Universal health insurance cost will not be known for a year

The Government will not make any decision on implementing Minister for Health James Reilly’s universal health insurance (UHI) plan for at least a year until a “major costing exercise” is completed.

The plan will not be given the go-ahead, it has emerged, until Ministers are given an estimate of the “average premium costs to be paid by individuals”, among other issues.

A draft memorandum circulated to Ministers ahead of the weekly Cabinet meeting today says the cost review will focus on the policy proposals within the UHI scheme. “No decision will be taken to advance implementation of UHI before the completion of this exercise,” the memo says. The costing review will also decide issues such as the “detail and cost of health packages to be provided”.

An updated version of the UHI policy document also strengthens cost-control measures following concerns raised by the Departments of Finance and Public Expenditure and Reform. It says spending on health should remain the same under a single-tier UHI system as in the current two-tier system.

Cost-effectiveness
This will allow "for cost-effective additional health investment in health services" which would not breach spending limits set out in the Constitution and the EU fiscal treaty.

This approach will also “take account of demographic factors as our population changes”. Dr Reilly will seek permission today to publish the policy document, or white paper.

The next phase will be a consultation process, including a proposed citizens assembly which will make recommendations on what services should be covered under the policy.

Another step will be to “further develop and refine the proposals including the cost-control mechanisms, the financial support mechanism for citizens and costed recommendations for the basket of services to be provided under UHI”.

Enforcement measures
The proposals confirm that people who refuse to take out cover for UHI face having the cost deducted from "earnings or benefits".

The Coalition maintains that UHI will be fully in place by 2019.