A new report on cutting the cost of private health insurance has recommended a financial penalty for people over the age of 30 who take out cover for the first time.
The report published today was commissioned by the Minister for Health James Reilly.
It also says there should be a fixed fee for each type of treatment.
€2 billion was paid out by private health insurers in 2012 in claims - 46% of this was to private hospitals, 27% to public hospitals and 20% to consultants.
The new report makes 32 recommendations to try and reduce costs.
Among them are measures to avoid in-patient treatment, if this could be provided as a day case.
It also suggests continued discounting of premiums for full time students up to the age of 23.
The report says details should be compiled and published of any money recovered from hospitals or consultants that should not have been paid.
Public hospitals also need to speed up the system of processing claims in order to get paid faster.
The second phase of the report will be completed within three months.
The average premium paid by each insured person last year was €1,047.
Premiums have increased 44% since 2008.
Fianna Fáil spokesperson on health Billy Kelleher has urged Minister Reilly to move quickly to implement the recommendations.