Health Insurance in Ireland – Drivers and
Influencers
D.O. O’Connor
Deputy MD Laya Healthcare
The private health insurance market is critically ill
MASS
EXODUS
•
Continued acceleration of dropout
and downgrading will create
HUGE problems for the
Government’s proposed reform
agenda.
•
Market in a cost spiral, the more
people drop out the more the cost
goes up and the more the cost
goes up the more drop out of the
market
47,000 in
2013
FROM PMI MARKET
45% OF
POPULATION
INSURED
ONLY 1/3
INSURED BY
2015
The Road to Universal Health Insurance
Laying the foundations
•
Clearer picture is needed of UHI
model.
•
Meaningful consultation to effect
positive change.
•
Industry-led solution critical to
underpin future of Irish healthcare
system.
•
Stakeholder collaboration is key to
driving reform agenda.
•
We need a fully regulated and
sustainable market before UHI can
be achieved.
SUSTAINABLE
MARKET
THE ROAD TO
UNIVERSAL
HEALTH
INSURANCE
The Road to Universal Health Insurance
FAIR RISK
EQUALISATION
FULLY
REGULATED
MARKETVHI/DOH
RELATIONSHIP
LIFETIME
COMMUNITY
RATING
THE ROAD TO
UNIVERSAL
HEALTH
INSURANCE
DATA
TRANSPARENCY
eCLAIMING
MONEY
FOLLOWS THE
PATIENT
What can we do ?
What are we doing?
•
Lobbying
•
Health Insurance Council
•
Independent review of the market by Pat McLoughlin
•
Challenging providers on all practices
•
Utilisation reviews across all providers of care
•
Constant feedback from members on all aspects of care
What can you do?
• Corner stone of the community rated market
•
Great degree of influence
•
25,000 jobs