Rising Health Insurance Premiums in Ireland:
What’s Really Driving Health Insurance Increases
Jim Dowdall, CEO Level Health.
Every time health insurance premiums increase, the public debate collapses into a familiar headline: “Insurers hike prices again.” It’s convenient. It’s simplistic. And it’s wrong.
Half of Ireland’s population pays for private health insurance because they want timely, reliable access to care. Private hospitals deliver over a million treatments and half a million scans every year. More than half of all cardiac procedures and two-thirds of spinal surgeries happen in private health care facilities - funded not by the State, but by the 2.5 million people who pay premiums. Private health care is not a luxury. It is a pillar of the national health system.
Every private patient treated is one less person waiting in the public queue. Remove the private health system tomorrow and the public system would collapse by tomorrow night.
This is why Ireland urgently needs a health policy that strengthens both sectors - not one that clings to the outdated ideology that public is good and private is bad. At times, you’d wonder whether we have a Department of Health or merely a Department of Public Health.
Why are Health Insurance Prices Increasing in Ireland?
- the Truth, Not the Soundbite
Health insurance price increases are happening for one reason: the cost of delivering health care is rising globally. And Ireland is no exception.
Hospital costs, consultant fees, diagnostics and pharmaceutical prices continue to climb. At the same time, medical innovation - precision oncology, biologics, advanced implants, cutting-edge imaging - is improving outcomes but pushing costs upward.
Demand for health care is accelerating too. A growing and ageing population means more chronic illness, more complex care, and more people needing treatment.
In 2024, health insurers paid more than €3 billion for customers’ health care. Next year it will be €3.5 billion. By 2027, close to €4 billion. These aren’t profit margins. They’re bills - bills for accessing health care that people expect, need, and receive.
"Private health care is not a luxury.
It is a pillar of the national health system."
The People Funding the System Are Being Squeezed
Ireland’s 2.5 million health insurance customers pay premiums on top of taxes that already fund the public health system. They are effectively paying twice - once for a public system they are entitled to use and then for one they must use if they want timely treatment.
Our community-rated health insurance model, relies on intergenerational solidarity, where younger, healthier people subsidise the cost of health care for older people. Whether sick or healthy, young or old - everyone is charged the same for the same health insurance cover, but for how long will this model hold?
Younger people face unaffordable housing, high rents, childcare costs and rising taxes. Health insurance should not become the bill that breaks them.
Employers contribute as well - almost €1 billion per year. Their investment keeps the community-rated system viable. But for how long will they do this? At what point do businesses decide they simply cannot absorb continuous health insurance increases?
There Is a Better Way
Imagine if we could remove another 500,000 - or better still, one million - treatments from the public system each year. Waiting lists would shrink. Public patients would be seen faster. Access would improve for everyone. That’s the prize on offer if government embraces, rather than sidelines, private health care and health insurance.
To get there, several changes are essential
1. Recognise - and support - those funding the public and private health system
Taxpayers who pay for health insurance should receive full tax relief on premiums.
Employers, who contribute over €1 billion annually to the health system, should be incentivised to encourage significant workforce participation in the health insurance system.
And health insurance should not attract Benefit-in-Kind tax. Penalising people for seeking timely health care and who also remove a demand from the public health system is absurd policy.
2. Promote true competition
Just four insurers serving 2.5 million customers is not a competitive market. Compare this to motor insurance where there is almost 4 times more insurers for the same number of customers. The Health Insurance Authority should be tasked not just with oversight, but with growing the market and encouraging new entrants. It must now start to consider the competitiveness and sustainability of the market.
3. Modernise outdated regulation and make health insurance affordable for young people
The Risk Equalisation Scheme (RES), designed decades ago, no longer fits today’s market. It must be reformed to be fair, proportionate, and aligned with EU rules - not a blunt instrument that drives younger members and employers away.
If young members walk away, the entire system destabilises as there are not enough young people subsiding the costs of older people. Yet under RES, the Department of Health is again increasing the health insurance levy, now to a huge €517 for most adults - regardless of what their policy costs. For younger people on lower-cost plans, this levy can now exceed 50% of the price of their cover! That is not solidarity; it is ill-judged barrier to the participation of younger people on whom the system depends.
Government must demand the Department and the Health insurance Authority review and refresh this scheme rather than just renewing it in 2027. Level Health is currently pursuing a complaint with the European Commission about RES to force the government to modernise it in the interest of all health insurance customers.
4. Manage rising healthcare costs
Similar to the initiative to manage motor insurance costs, the government should put in place a mechanism to investigate the cause of increasing health insurance costs - to identify how these costs can be managed.
A Crisis We Can Still Avoid
Policy makers are sleepwalking into a crisis. If younger members drop out, if employers pull back, or if premiums become unsustainable, our community-rated insurance model will fracture. Premium costs will surge. Access will shrink. Hundreds of thousands will fall back onto an already overstretched public system.
We cannot afford that outcome.
Ireland needs a smarter, more balanced health policy - one that sees private health care and health insurance for what they are: not the problem, but each an essential part of the solution.
Jim Dowdall, CEO Level Health.
Jim Dowdall is an experienced executive within the Irish health insurance and financial services sectors. He has held several high-profile roles including Managing Director of Aviva Health, CEO of Aviva Ireland, co-founder and CEO of GloHealth and Managing Director of Irish Life Health.
Jim has played a key role in creating and leading high performance entrepreneurial teams, shaping the strategic direction and driving the growth plans for these companies.
Jim is passionate about the importance of strong competition and the opportunities for tech-led challengers to disrupt the status-quo in established markets. He is dedicated to redefining how the health insurance industry performs by creating real partnerships across the private health care and tech sectors, bringing new solutions that respond to the evolving needs of customers and ensures access to healthcare remains affordable for everyone.
Frequently Asked Questions
Why is health insurance more expensive now?
Health insurance is more expensive because the cost of delivering healthcare has increased significantly. Medical innovation, higher hospital charges, an ageing population and greater reliance on private care all contribute to rising premiums in Ireland.
Why do younger people feel hit hardest by health insurance increases?
Younger members often pay more than the cost of their own care to support community-rated pricing. When prices rise, younger people feel less value, which risks them leaving the system entirely. That creates instability and pushes prices higher for everyone.
Will health insurance prices keep increasing?
Without reform, yes. If younger people drop out, employers pull back or private care continues to subsidise an overstretched public system, health insurance price increases are likely to continue.
What would help reduce health insurance increases in Ireland?
Supporting those who fund the system, modernising regulation, encouraging real competition and tackling rising healthcare delivery costs would all help stabilise prices.
