The undeserving whipping boy for Reilly’s blundering
This week’s mailbag of readers’ queries highlights the confusion and anger over one explosive and badly mishandled issue: medical cards.
First, discretionary medical cards on which many families depended to cope with serious illnesses were to be taken away. Then the HSE said it would stop taking them but insisted it would be illegal to give any back.
Now, after a trouncing in the elections, the Government has ordered officials in Health Minister James Reilly’s department to fix the legal problem and return the cards.
It appears that the proposed solution, to be confirmed within weeks, is to have a panel of doctors draw up a new system for medical cards so they can be awarded on the basis of medical need rather than on income alone.
(Isn’t that going to increase costs when the whole point of the review that caused the furore was to save money?)
As HSE officials scurry off to consult the Attorney General, warning letters are still arriving on the doorsteps of the seriously ill. People with cancer and cerebral palsy were told this week that their medical cards are under threat even after the U-turn on the issue.
Meanwhile, Ireland got rapped on the knuckles for overspending on healthcare.
In an economic review, the European Commission said health spending here, at 8.7% of national income, is among the highest in Europe and needs to be reduced.
So how are we spending so much on a system nobody seems to be happy with?
To be fair, the health service is not as bad as it seems. Standards have risen enormously but simply can’t keep pace with our rising expectations.
Expensive medicines and surgical procedures that were unheard of a couple of decades ago are now routinely available.
We also hear only about the bad stuff. And since the amalgamation of the health boards into the HSE, it has become the brand name that collects all the flak.
Nobody writes about the 4,500 successful hip replacements each year or the hundreds of thousands of ambulance call-outs that arrive on time. But if an operation goes wrong or one ambulance is tragically late, it will be splashed across the media and the HSE blamed.
Collectively, these stories make you think the health service is staffed by a bunch of murderous incompetents – a perception that could not be further from the truth.
It’s also unfair to depict it as full of heartless bureaucrats who can’t wait to take medical cards off sick children. The system that’s there for awarding cards is far from draconian. Nearly two million cards have been awarded, covering half of our population.
New income limits were introduced this year for the over-70s. But at €45,000 a year per couple, they aren’t particularly unreasonable. Without children or a mortgage, a couple on that income level could afford a decent health insurance package. Even if you don’t qualify for a card, there are other supports:
The drugs payment scheme ensures no family has to pay out more than €144 a month for medicine.
The GP visit card pays for trips to the doctor (with a less onerous means test than the medical card).
The long-term illness scheme pays for medicines and appliances regardless of your income for certain specified conditions.
There are many other checks and balances in the system to help the less well off (see hse.ie for details).
Of course, the HSE is far from perfect. It has made plenty of mistakes during the medical card fiasco.
But the mess was largely a political one.
The review was caused by a Government desperate to save money – then rescinded by a Government desperate to save its political hide.