also to be a cap placed on the level of State expenditure on healthcare. This was a key concern for the Department of Finance.

The amended White Paper is also expected to set out timelines for developments under the initiative in greater clarity.

Sources said that at the meeting of senior Ministers, a range of concerns was voiced about the cost of the proposals for universal health insurance drawn up by the Minister for Health James Reilly.

It is understood there were also concerns about how these could be controlled in the future given the key role that would be given to insurance companies under the reforms.

However, it is understood Dr Reilly argued political controls would remain and that even after the planned public consultation on what should be included in the standard basket of health services covered, the Government would make the final decision.

Disagreement
The introduction of universal health insurance is one of the key reforms planned by the Government. However, there has been serious disagreement between Ministers regarding the proposals for the scheme over recent weeks.

Senior figures in Fine Gael last night said the plan to circulate an amended text of the White Paper within the week meant there would be no fundamental rewriting of the proposals.

A fortnight ago the Department of Public Expenditure and Reform argued that the proposals put forward by Dr Reilly could threaten the financial stability of the State.

The department also suggested the cost of the standard package of health insurance under Dr Reilly’s proposals could cost €1,672.

The Department of Health strongly rejected the claims made by the Department of Public Expenditure and Reform.

Under the proposals the State would pay insurance premiums for lower-income groups and subsidise the cost for others. However, the income thresholds at which such payments and subsidies would apply have not been set out to date.