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Dublin: 11 °C Wednesday 22 May, 2013

Column: Medical cards are a hot issue – but the Government shouldn’t shy away

Means-testing medical cards for the elderly got a previous government in trouble – but that doesn’t mean it’s a bad idea, writes Eoin Lynch.

Eoin Lynch

MINISTER FOR FINANCE Michael Noonan has stated that people will have to “wait and see” what Budget 2013 brings. However, Government kite-flying has indicated that it is likely Minister Noonan will toe the line in accordance with an IMF report published in July of this year and review child benefits, social welfare payments and means testing criteria for the medical card.

Means testing for the medical card is a volatile area for any government, as was proven by the public’s reaction to the decision in Budget 2009 that over 70s would not automatically be entitled to the card.

In a recent statement Brian Hayes said: “It seems to me that the Irish political system will never countenance cutbacks on the elderly. My view is that all this needs to be on the table.” Reacting to these comments Mairead Hayes of the Irish Senior Citizens Parliament stated that “this matter is so serious that both the Tánaiste and Taoiseach should state publicly if the remarks by the junior minister are representative of the views and depth of knowledge of the cabinet as a whole with regard to older people”.

As anyone who has recently visited an A&E department can attest, the health system is still in dire straits. The HSE is currently running at a deficit of €400 million, the Fovernment are looking to close essential facilities in regional hospitals and an apparent €1 billion is due to come off health spending in 2013. So is it now time to appraise the medical card scheme and be more specific about those who are entitled to it?

In Budget 2000, Charlie McCreevy announced that people over 70 would automatically be entitled to the medical card. The allowance was a last minute addition to the budget and was seen by many as an irresponsible move by the government to win over the grey vote for the following year’s election. The repercussion of McCreevy’s generous gesture is that the medical card scheme is based on a person’s age, and not, as it should be, on their income.

Mishandled

In 2008 Brian Lenihan made an attempt to address this problem created by his predecessor. That year saw the budget brought forward to mid-October as opposed to the usual December date. The reason given at the time was “the global economic crisis”. This was Lenihan’s first Budget and the implication of bringing the date forward meant that there was little indication, or kite flying, as to what to expect.

It was a budget that saw HPV testing for 12-year-olds shelved, widespread cuts to education spending and a levy on all income. However, the issue that garnered most media attention was a move to means test the medical card for over 70s. The announcement was mishandled by the Government – Lenihan read this section of his budget quickly and even though he clearly stated the criteria of the means testing, it could be argued that he should have driven home the point that this would only affect the wealthiest five per cent of the over-70 population.

It was proposed that individuals over 70 who had a weekly income of €650 plus, or couples with an income of €1300 plus, would not automatically be entitled to the medical card. It would have meant a saving of around €16.5 million per annum. But the grey army mobilised itself very quickly and did something that no other sector of society, bar students, had done to an Irish government in quite a while – they collectively stood up and said “NO”.

Due to a day of protests outside Leinster House – and the fact that the Government was all too aware that the elderly of Ireland will get themselves to a polling station by hook or by crook on election day – the criteria changed so that those with a weekly income of €700 plus or a couple with €1400 plus would not automatically qualify for the medical card scheme, a change in conditions that would affect just 20,000 people.

Turnaround

The government’s turnaround was seen as a victory for the senior citizens of Ireland but it proved less clear cut than initially thought. This was a battle won on behalf of a relatively well-off section of the over 70s, many of whom would never use the card.

Later in 2009, Mary Harney introduced a 50 cent charge on every prescription to medical card holders, a move that affected all card holders regardless of their income. The Fianna Fáil/Green coalition was a government that showed such a lack of foresight that it would be laughable were the consequences not so dire, but ministers should have had the gumption to articulate that any concessions given on the medical card means testing would be recouped, as they were, at a later date.

The danger of grouping people based primarily on their age means that the economic diversity within that group is not taken into account. If the government goes after ‘the elderly’ in the forthcoming budget it is likely to go after them as a collective group. Fine Gael, as the dominant party of the coalition, are likely to push their right-of-centre ideology and apply general taxes and cuts onto the elderly as opposed to aiming at the wealthier proportion of the over 70s.

With the growing rate of unemployment the number of people entitled to the medical card has increased. At the moment there are 1.76 million people in the State who hold a medical card. Means testing for over-70s will have to take place, because if it does not a time will come when the scheme will be stretched to a breaking point and those who are most in need of the services provided through the scheme will suffer.

Approximately 9.6 per cent of the Irish population over 70 years of age are living below the poverty line. If general cuts are applied, these are the people who will be worst affected by reductions in heating and electricity allowances, home help and possibly the medical card. These are the people most at risk: a small proportion of our society, who must be looked after.

Eoin Lynch tweets at @Eoinlyncho

Read more articles by Eoin Lynch>

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Comments (34 Comments)

  • We should look after our elderly its the able bodied young people who sit on their arses and claim every possible freebie, these people have our country fleeced, I’m talkin about the ones who have never worked or made an effort to work, the pyjama brigade who laugh at our legal system, who spend maybe an hour in prison for huge fines they have amassed over a few months and reoffend knowing that the tax payer will cover their legal aid and fuel their lax a daisy life style. There has to be a system introduced whereby their fines are taken from where it hurts, their dole. Please god let some common sense prevail in this forth coming budget and stop punishing the people who are making an effort.

    Reply
    • The pyjama brigade and their ilk do not have this country fleeced. The politicians, the property developers and their banker friends have this country fleeced. The pyjama brigade are amateurs in comparison.

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    • Who’s going to hire all these civil servants to do the means testing, and how much will they be paid? At HEO level?

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    • Incidentally, shouldn’t we be trying for a universal healthcare system, backed by a vigorous prevention/healthy-living-promotion regime?

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    • I think you are being a bit unfair there Chris. You are talking about a pretty small minority of young people who want to sit on their arses and get the freebies. In all fairness anyone born from the mid 80s onwards had very little to do with the madness of the celtic tiger or what caused the recession.

      Most teenagers these days can’t even get a job in McDonalds or the local Spar because there is an EU economic migrant working in the job already. In my experience, most of the low end service industry jobs traditionally done by young Irish people are now staffed with EU migrants. Its in those jobs that teenagers and young 20 somethings learn responsibility and develop a real world work ethic. I’m glad I am not in school still now, when all you hear day in and day out is how the country is doomed, planning for migration before you even turn 18.

      It was the older generations that voted for our borders to be opened to all in such a fashion. It was how they acted taking out crazy bank loans, buying multiple properties that had a huge part to play in our economic collapse. Should we still look after them? Of course. But you cannot punish young people for their parents sins.

      You are right about punishing the ones (of all ages) who never would give back to society, or have no ambition or work ethic. Prison won’t work because you can’t throw someone in jail as easily as that without dragging it through the courts, forcing them to work in the community won’t work because they will do a poor job of whatever is assigned to them. Only thing I can think of is the cut their benefits and repossess their property to pay off fines.

      I won’t hold my breath though. This government is doing everything possible in order to make us pay for electing them into power. At least you knew where you stood with Fianna Fail.

      Reply
    • King Olaf told there are no jobs because of migrants… but does local youth is ready working hard for the salary we get? I am a migrant, working fulltime in clothing alteration shop my weekly income 330 EUR. Actually in 15 of ZIPYARD branches nationwide no local tailors/seamstresses, not because nobody give them a job, but because of absence of candidates… I think the same story is on other low paid job sector. And I tell you why, it is because migrants used to survive in they homelands with 1/4 of they have here. For people who lived normal live for last 20 years it is not a salary, but a joke…

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    • @Ansis…I’m not trying to suggest we stop people from coming to Ireland…I think in all fairness that your profession would be considered a skilled one, not many young Irish people would be able to walk into it. I’m more talking about bar jobs, retail and restaurant work where it was once very common to have many part time employees rather than a couple of full time staff. That kind of work provides great learning experience for a young adult or teenager.

      Reply
  • When will the other benefits be means tested?

    Yes, those that benefit those whose job is to leave off welfare,
    whose working attire is a tracksuit,
    those who have children not for love to their couples but for love to free housing,
    those who have never worked or plan to in their lives but…

    they always have money for holidays in the sun,
    they are the ones who spend more money on cheesy xmas decorations…
    when will the cuts get to them? WHEN TO THEM?

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  • Every benefit should be means tested, EVERY! Just because you’re a certain age, shouldn’t entitle you to certain handouts. The problem this country has is a self sense of entitlement to everything. I’m sorry but this county is bandjaxed, everything needs to be on the table!

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  • I wholeheartedly agree that the medical card should be means tested. However, I find it hard to understand why my wife, who has worked all her life has been getting chemo for the last 3 years should not be considered. Granted that I am working full time, however without VHI etc it would be difficult if not impossible to meet the bills (and that’s without a holiday in the last 4 years). To my mind the means testing currently in place is skewed and its mainly the wrong people are being granted medical cards.

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  • mattoid 29/11/12 #

    In general I agree with the concept of a means test, but the problem is that when its applied so widely to so many benefits across our society it very quickly erodes the motivation to go out to work.
    If you can sit on your arse all day long and claim everything going, why bother joining the mugs who work all day, pay for everything in our society and get nothing back in return?

    Reply
    • And luckily there’s lots and lots of work. #irony

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    • mattoid 29/11/12 #

      Ah Sinabhfuil, you do know there’s a percentage of the population who are professional couch surfers – the same people who never took a job at the height of the celtic tiger?
      There are also people who are more recently unemployed who have decided that for the marginal additional benefits (if any) of going out to work, they’re better off spending time at home with the kids. I’m not blaming them for making that decision btw, the whole point of my post is that the system is completely arseways when it makes that decision a viable option.

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  • What infuriates me is that people who pay the most taxes see the least benefit from them. I have never been out of work since I turned 18, I payed my own way through college because the government decided that my hard-working, tax paying parents mean I do not deserve a grant.

    I graduate, start my career, pay my taxes and when I apply for a medical card and I’m told “sorry, you work too much.”

    Where the hell has my tax gone? For that matter, where has the tax of my parents’ gone? They have worked solidly for for over 30 years, and they are not entitled to a medical card. I’m not rich, my parents aren’t rich so why is it that despite working hard and paying our taxes all our adult lives we see no benefit while the fella who lives across the road has never worked as long as I’ve know him, contributes noting to society apart from keeping the local offie going and gloats about how he gets his dole, rent allowance and has a medical card?

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    • then go on the dole if your so worried about what others get . i work but would nevet begrudge familys who have lost there jobs help. you never know when you may need help yourself. of course theres people that take the mickey but most dont . and half of the things people that are under the impression people get off the social most dont. i have been on the dole once in ten years of paying tax and its not easy .

      Reply
    • Kellyanne, I begrudge nothing to the unfortunate. But, there are two facts about our tax/social welfare system which annoy me. The first is that many people do not want to work and never have, even when the country was booming, and yet just because they are unemployed they get a medical card. Hard-working people who have lost their jobs in this recession deserve what they get, but those who see the dole as a career get far too much.

      The second is that when people work and pay tax, as I do and you do, we see very little benefit. How is it that me, and perhaps you, are less entitled to a medical card than someone who has never paid income tax?

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    • i agree with i must have read ypur comment wrong . im not a fan of life long dolers meself . just when i read comments or speak to people about it , some people are under the impression that your getting more than they are .

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  • If the medical card system is to be based on a means test alone them it should apply to all citizens regardless of age. There should be no allowance for anything else rather than their means. If the system is to be based on anything else it is open to manipulation. As it stands it is a farce anyway , as there seems to be various reasons to get one : low income , medical discretion and who you know in the HSE ! It needs a root and branch shakedown and it should be more transparent. BUT the pcrs , the department which administers it can’t organise a p**s up in a brewery. It’s a joke how it’s all handled.

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    • The medical card for most people is means tested currently, with exceptions for people that the financial burden of medical or other exceptional circumstances would cause undue hardship and over 70s. Which seems fair enough to me.

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    • You forget that UK pensioners living here are automatically entitled to a medical card.

      Taking it away from them would mean a new inter-government agreement from which Ireland would lose as it has constantly exaggerated the amount of money it is due from the UK.
      It has been ripping Britain off for years.

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    • The Irish administration gets money to pay for the healthcare of people who worked in the UK, then went home.
      But in 2007, the UK overpaid by 150m euros (£135m) and the Tories say they want a parliamentary inquiry to see if further overpayments have been made.

      Reply
  • Probably should be means tested as there are a number of over 70′s who do not need the card. Bit like child benefit I guess.

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  • The present government would take the medical card away altogether, if they thought they’d get away with it.

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  • The medical card for the the over 70′s has been means tested since the 1st of January 2009 why has this not been mentioned the article?

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  • @Brian this is exactly what i though. anyone earning over ?700 doesn’t get one. is that still the case. really there should be a good threshold for pensioners. my parents are under seventy and don’t get it because they’ve two contributory pensions. my father is in the doctor every second week with a chronic chest complaint and they reach the dps limit every month. a lot of outgoings. they are over sixty five but not seventy and are suffering. also my mother has coeliac disease and they recently stopped the facility to get this food at the chemist just an over night thing. no warning. the limit you can earn when you retire initially should be reduced

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  • Who voted for that bastard noonan??? I bet you there’s a board in Germany with a draft of the Irish budget in front of them but the paddies can wait

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  • A friend of mine recently got a medical card, she works p/t and earns a bit on side, partner works in public service and certainly not on low wage, no long term illness in family just an attitude of “I know how to screw the system so I’ll do it”!

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  • Its the Senate and all the free extras that they get that has the country fleeced.

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  • Marie, yes and also they are reviewed when been renewed and if your are over the limit of entitlement you do not get it renewedv.

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  • O yes youwl want to think on that you dont want your mouf to walk you where your feet dont want to go.

    Reply

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