Do you agree that BUPA should have to pay VHI compensation for having younger subscribers?

# 123

Posted: 17/09/2008 11:22

Damo, if you want to get treated rather than risk death on a waiting list then private insurance is the means of doing this therefore is a not a luxury - unless you consider life a luxury!

# 122

Posted: 17/09/2008 10:22

I think you're taking this wrongly. Private health insurance is a luxury. The concentration from the government should not be put on artificially propping up a monopoly player ina market - it should be about fixing the problems that already exist in the public sector!

# 121

Posted: 16/09/2008 11:31

Damo, if you knew the first thing about the public health system in this country, you would know that private health insurance is an absolute necessity in this country. EVERYONE is entitled to a health service and the only way you can secure that without risking life and limb on a public waiting list is by having private health insurance.

# 120

Posted: 10/09/2008 11:49

The argument that BUPA (now Quinn-Healthcare), or any other new-comer to the market for that matter should pay compensation is ludicrous. Anyone with a basic understanding of economics could see that. Essentially what the Risk qualisation scheme was doing was allowing a new company three years to build up some kind of equity and then, after this three year period of grace, forcing this new company to pay the incumbant monopoly absurd amounts of money - all to ensure that the monopoly could maintain it's monopoly position!!

JamesH - I don't think that BUPA left the country because they knew that they were going to lose. I believe the contingent liability incurred after the high court decision was so high, that from the perspective of the heads of the BUPA group, it was unviable to continue doing business in Ireland. This decision from the supreme court was not a surprise, and I would not be surprised if it lays the groundwork for a case against the Irish government for breaching EU competition law.

I don't accept the argument that these new companies cherry-picked the market by creating new plans that were designed to cater for the younger, less expensive generations. As one who has a serious in-depth knowledge of every plan from VHI/BUPA/Vivas, each plan had an equivalent from each of the other companies.

If VHI went out of business due to the lack of funds from Risk Equalisation, well so be it. This scheme has already put BUPA out of business - but there does not seem to be the same outcry in some of the comments here about that.

I would like to also make the point again that I have made in previous comments - that private health insurance is a luxury, not a necessity. Although that provides no solace to somebody waiting for a procedure for a long period of time on a public waiting list, everyone does not have a right to have health insurance.

We have a public health system in Ireland. As a nation we should be fighting with our politicians to ensure that is up to scratch. We have voted the same government back into place, knowing their record on healthcare. Decisions in our health service are made for political reasons and there is no emphasis put on the patient. We have the HSE which sees accountable to no-one, not even the minister for health. And our Minister for Health is incompetent. I think these are the vital issues which need to be addressed.

# 119

Posted: 09/09/2008 19:19

The unhappy monopoly (VHI) created by the state has grown strong and prosperous on the back of a dysfunctional health service which- like all apparatus of the state- becomes the child of pork barrel politics rather than efficiency and practicality; & burdened with state unions & bureaucrats, not to mention vested interests in the medical profession who are elevated to the awesome status of demi-gods through lack of independent monitoring systems. Incompetent surgeons swim in this huge amorphous pond,and generate numerous law suits from patient victims of theirs.
Overcrowded hospitals spawn dreadful infectious diseases,and chaos reigns in a political vacuum whereby the overseers of the system-in pandering to all-please none.
Now our salvation is competing insurance companies and private hospitals countrywide.
When the client who pays so dearly for his private insurance can choose from outside this incestuous mix of speculators and medics- many of whom are shareholders in the Hearneyization of our health system-and opt for treatment in the finest hospitals in Europe abroad we will begin to have a free and open health insurance system.
Mary Hearney´s last political coup détat consisted of twisting Bertie Ahern´s arm a decade ago and ushering in liberalization of the taxi industry.
That industry and the livelihood of many thousands of drivers is in tatters today.
It suits Fianna Fail to have a "fall guy" figure to take the flak for decades of incompetence and misuse of the health services in Ireland
Smokeless chimneys will be her enduring legacy,but any lowly civil servant could have led that particular revolution.

# 118

Posted: 09/09/2008 16:23

Soldiers,

You are of course correct and that is the point. All the new comers have the young people and VHI have the older population, by in large. Plan A was to get the new companies to redress the balance by paying VHI, but the supreme court rejected that. Funninly not even BUPA thought they would win the supreme court action as otherwise they wouldn't have left the country.

There is no reasonable way to force anyone to join a particular company. The reason tends to be inertia on the part of older people and being comfortable with who they know and not wanting to move.

# 117

Posted: 09/09/2008 15:39

Ok James but the new entrants are not exactly going to go out looking for older members-particularly as they are not allowed to charge them more.!
The corollary of this is that the VHI will surely go out of business in the long term as it will continue to be disproportionately burdened, and will seek across the board increases for supporting the large number of older clients on its books.
The only way to prevent this would be for all the competitors to be "forced" to take over a number of the costlier, older clients from VHI- a totally unrealistic scenario in law I would imagine.

# 116

Posted: 09/09/2008 12:31

Soldiers of destiny,

You story sounds very complicated and a lot of bother for you to administer while at the same time fighting cancer. Hope at least that you are winning the fight against cancer.

One point of correction. Community rating is not being abolished here. It is enshrined in law. The method called "risk equalisation" to redress the balance between the insurance companies has been shot down by the supreme court. Nobody at this point knows what will happen next. Risk equalisation would have made other companies pay compensation to VHI in recognition of the fact that VHI had the majority of older, more expensive customers on their books. Community rating means that everybody availing of a particular scheme will pay the same price regardless of age or risk; this still continues. The speculation is that insurance companies will create schemes that are more meaningful to young people and be cheaper and other schemes that are more attractive for older people and that they will be more expensive. The principle will be that within each scheme everybody pays the same.

# 115

Posted: 09/09/2008 10:58

I retired at 52 and moved abroad to live the good life before old age or a worse fate would fall upon me.
some years 9 ago and the VHI told me I could continue on their books through a subsidiary company called "Global health Insurance", as they did not like to lose a good and trouble free customer.the policy was cerca 2000Euros per annum.
last November I was unhappily diagnosed with Prostate Cancer and opted for an operation in a local hospital abroad rather than return to Ireland. I was particularly influenced by the assurance from my Surgeon that MRSA was virtually unheard of in the hospital.
(My wife and I were originally paying 2000 euros a year for a VHI policy which covered us for one of the less expensive MRSA free private hospitals in Ireland, but we still pay for all pre operation diagnostic tests etc.)
Only the hospital stay and operation was covered.The hospital/surgeon bill was 11000 euros in total, but the surgeon was at my side day and night following the operation, and there was no extra fees for follow up consultations,administering injections etc.
Follow up medication consisted of two expensive three monthly injections.I was covered for medication in my policy but only for three months.
When I tried to claim for the second injection bang on the three month limitation, I was refused on the grounds that two days before sending in my claim, I had agreed a new contract with VHI and changed to their irish based insurance.
I had just received a renewal bill for 3000 Euros, for the Global cover!
I baulking at this enormous increase-it seemed to me they wanted their money back-if only in yearly instalments.
I discussed the matter with VHI I was told overseas members were not community rated,and I had suddenly grown old enough- or expensive enough- to be persona non grata.They allowed me to return to the irish system,for 2000 Euros per annum which means all medical treatment must hencefore take place in Ireland.
Now we know that community rating has been abolished.My next bill for irish insurance, will presumably be for 3000euros(or more).!
I should have never joined VHI but personally invested the money they got from me for the past 20 years.It would be worth about 80,000 euros by now.!!
The government are in serious crisis now due to the high court case which threw out community rating.Private VHI clients will be abandoning them in droves, just at a time when Hearney is phasing out the public Health Service (disfunctional as it is) and building private hospitals on free adjacent sites.

Well, I then attempted to claim on a serious illness policy with a large irish insurance company based in Dublin.
That was a nightmare.None of the correspondence sent by the local doctors ever arrived in the office of the insurer.They had not registered the letters.I never before had mail sent from here going astray.
I asked VHI to forward their complete file to the insurer. They obliged.
None of the documentation which I then asked the VHI in Dublin-who had paid for everything and had all the doctors reports-to send to the insurer ever arrived until registered letters were finally sent.
Either half of Dublin is reading my medical history-or there is a new black hole somewhere between Spain and Dublin where large amounts of letters now disappear weekly.I since heard that the company had been featured on the Joe Duffy Show.I was not alone it seems.
This carry on went on for 5 long months.Just when I was giving up and my daughter was going to go to law, I got paid.
Some of the delay was explained as being outside the insurer's control as the claim had to go to other underwriters.I think they call this re- insurance.
It may be the same kind of financial jiggery that has reduced half the banks and insurance companies in the world almost to ruin.
I actually felt a little sorry for them.Their shares have lost 70% of their value on the stock markets.I kind of understood that by stalling they perhaps hoped the markets would recover a little.
But would love to know where all these billions in re-insurance losses etc have gone.? it must be into somebody´s pocket.?
I think the only "serious illness" these companies cannot really dispute is the term in their own policy which defines cancer as the "unconrolled growth of abnormal cells" or something to that effect.they had that evidence in black and white.
They probably knew that I was unlikely to be in Heaven before the cheque arrived, and were in no hurry to cough up.
I had to continue making monthly payments on a policy which should have been suspended-or my 5 months payments refunded-from the day the claim was set in motion.

If community rating is now being abandoned by law, in Ireland, I think most people would be wise to put three thousand Euros in the bank every year from 50 years onwards,instead of fattening the surgeons and private hospitals.
They could place themselves at the disposal of Mrs Hearneys wonderful new reformed public health service-if they believe that the choice between turning left and turning right at the entrance to the twin hospital compounds now under construction countrywide amounts to nothing more than parting unnecessarily with hard earned cash.
If the worst comes to the worst and she wont look after them in their older years, I believe there is an increasing internationalization of medical procedures and top class surgeons and hospitals in exotic locations like Thailand for which more and more americans are voting with their pockets.
It would probably be impractical to close down the whole public health service and send all patients on a holiday to these places,but it would certainly save the taxpayer billions.!
Last year one of my family required a delicate and difficult operation and I wanted her to go to a hospital in Sweden which is the finest in the world for spinal procedures.
She was covered by VHI but they point blank refused to consider paying any portion of the cost of this abroad-providing the same procedure was availible in Ireland.
I dont know if it is coincidence that following my approaching the VHI on this unpalatable topic-the best surgeon in Ireland found a sudden cancellation ,and she jumped the long queue for this mans expertise-while at the same time defusing my troublesome enquiries.
Now which company will initiate a new health insurance policy giving patients to opt for world class surgery in whichever country and which hospital has the highest reputation for the particular procedure they require.?

# 114

Posted: 30/07/2008 16:58

And nothing is to stop those older cusotmers - who were young once,from switching to Quinn or Hibernian if they want to.

# 113

Posted: 29/07/2008 18:44

Of course! VHI have kept all the older customers without making them pay a huge amount extra...

# 112

Posted: 25/07/2008 19:29

certainly not ! VHI had the monopoly for long enough,hence the large amount of elderly subcribers,if we all dropped private insurance ,then the Government would have to face their responsibility,once and for all .Perhaps Mary Harney should pay a visit to Canada,that Country has a Health System second to none. She might learn something.Cassandra

# 111

Posted: 17/07/2008 16:11

James H where is the credit for Mary Harney now. Her 'courage' may cause us to have to pay millions in compensation. I wont listen to you any more as you just blindly support the top dog.

# 110

Posted: 17/07/2008 13:03

The problem is the interpretation of the Community Rating concept in Ireland.

Community Rating basicaly states that people of all ages/genders/backgrounds must be charged the SAME price for the SAME product. It is written into the Health Insurance Act, and therefore any company wishing to trade in the Health Insurance market in Ireland is bound by that law. It does not need further protection that the Minister believes it does.

What the Risk Equalisation Scheme does is protects the incumbent, in this case VHI. VHI have a huge share of the market, although when one looks at the statistics, their older customer base was not hugely different to BUPA Irelands. VHI squandered their reserves which they should have kept for the future when their members would become older. If they could not afford to keep their costs down due to this squandering, and had to raise premiums, so be it. This is how business and competition works in a proper market - the customers have the ability to move to another insurer, namely BUPA Ireland or VIVAS. People should have had no fear of leaving as under the Health Insurance Act customers have continuity of cover which means that the new insurer had to recognise all time spent with their previous insurer - taking over where the old insurer left off so to speak. VHI had to be taken to the Heath Insurance Authority to admit this.

I don't take the point that BUPA knew what they were getting when they entered the market. Because there is a possibilty of a scheme being brought in, that does not make it any more legal or right.

The ruling in the Supreme Court yesterday could have a very serious effect on the future of the Health Insurance market in Ireland. Also who will foot the bill for the loss of earnings that the BUPA group has sufferred due to being bullied out of the Irish market?

Personally, I believe that justice has been done, and that after this most recent debacle (there's quite a list there at this stage), Minister Mary Harney should do the right thing for once and resign from her position as Minister for Health.

# 109

Posted: 20/03/2008 20:49

Most certainly. This was made very clear to BUPA on entering the Irish market so why should they be allowed to cream it off with the less illness-prone being their choice,and they loading the elderly??

# 108

Posted: 22/03/2007 23:12

I totally disagre with VHI receiving compensation from BUPA. It is to be expected that people are penalised based on their risk category. As a young male motor insurance is more expensive for me. It is a fact of life. Likewise as a smoker, personal insurance policies are more expensive. Bupa haven't done anything shady, or tried to slect a particular consumer base. If the VHI wasn't a state entity, this issue would never have come to a front. I have worked for various multi-national as ahve many of my friends, and their also. They all had VHI, as their insurer. Perhap and it is of course only speculative: these scemes were some kind of golden handshake to attract inward investment. If this is the case, it would certain be a contributing factor in VHI's extra overheads.

# 107

Posted: 15/03/2007 23:09

No, I am over 60 and i think it is ludicrous as I have never claimed from vhi, nor my wife. It is a monoply. Fred

---

garden

# 106

Posted: 15/03/2007 20:00

No, I do not agree that Bupa should have to pay VHI compensation. They had a monopoly for years.
No other company was allowed into the health insurance market. That is the reason their customers are older. If the Government was serious about competion, they should have made VHI comply with solvency regulations first, before forcing Bupa into risk equalization. To make matters even worse, they then changed the rules to suit VHI even more.

# 105

Posted: 08/03/2007 15:09

BUPA werte agreeable to paying VHI compensation but not at the level being demanded that the Judge agreed was excessive. Two things to bear in mind
1) THe Dept of Health and the VHI wrote the Risk Equalisation formula. It is clearly unfair and should have been audited for reasonableness by an independent body such as the Instiute of Auctuaries.
2) BUPA are a provident society..unlike Quinn Direct. Every penny of their surpluses are reinvested in patient care. They are a \'Not for Profit\' organisation.
I think that Mary Harney has been badly advised on this issue.

# 104

Posted: 08/03/2007 14:17

I believe that the health insurance business should be run in the same way as pensions. If you join when you are young, you pay lower premiums...for life. If you move providers, you should be able to transfer credits(i.e. money) to the other provider. There should be a large "deposit" by the company, to ensure they won't pull out of the market when a larger proportion of their clients are older, and claiming more often.

# 103

Posted: 08/03/2007 13:06

Don't agree with this at all, if you want to take this a step further then surely older drivers should be penalised and have their insurance premiums increased and younger drivers' premiums reduced to allow equalisation of the motor insurance industry. Surely this decision is going completely against the idea of competiition, I am in my 50's and have had a lot of health problems and BUPA have had to pay out a huge amount of money to cover my expenses so it's not as if BUPA don't have clients who are also very high risk, VHI have had a monopoly for long enough.

# 102

Posted: 02/03/2007 09:41

JamesH, after reading you post of 26/02/2007 perhaps I was wrong on the risk equalisation issue. I was replying based on the huge payment of millions of euro to the VHI. I was not aware that there would be different methods of calculation. That was naive of me in the extreme of course. I think the reason I am opposed to risk equalisation in Ireland is due to a large number of issues, most importantly though it is because of the farce of a health service that we have in this country and the idiots who run it from each minister of health in recent years (especially since Charlie killed the hospitals in the 80's), to the health managers with supposed responisibility but no accountability.

# 101

Posted: 01/03/2007 14:21

No way. This risk equalisation issue is completely ridiculous. I hope Quinn shakes up the health insurance market. He even has the potential to ruffle feathers in the HSE and show them up for the poor excuses of "professionals" that they are. I hope he goes through the VHI, the government and the HSE with the bulldozer they deserve.

# 100

Posted: 26/02/2007 09:36

Quinn forever, For the record I have absolutely no affiliation to VHI. I am merely being rational in this debate and debating the issues, rather than simplistic name-calling.

I too welcome Quinn-direct. He is a great role-model for any aspiring business-person. He is (like BUPA) knowingly entering the market which has community rating as the norm. He knowingly enters this market having to pay risk-equalisation from the word go, without a three year reprive on risk equalisation (unlike BUPA). He like me challenges the solvenecy arrangement whereby VHI do not have a solvency requirement until 2012. This is totally unfair on any competitor. I haven't heard him saying that he disagrees with risk equalisation (although I am sure you will correct me if I am wrong on that point). However, I am sure that he will fight for a fair risk equalisation system. Risk equalisation seems to be working very well in Austrialia with 26 companies in competition, including BUPA. The public in Ireland have never had explained to them what is different in Austrailia that is acceptable to BUPA there, but not here. It is obviously not the principle of risk equalisation, so the only thing it can be is the method of calculation. Both the Gov & BUPA have kept very quite on this issue. I would love to know why.

Finally, credit must go to Mary Harney for having the guts to take a very unpopular decision in removing the three year reprieve loop-hole. A more cowardly politician (as in most of them) would have long-fingered that decision until after the election, for fear of rocking the boat. Quinn has also to his credit taken it on the chin, with the atitude that he is in it for the long haul, and so it was only a short term bonus anyway, and he aims to make it a viable business with or wothout the three year reprieve. Apparantly according to the papers, he drove a price-cut with BUPA beacuse of thsi, and so didn't loose out too much at all.

# 99

Posted: 23/02/2007 17:05

I'm hoping that now Quinn have entered the market, I might actually be able to afford Health insurance - I haven't been able to up to this. So if myself, hubbie or three kids get sick in the future, there might be some hope of us getting the right treatment!!!

# 98

Posted: 23/02/2007 13:06

The Mighty Quinn has spoken. VHI quivers in its boots. Hello James H (whaqt's your VHI name by the way ?)

# 97

Posted: 22/02/2007 22:12

I joined bupa two years ago aged 64 years old. I do not agree that bupa should pay VHI compensation for having younger subscribers.

# 96

Posted: 08/02/2007 19:30

I don't know enough about how BUPA operated, but I think health insurance should work the same way as pension plans..if you join when you are young, you pay less...for life. If you transfer from one "provider" to another, you should be able to transfer credits too...to compensate. A fixed penalty for BUPA realy doesn't make sense. Maybe they are cherrypicking, in that they are taking on the younger, low-risk clients, but as long as they were bound to stay with them when they DO need payback, it shouldn't be a problem. I'm sure that the VHI worked the same way in their early days !.

# 95

Posted: 21/12/2006 18:17

John, You said in your last posting

\"Ann. You are right on one issue and wrong on one. The VHI is owned by all the people of Ireland and the Minister for Health is the only shareholder. It is a very democratic system.\"

Whilst I am not argueing with you, I just find the part about the VERY democratic system a wee bit hard to swallow.

What was democratic about CJH insisting that the VHI paid for B.L\'s liver tx?


Whilst I fully support any treatment for any citizen which cannot be done in this state, being done outside the state when its a life/death situation (as for the past 20 years heart & heart/lung txs could only be done in UK not here).
(I also fully support any treatment given to BL as I always admired him)

I think it can only be called democratic when it applies to all & not just those that know someone with clout!
If you call it democratic that the VHI can cover people at the total whim of a government minister, then that is not my idea of democracy.
Neither does it show the ownership of VHI by the people.

# 94

Posted: 21/12/2006 16:53

Anon, BUPA weren't forced out of the market; they knowingly entered a market where community rating was the rule, and by default risk equalisation was always on the cards. They were not blind to this, they knew it was coming the first day they entered the market.

I too think that it is terrible to not have competition. Austrailia has great competition with, I believe, 26 health insurance companies, and their own version of risk equalisation. We need to understand why it works in Austrailia but not in Ireland. I think that it has to come down to the way that the risk equalisation is calculated, but neither BUPA or the Gov are revealing the details of how the calculation is done and what other proposals were rejected. In the absence of this level of detail it is impossible to know who is not being reasonable; either BUPA or the Gov.

Without any question there is certainly one aspect that should be rectifed straight away. VHI do not have to have solvency reserves whereas all their competitors do. This is being changed but not until 2012 for some reason. It would seem only fair that it should be changed at the same time that risk equalisation is being implemented, so as to be fair to both sides.

# 93

Posted: 21/12/2006 15:08

So BUPA is forced out of the market!!!! To all of the people who have submitted to this conversation who think this is a good thing. In a few years when you can either pay for your kids health insurance or your mortgage, you'll release what a mistake pushing BUPA and any other competition out. NO COMPETITION, NO REASON TO LOWER PRICES. More RIP-OFF REPUBLIC nonsense. No one in their right MIND can compete with the VHI now. VOLUNTARY health insurance??? if you boot the competition out its MANDATORY health insurance. Long live the MHI !!!!!

# 92

Posted: 20/12/2006 21:26

Ann. You are right on one issue and wrong on one. The VHI is owned by all the people of Ireland and the Minister for Health is the only shareholder. It is a very democratic system.
I agree with you that there should be one quality public health service with no need for private insurance but what would Mary harney's pals in the private hospitals do. They wouldn't be able to make money out of the illness of other people.

# 91

Posted: 20/12/2006 17:25

When things get going fewer and fewer of us will be able to afford the insurance but by then the public system will be completely decimated.

# 90

Posted: 20/12/2006 15:49

Actually Maria, I have been private and am now on the public health and I have never waited any longer on the public system than I have on private.
It depends what is wrong with you as Ann stated.
It is prioritised that is actually the reality.

I agree with Ann, you pay for something that you are already entitled to.
I would never go private again.

# 89

Posted: 20/12/2006 10:02

Ann, if you think Private health insurance serves no purpose, you should try waiting on the public list - it's months rather than weeks.
If you have private insurance insurance or can pay, you get priority as the public waiting list is longer.
Private health insurance will exist so long as there is a need for it in the market.
On top of extortinate amounts of tax, PRSI and a health levy, I pay €56 to VHI every month - not extortionate by any means.
All I can say is that, the woman the JD show must have one heck of a big family - even with paying the top health plan

# 88

Posted: 19/12/2006 20:48

John, The fact is VHI is only owned by those of us that can afford to join the VHI.
It is not owned by ALL the people, therefore it is elitist and defunct in this day and age.
The fact that almost half a million people joined Bupa tells you something in itself.

All private health care should be abolished. It serves absolutely no purpose whatsoever.
You wait if your insured, you wait if your not insured.
You are treated according to need & priority & that is the only way a health service can run so cutting out private health care is the only answer.
Those that can afford private insurance could pay more tax instead of paying extortionate amounts to VHI.

I heard a woman on the JD show last week saying that she paid 4,000 per year in health insurance for her family. The mind boggles!

As for the Government not jumping the queue!
It doesn't actually make any difference with a Government member whether they have private health insurance or not, they would still be able to jump the queue.
We all know, its who you know here, not what you know.
That is the same the world over. There will always be people who can pull strings & there always will but if they were paying a proportion of their vast salaries towards the health system, then at least, we would know they were only getting the same as the rest of us & it would encourage them to sort out the health service once & for all, instead of just paying lip service.
Its a complete myth to think that because you pay private insurance, you get better treatment because you simply do not.

# 87

Posted: 19/12/2006 12:19

An excellent idea was proposed earlier.
What if all Government ministers were forced to use the public health system for their own personal health care., as one of the conditions of being in office
i.e No jumping the queues because they have private cover in a hospital etc. That might see a quicker shake up of the health service and the whole issue of private insurance might become LESS of an issue!

# 86

Posted: 14/12/2006 18:44

Many of your posters don't seem to realise that the VHI is owned by the people of Ireland and that the rates charged were sanctioned by the Minister for Health. These rates depended on the cost of private beds in public hospitals, again set by the Minister for Health. In the recent budget Mary Harney announced a huge increase in the cost of private beds. This has to lead to large increases in the cost of medical insurance. I bet you when these increases come in the posters will be out in force claiming that it is lack of 'competition' which is the reason for the price rise.

# 85

Posted: 14/12/2006 18:05

So BUPA is pulling out!! Where does that leave us? A monopoly which can rip us off in line with Mary Harney's strategy to give massive profits to the private investors

# 84

Posted: 14/12/2006 16:33

Iff12, good point regarding some of the reason why the over 50s do not move from VHI to BUPA. In addition in general the older the age group the more relucant they are to move services such as banks, phone companies and insurance companies.

However the second half of your message seemed to contradict the first half. VHI have 80% of the over 50s market and most of them as you point won't move from VHI to BUPA and therefore VHI have the lions share of payouts. Yet risk equalisation is not correct in your view. How do you propose that VHI operate on a level pitch if it is not through risk equalisation? In addition do you agree that if BUPA had 80% of the over 50s market that they would have to increase their fees in order to cover the increased costs? Risk equalisation is merely to level the pitch in a community rating environment. Once the pitch is level, then the other factors in competition such as customer service, product range, effiencey come into play, and it is game on.