Competition in the Irish Private Health Insurance Market

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BIBLIOGRAPHY Bain (1956), Barriers to new competition: Their character and consequences in manufacturing industries. Cambridge, MA, Harvard University Press. Besley, T. et al (1999), “The Demand for Private Health Insurance: Do Waiting lists matter?” Journal of Public Economics vol 72, pp.155-181. Bickerdyke, I., Dolamore, R., Monday, I. and R. Preston (2002), Supplier- Induced Demand for Medical Services. Australian Productivity Commission Staff Working Paper. Available online at http://www.pc.gov.au/research/swp/sidms/sidms.pdf Blair, R.D. and D.L. Kaserman (1983), Law and Economics of Vertical Integration and Control, New York: Academic Press. Brennan, N. et al (2003), Report of the Commission on Financial Management and Control Systems in the Health Service. Available online at http://www.hse.ie/en/Publications/Background/FiletoUpload,1717,en.pdf Clarke, R., Davies, S., Dobson P. and M. Waterson (2002), Buyer Power and Competition in European Food Retailing. Cheltenham: Edward Elgar Press. The Competition Authority (2006), Consultation on Guidance in respect of Collective Negotiations relating to the Setting of Medical Fees. Available online at http://www.tca.ie/professions/medical_fees_consultation.pdf The Competition Authority (2005), Submission to the HIA Minimum Benefit Regulations Consultation. Available online at http://www.hia.ie/docs/minimum-benefits/Minimum-Benefit-Submission-The- Competition-Authority.pdf The Competition Authority (2002), Notice in Respect of Guidelines for Merger Analysis, Decision No. N.02/004. Available online at http://www.tca.ie/decisions/notices/n_02_004.pdf The Competition Authority (2005), Competition Issues in the Non-Life Insurance Market - Final Report and Recommendations. Available online at http://www.tca.ie/insurance.html Competition Commission (2000), British United Provident Association Limited and Community Hospitals Group Plc: A report on the proposed merger. Available online at http://www.competitioncommission.org.uk/rep_pub/reports/2000/449BUPA.htm#full Department of Health and Children (1999), Government White Paper on Private Health Insurance. Available online at http://www.dohc.ie/publications/pdf/phi.pdf?direct=1 Department of Health and Children (2002), Health Statistics 2002. Section D: Community Health and Welfare Services. Department of the Taoiseach (2002) Regulating Better. Available online at http://www.betterregulation.ie/upload/Regulating_Better_html/index.html 165
Dobson, P., M. Waterson and A. Chu, (1998), The Welfare Consequences of the Exercise of Buyer Power. Available online at http://www.oft.gov.uk/NR/rdonlyres/9A4F0B82-1514-4344-9C1F- 39621912E9DE/0/oft239.pdf European Commission (1997), Notice on the Definition of the Relevant Market for the Purposes of Community Competition Law. OJ [1997] C 372/5. Available online at http://ec.europa.eu/comm/competition/antitrust/relevma_en.html European Commission (2002), Solvency 2. Available online at http://ec.europa.eu/internal_market/insurance/solvency2/index_en.htm European Commission (1997), Case no. IV/M.1033 - AXA-UAP / AXA AURORA. Available online at http://ec.europa.eu/comm/competition/mergers/cases/decisions/m1033_fr.pdf European Commission (1996), Case no. IV/M.812 - ALLIANZ / VEREINTE. Available online at http://ec.europa.eu/comm/competition/mergers/cases/decisions/m812_de.pdf European Commission (2000), Notice: Guidelines on Vertical Restraints, OJ [2000] C 291/1. Available online at http://europa.eu/scadplus/leg/en/lvb/l26061.htm The Financial Regulator (2006) Guide to Industry Funding. Available online at http://www.ifsra.ie/data/pub_files/2006%20Guide%20to%20Industry%20Fun ding.pdf#search=%22%22insurance%20undertaking%22%20levy%22 The Financial Regulator (2004), Serious Illness Insurance. Available online at http://www.ifsra.ie/data/cr_pub_files/Serious%20illness.pdf The Financial Regulator (2004), Income Protection Insurance. Available online at http://www.ifsra.ie/data/cr_pub_files/Income%20protection.pdf Gaynor, M. and Vogt, W.B. (1999), Antitrust and Competition in Health Care Markets. Available online at http://equilibrium.heinz.cmu.edu/mgaynor/papers/antitrust.pdf Greencore (2005), Annual Report. Available online at http://miranda.hemscott.com/ir/gnc/ar_2005/ar.jsp Harmon, C. and B. Nolan (1999), “Health Insurance and Health Services utilisation in Ireland” in Health Economics 10:2 The Health Insurance Authority (2005), The Private Health Insurance Market in Ireland – A Market Review. Available online at http://www.hia.ie/docs/consumer-research/PHI-A-Market-Review-Final- Report-Incl-Appendix%20A-220905.pdf The Health Insurance Authority (2006), Understanding and Comparing Private Health Insurance Products. Available online at http://www.hia.ie/docs/pcaci/Comparison-Table-March-29-2006.pdf The Health Insurance Authority (2005), Submission to the Department of Health and Children - Minimum Benefits. Available online at 166
Page 1 and 2:
A Report to the Minister for Health
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CONTENTS TABLE OF FIGURES _________
Page 5 and 6:
CONSUMER ATTITUDES TO SWITCHING ___
Page 7 and 8:
EXECUTIVE SUMMARY AND RECOMMENDATIO
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As a result it does not have to sat
Page 11 and 12:
Recommendation 7 The Minister for H
Page 13 and 14:
indicates that consumers of PHI hav
Page 15 and 16:
Recommendation 13 The Minister for
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is quite unclear, so far as the Aut
Page 19 and 20:
1.4 For the next number of months t
Page 21 and 22:
other insurers were to enter the ma
Page 23 and 24:
2.6 Private health insurance (PHI)
Page 25 and 26:
2.17 Open enrolment and lifetime co
Page 27 and 28:
• 2001: The Health Insurance Auth
Page 29 and 30:
Figure 2: Annual Change in PHI memb
Page 31 and 32:
of medical inflation and the higher
Page 33 and 34:
VIVAS Health is rising steadily. In
Page 35 and 36:
• Table 1 below shows the annual
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Figure 6: PHI Products BUPA Ireland
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• Work-based group schemes where
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from year to year and also during t
Page 43 and 44:
3. DEFINING THE PRIVATE HEALTH INSU
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Figure 7: Key features of Related H
Page 47 and 48:
price increase unprofitable by a hy
Page 49 and 50:
4.6 Aspects of the exemption from i
Page 51 and 52:
and quarterly management accounts t
Page 53 and 54:
Table 4: Regulation of PHI Firms 48
Page 55 and 56:
4.31 This is a positive step. Just
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obliges Vhi Healthcare to seek appr
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4.41 In the regulatory approval pro
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4.50 However, the Authority is clea
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Unfunded Lifetime Community Rating
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President of the Society of Actuari
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− The main other deterrent at pre
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o The former members of the Advisor
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materially affected by any seasonal
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It may also be noted that the propo
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4.94 There are 37 health insurers i
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Interviews with Possible New Entran
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have shown that new sales and switc
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not binding on incumbents and no in
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5.33 In this context Vhi Healthcare
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5.44 As the former incumbent monopo
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5.52 Vhi Healthcare’s first mover
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• Psychological costs 6.5 Transac
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18-24 9% 13% 25-34 34% 19% 35-44 31
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6.24 The provision of renewal notic
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The HIA publishes on its website a
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Recommendation 10 Following consult
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Recommendation 11 The insurance com
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Regulations were established to aff
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transferred and the amounts require
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Buyer Power and Concentrated Market
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The Supply of Private Medical Facil
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VIVAS Health claims that Vhi Health
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approval on coverage of facilities
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Supplier-Induced Demand 7.36 The Vh
Page 115 and 116: Questions Relevant evidence Irish P
Page 117 and 118: to restrict individual choice of pr
Page 119 and 120: 8. CONCENTRATION AND MARKET POWER I
Page 121 and 122: gives us some indication of the com
Page 123 and 124: wishes to retain the flexibility to
Page 125 and 126: largest price increase that is prof
Page 127 and 128: scheme. Employees may be under the
Page 129 and 130: elevant regulatory requirements, ex
Page 131 and 132: Table 7 Vhi Healthcare Financial Re
Page 133 and 134: • There is limited buyer power fr
Page 135 and 136: Breaking up Vhi Healthcare would di
Page 137 and 138: expertise and other staff resources
Page 139 and 140: APPENDIX 1 Other forms of health re
Page 141 and 142: APPENDIX 2 Report of UK Government
Page 143 and 144: Australia Ireland Public hospital U
Page 145 and 146: Australia Ireland Risk equalisation
Page 147 and 148: 1.22 The Irish data is not split at
Page 149 and 150: Conclusion of normal claim payments
Page 151 and 152: APPENDIX 3 Consumer Attitudes to Sw
Page 153 and 154: Survey Respondent factors promoting
Page 155 and 156: APPENDIX 5 OECD Review of PHI The O
Page 157 and 158: not-for-profit insurers has posed c
Page 159 and 160: 114. Private insurers have not impl
Page 161 and 162: APPENDIX 6 List of Submissions The
Page 163 and 164: Understanding and Comparing Private
Page 165: Benefits Outpatient Cover Cover for
Page 169: Vhi Healthcare (2005), Annual Repor
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Competition in the Irish Private Health Insurance Market

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