Private health insurance and Slintecare Colm Conaill | Private - PowerPoint PPT Presentation

Private health insurance and Sláintecare Colm Ó Conaill | Private Health Insurance Unit 3 December 2019

If the present private health insurance market didn’t exist…. ….would we need to invent it? Body Level One Body Level Two Body Level Three Body Level Four Body Level Five 2 An Roinn Sláinte | Department of Health

Changing attitudes towards private/public mix Government should be sensitive to the need to ensure that the public hospital system caters adequately for the requirements of private patients and that the important role and contribution of voluntary health insurance is not diminished in any way. - Programme for Economic and Social Progress, 1991 “On balance, the Government are satisfied that sustaining the mix of public and private practice in public hospitals is desirable and to the benefit of all patients .” - White Paper on Private Health Insurance, 1999 “The Government is committed to ending the unfair, unequal and inefficient two-tier health system and to introducing a single-tier system, supported by universal health insurance…” - White Paper on Universal Health Insurance, 2014

Continued changing attitudes towards private/public mix The Committee recommends a model where private insurance will no longer confer faster access to healthcare in the public sector, but is limited to covering private care in private hospitals. - Sláintecare Report, 2017 “Inequality of access is embedded in our current system and creates barriers and perverse incentives that stand in the way of doing the right things for patients that need care.” - Sláintecare Implementation Strategy, 2018 “Successful Sláintecare reforms would reduce the size of the market and ultimately lead to a change in the nature of health insurance to a more supplementary role over time.” - de Buitléir Report, 2019

Our population is increasing and ageing (ESRI) Increase in 85+ Population 2016 -2031 Increase in 65+ Population Increase in Total Population 12% 59% 95%

Claims costs doubled in 10 years 2015 126% increase 8.5% per annum 2005 Ageing Incidence of chronic disease Medical technology € 876m advancement € 1.9bn Professional fees

Share of all spending in hospitals financed by private health insurance and out- of-pocket, 2015 (or nearest year) Private Health Insurance OOP 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% United States Korea Greece Ireland Mexico Belgium Latvia Switzerland Australia Portugal Turkey Slovenia OECD33 Luxembourg Finland Japan Austria Slovak Republic Hungary Israel France Netherlands United Kingdom Denmark Italy Estonia Poland Canada Germany Spain Czech Republic Norway Sweden Iceland Note : Private health insurance refers to voluntary insurance. Source : OECD Health Statistics 2017, http://dx.doi.org/10.1787/health-data-en

% of the Irish population covered by health insurance (White Paper 1999; HIA 2018) 52.0% 50.5% 47.0% 45.0% 42.0% 37.0% 32.0% 27.8% 27.0% 1975 1980 1985 1990 1995 2000 2005 2010 2015 2020 Rate

Ireland is an outlier in how we use health insurance (OECD)

Health insurers are increasingly moving into the healthcare provision space

Disentangling public & private Public Free at point of entry? Public Improved Health Act Means-tested access? co-payments 1970 Increased Medical card GP visit capacity? card Private treatment in public hospitals Private Private hospitals Private hospitals health Reimbursement insurance Increased for primary care coverage primary care Private coverage? Private Present Potential