Competition in the Irish Private Health Insurance Market

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http://www.hia.ie/docs/minimum-benefits/Submission-to-DoHC-on-Minimum- Benefits-Sept05.pdf The Health Insurance Authority (2003), Consultation Paper – Minimum Benefits. Available online at http://www.hia.ie/docs/minimumbenefits/Minimum-Benefits-Consultation-Paper.pdf The Irish Times The Irish Examiner The Irish Medical Times Klemperer, P. (1987) “Markets with Consumer Switching Costs”. Quarterly Journal of Economics, pp.375-294 Klemperer, P. (1988) “Welfare Effects of Entry Into Markets with Switching Costs”. Journal of Industrial Economics, pp.159-165 Klemperer, P. (1995) “Competition when Consumers have Switching Costs: An Overview with Applications to Industrial Organisation, Macroeconomics and Industrial Trade”. Review of Economic Studies, pp.515-539 National Treatment Purchase Fund (2005), Annual Report. Available online at http://www.ntpf.ie/news/NTPF%20Ann.Report%202005.pdf Nolan, B. and M. Wiley (2000), Private Practice in Irish Public Hospitals. ESRI General Research Series 175. OECD (2004), Private Health Insurance in Ireland: A Case Study. Available online at http://www.oecd.org/dataoecd/55/29/29157620.pdf OECD (2004a), Private Health Insurance in OECD Countries. Posnett, J. (2002), “Are Bigger Hospitals Better?” in McKee, M. and J. Healy, eds., Hospitals in a Changing Europe. Available online at http://regnet.anu.edu.au/program/review/Publications/HealyP2.pdf Schumpeter, J. (1994), Capitalism, Socialism and Democracy. Oxford: Routledge. Stigler, J. (1968), The organization of industry. Chicago, IL: University Chicago Press. The Sunday Business Post Tirole, J. (1989), The Theory of Industrial Organization. MIT Press, Cambridge, MA. Vhi Healthcare (2006), Multi Trip Travel Insurance Policy Document. Available online at http://www.vhi.ie/pdf/products/multitrip_terms.pdf Vhi Healthcare (2005), Group Business Travel Policy Document. Available online at http://www.vhi.ie/pdf/products/businesstravelterms.pdf Vhi Healthcare (2004), Annual Report. 167
Vhi Healthcare (2005), Annual Report. Available online at http://www.vhi.ie/pdf/about/annual_report_05.pdf The Wall Street Journal Waterson, M (2003). The role of consumers in competition and competition policy. International Journal of Indusrial Organisation, pp.129-151 Watson, D. and J. Williams (2001), Perceptions of the Quality of Health Care in the Public and Private Sectors in Ireland: Report to the Centre for Insurance Studies Graduate Business School, UCD. Dublin: ESRI. Wilson, C. (2006). “Markets with Search and Switching Costs”, Centre for Competition Policy Working Paper 06-10. Available online at http://www.ccp.uea.ac.uk/public_files/workingpapers/CCP06-10.pdf York Health Economics Consortium (2003), Assessment of Risk Equalisation and Competition in the Irish Health Insurance Market (Report prepared for the HIA). 168
Page 1 and 2:
A Report to the Minister for Health
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CONTENTS TABLE OF FIGURES _________
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CONSUMER ATTITUDES TO SWITCHING ___
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EXECUTIVE SUMMARY AND RECOMMENDATIO
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As a result it does not have to sat
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Recommendation 7 The Minister for H
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indicates that consumers of PHI hav
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Recommendation 13 The Minister for
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is quite unclear, so far as the Aut
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1.4 For the next number of months t
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other insurers were to enter the ma
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2.6 Private health insurance (PHI)
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2.17 Open enrolment and lifetime co
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• 2001: The Health Insurance Auth
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Figure 2: Annual Change in PHI memb
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of medical inflation and the higher
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VIVAS Health is rising steadily. In
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• 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
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3. DEFINING THE PRIVATE HEALTH INSU
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Figure 7: Key features of Related H
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price increase unprofitable by a hy
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4.6 Aspects of the exemption from i
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and quarterly management accounts t
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Table 4: Regulation of PHI Firms 48
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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
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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 and 166: Benefits Outpatient Cover Cover for
Page 167: Dobson, P., M. Waterson and A. Chu,
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Competition in the Irish Private Health Insurance Market

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