The healthcare market in Ireland is facing a series of problems arising from the dual nature of the market. Health insurance is an important element of this dual market. Yet the main issues confronting the health insurance industry - the ageing of the population and medical inflation - have not produced a set of insurance products in response. Subscribers thus face continued increases in charges well above inflation and these increased charges could well adversely affect new membership of younger people. The introduction of competition has not resolved this issue. Instead, it has concentrated attention on measures to maintain the existing situation. Some of the institutions associataed with the regulatory environment, for example the Risk Equalisation Scheme, have their own problems; and while it is worthwhile to resolve them, it is more important to consider the long-term issues.