Are you caught in the healthcare trap?

MIDDLE-income people in Ireland are the worst hit by our two-tier healthcare system because they earn a little too much to qualify for a medical card, but not enough to easily afford health insurance, a new report has found.

Healthcare inequalities in Ireland are ‘more significant’ than in any other Western European country, it said.

Ireland’s system means that while high earners are able to afford private healthcare and fast-tracked appointments with specialists, while those on low incomes are granted a medical card, many people on middle incomes are being left behind.

The report, by the Think-Tank for Action on Social Change (TASC) and the Foundation for European Progressive Studies (FEPS), revealed the gap between the health of the rich and poor in Ireland was ‘more significant’ than in other Western European countries.

Ireland is the only European country with an ‘out-of-pocket’ payment for primary healthcare, with a trip to the GP costing more than €50.

Timon Forster, co-author of the report, told RTÉ’s Morning Ireland: ‘In other European countries, in some cases there are co-payments so that patients contribute at least partly [to the costs] but Ireland does not have this.

‘The medical cards grant access to health for the most disadvantaged which is good, but the ones in the twilight zone are just above the threshold to qualify for a medical card. They are not far above the threshold but they still need to pay for the GP visit out of pocket.’

This ‘healthcare trap’ has forced people who are just above the threshold for a medical card to pay for GP visits they cannot afford.

‘In some cases, people will avoid a trip to the doctors which can result in poorer health as conditions worsen.’

‘You have a grey area where people are above the threshold but do not have private healthcare. Primary healthcare costs are very expensive. In other countries, you might have a supplement, but here it is €50 plus.

‘If you are on a low income, it comes down to whether you will go to the doctor or not.

‘This can cause complications down the line. While just 1.1% of people with the highest incomes have unmet medical care needs, people in the bottom 20% of income report 4.2% unmet care needs,’ the spokesman added.

Mr Forster said: ‘Because the medical card is means-tested, this research suggests that things might be even worse in Ireland for people just above this threshold.

‘They could be the people who are really losing out.’

‘In some cases, people avoid trip to the doctor’