Madam, - Dr Norman Stewart (January 14th) restates his support for compulsory health insurance such as exists in Germany, where ability to pay is taken into account in setting premiums. This is a solution which deserves serious consideration.
He also restates his opposition to community rating as practised in Ireland, on the grounds that it places an extra burden on younger subscribers who may have large mortgages. While that is true, to abolish it without introducing some other form of regulation will render health insurance unaffordable for all but the most affluent elderly people.
The less well-off will then have to be subsidised by their children anyway (see Eric Haywood's letter, January 10th) or, where that is not possible, treated in the public system and paid for by the taxpayer. The only improvement will be to the profits of the insurance companies.
With respect to Dr Stewart's argument about young people with large mortgages, that is not a reason to abolish community rating but rather an argument for reform of this country's extraordinarily irresponsible land policy. Housing and healthcare are not consumer choices but necessities.
Just as the market for development land has been cornered by those whose only interest is to see that the price to the end buyer is as high as possible, the same will happen if the market for health insurance is deregulated.
I realise that to utter these words in Celtic Tiger Ireland is akin to heresy, but there is a strong argument in both cases for a non-profit State monopoly, as VHI used to be. Has no one noticed that health insurance premiums have risen far more quickly since private competition was introduced? Is anyone actually surprised by that? - Yours, etc,
CHARLES BAGWELL, Millbrook, Straffan, Co Kildare.