Dáil Éireann Debate, Thursday - 26 June 2025
30. Deputy Michael Murphy asked the Minister for Health the steps she is taking to improve transparency and scrutiny in relation to the amount hospitals are charging health insurance companies in order to address rising premiums. [33416/25]
View answerIreland’s health insurance market is community-rated. Health insurance premiums are based on the average cost of providing the services covered by a particular product, rather than on an individual health’s status.
Insurers make predictions based on their customer base and what services they will require in the coming year and price their premiums accordingly.
There are several contributors to premium price increases, including age and demographic profile. Older people have more complex health needs. However, community rating means that older and sicker people pay much less for health insurance than they would in a risk-rated market. Other factors include increases in staffing costs and medical inflation relating to new high-tech treatments.
Private patients may be treated in a private or, to a lesser and decreasing extent, a public hospital. In public hospitals, patient charges are fixed by legislation and are fully transparent [Schedule Four of the Health Act 1970 (revisedacts.lawreform.ie/eli/1970/act/1/revised/en/pdf?annotations=false) .
The charges that apply in a private hospital are negotiated between private health insurers and health service providers. It is in the insurers’ interest to negotiate the best possible rate for procedures and services, as this will control their claims costs.
All of these matters are factored into the health insurers’ commercial considerations and business pricing strategies. However, as Minister for Health, I have no role in the commercial decision-making of any private health insurer.
