The design and regulation of individual health insurance in voluntary markets for which a risk solidarity objective applies is an increasingly important topic for many countries (e.g., Australia, Ireland, and some sectors in the United States). There is controversy in all countries with regard to the extent governments should intervene in private markets. This chapter outlines how Ireland has structured its voluntary health insurance market to meet its solidarity goals, particularly through the use of premium rate regulation and cross-subsidies to health plans (risk equalization). The design of health plan payments balances concern for fairness against creating incentives for risk selection. The analysis confirms that there is still some way to go to improve the risk equalization system in Ireland. The Irish example is a powerful case study for policy-makers in other individual voluntary health insurance markets who seek to meet specific risk solidarity objectives.

Health insurance, Health policy ireland, Risk adjustment, Risk equalization, Voluntary health insurance,
Erasmus University Rotterdam

Armstrong, J. (2018). Health plan payment in Ireland. In Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets: Theory and Practice (pp. 331–364). doi:10.1016/B978-0-12-811325-7.00012-9