SaraBurke.com

The means test just got meaner

Posted in Uncategorized by saraburke on March 17, 2013

The HSE Service Plan for 2013 details how 40,000 people who currently have medical cards will lose them in the year ahead. Column from Medical Independent, 14 February 2013

Of these, 20,000 are expected to be over 70 years of age, as Budget 2013 reduced the threshold for eligibility from €700 a week to €600 a week for that specific age group. The other 20,000 who will lose them are under 70, who currently have to earn less than €186 a week to qualify, as well as meeting many other requirements.The HSE Service Plan tells us how 40,000 people will lose their medical cards in 2013, but what about the thousands of others who would have qualified in 2012 and won’t this year? Medical Independent column from 14 February 2014. The HSE Service Plan for 2013 details how 40,000 people who currently have medical cards will lose them in the year ahead. Medical Independent column from 14 February 2013. 

Of these, 20,000 are expected to be over 70 years of age, as Budget 2013 reduced the threshold for eligibility from €700 a week to €600 a week for that specific age group. The other 20,000 who will lose them are under 70, who currently have to earn less than €186 a week to qualify, as well as meeting many other requirements.The HSE Service Plan tells us how 40,000 people will lose their medical cards in 2013, but what about the thousands of others who would have qualified in 2012 and won’t this year? Medical Independent column from 14 February 2014. 

 

The HSE Service Plan for 2013 details how 40,000 people who currently have medical cards will lose them in the year ahead. Of these, 20,000 are expected to be over 70 years of age, as Budget 2013 reduced the threshold for eligibility from €700 a week to €600 a week for that specific age group. The other 20,000 who will lose them are under 70, who currently have to earn less than €186 a week to qualify, as well as meeting many other requirements.

There was no mention about having an even playing field between over and under 70-year-olds – a clear hangover from the terror that older people ensued on politicians when Mary Harney announced the withdrawal of medical cards from richer over 70-year-olds in October 2008. Marches on Dáil Eireann and protests in churches resulted in a series of u-turns which meant most over 70-year-olds kept their cards because you could earn up to a threshold of €700 a week. Also many older people who had higher incomes did not return their cards and have held on to them so as to gain free access to GPs and avail of prescription drugs at a minimal fee. The over 70-year-olds who will lose their full medical card, will get it replaced by a GP only card, so they will still have free access to GPs, but will now have to pay up to €144 a month for drugs.

For the under 70-year-olds, it’s not so clear what will happen. There was no mention of this in the Budget 2013 speech or in the Department of Health press release on same. However, queries to the Department of Health and responses to questions at the launch of the 2013 HSE Service Plan tell us a bit more.

The official response said “it is intended to tighten the rules relating to a person’s spending that is taken into account when carrying out the means test for medical card. These expenditures include home improvement loans, second home loans, a weekly allowance of €50 towards car depreciation and an 18 cent per kilometre travel to work allowance. It is also intended to include certain forms of income that are currently disregarded in the assessment process.”

Figure that out! Basically, they plan to make it harder to get medical cards. While this will hit hard on any of the 40,000 people who will lose it, it will hit even harder on those who are unable to get access to medical cards in 2013 despite their need and low income.

Anyone who has ever applied for a medical card or assisted someone to do so knows that vast amounts of personal and financial information are required, that cards are not given out easily or quickly. And yes we have higher amounts of people with medical cards than ever before.

As of 1 October 2012 (the most up-to-date figure at the time of writing) 1,838,603 were covered by medical cards. This is up by 144,540 from January 2012 when 1,694,063 people were covered. The increased growth is a direct result of the economic crisis as more people are unemployed and on low income and therefore eligible for medical cards.

We know from research carried out by the ESRI that medical cards are a progressive pro-poor measure which provides an essential safety net of access to GP care and medicines at a very low cost.

What the HSE 2013 Service Plan gently reveals is that there will be a net increase of just 60,000 medical cards in 2013. If the same amount of people need medical cards in 2013 as needed them in 2012, then 132,000 who would have got them in 2012 will not get them in 2013. This is a blatant example of rationing based on economic constraints. The latest troika report focussed on high consultant pay and over-paying for drugs, but it also mentioned the need to “tackle the unsustainable growth in medical cards”.

If the same amount of people need medical cards in 2013 as needed them in 2012, then 132,000 who would have got them in 2012 will not get them in 2013

There has been no public or political debate about the planned rationing of medical cards. In order to restrict eligibility, which is the plan, legislation is required. So as with all legislation going through the Department of Health, nothing will happen quickly. But as the legislation is being drafted and going through Dáil Eireann there is an opportunity to debate how a limited health budget should be rationed and whether 130,000 plus people on low income should be part of the austerity prey in 2013.

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