It's unacceptable for health insurance holders to pay twice for treatment in public hospitals

78% of Irish Adults Say It’s Unacceptable for Health Insurance Holders to Pay Twice for Treatment in Public Hospitals

-       Customers paying twice, once through their taxes and again through insurance, amounts to “Double Taxation” – Insurance Ireland calling for policy review

-       62% Unaware that private patients can be charged over ten times the public rate for the same treatment according to research by Insurance Ireland

Over three quarters of Irish adults feel that charging those with private health insurance for treatment in a public hospital twice, once through general taxation and again through their policy, is unacceptable according to a nationwide poll conducted by Ipsos MRBI. While up to 82% of respondents with health insurance considered this practice unacceptable, a broadly similar sentiment was expressed by those without a health insurance policy (73% consider unacceptable).

The research was conducted to gauge the level of understanding and attitudes of the public to the introduction of the Health Amendment Act 2013. Following the introduction of the Act, health insurance customers are charged a private rate for public treatment in public hospitals. To allow for this, patients are being asked to sign a Private Insurance Patient form which means they waive their right to treatment as public patients.

The research found that most people (65% of adults) were unaware that the form asks insurance holders to waive their right to public treatment. Of those admitted to a public hospital in the past 24 months who had been asked to sign the form, just 30% of those surveyed were aware of its purpose. Almost two-thirds (62%) of those surveyed were unaware that by signing the form health insurers could be charged over ten times more than the public rate, for a public service that policy holders are already entitled to.

When the charge was introduced, it was stated that it would cost no more than €45 million in a full year but is estimated to now cost approximately €200 million in a full year.

Kevin Thompson, CEO of Insurance Ireland stated “It is important that patients understand what they are being asked to sign when presented with this form in A & E. This research has confirmed that there is a lack of public awareness of the practice or indeed the cost implications of health insurance customers waiving their right to public treatment.”

“We believe that asking private health insurance customers to pay twice for a service they are already entitled to, once through taxation and again via their health insurance, is not fair or equitable and amounts to double taxation. This measure has introduced approximately €200 million in additional claims costs in the system and the policy needs to be reviewed.” 

Kevin Thompson concluded “Patients are being presented with a choice on admittance to Public Hospitals through A & E. When health insurance customers are asked to sign this form, they should ask what additional services they are going to receive by waiving their right to public treatment. If they choose not to sign, they can be reassured that their insurer will still cover their costs. We want to highlight what the form requests and what its cost impacts are”.

Find out more here.




Insurance Ireland is the Voice of Insurance in Ireland representing the Life, Non-Life, International, Reinsurance and captive sectors in Ireland. The Insurance Ireland Health Council comprises representatives of Irish Life Health, Laya Healthcare and VHI.

  • 82% of those with health insurance (69% strongly disagree & 13% somewhat disagree) and 73% of those without health insurance (54% strongly disagree & 19% somewhat disagree) disagree with the statement that “it is acceptable for those with health insurance to pay for their public hospital treatment twice, once through general taxation and again through their insurance policy”.
  • When Private Health Insurance customers sign this form in public hospitals their health insurer is charged €813 per day. Those treated as public patients pay a nightly rate of €80 which is capped at €800 in any 12-month period. If patients choose the public treatment option, their insurer will also cover this cost.
  • The reference to a full year cost of €45 million was contained in a letter from the Department of Health to the Chair of the Insurance Ireland Health Council on the 29th of November 2013.
  • Reference to cost of €200 million: Minister Simon Harris, 16th November 2016: “I heard Deputies talk about the public hospital subsidising the private system. People need to make those comments in the context of initiatives that have taken place in recent years because since 2004 we have seen the new charging regime for private patients in public hospitals. Our insurers must now pay for all private patients in public hospitals. To give some figures on that, we have seen payments increase from €454 million between July 2013 to July 2014 to €650 million from July 2015 to July 2016.”