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Extending medical cards to children not enough - McGrath
Fine Gael Deputy spokesperson on Finance Deputy Paul McGrath said today that Government proposals to extend medical cards to children do not go nearly far enough. "We need a comprehensive approach to primary care (GP services) and Fine Gael’s proposals are the following immediate increases in current medical card income limits so as to make medical cards available to the poorest people without delay.
- Single person under 66 years old: £10,200 (up from £4870)
- Married couple under 66 years old: £16,820 (up from £7044)
- Married couple with two children: £19,720 (up from £8760)
"To extend a free GP service to the whole community would probably cost about £650m in additional spending. Given that the main pressure on the health services is at secondary care level it would seem more prudent to target certain categories of the population for free GP services and to target most resources directly at secondary care.
Accordingly, Fine Gael also proposes extending free GP services to:
- Children up to the age of 18 years, and beyond that age when they are in full-time education
- All senior citizens over the age of 65 years
- Those in the lower 60% of income groups
- With special provision for asthma sufferers and those with similar chronic disabilities
"This would cost about £300m in a full year. The upper 40% of income earners, excluding senior citizens, would continue to pay for GP services, but would also continue to be eligible to claim back annual expenditure in excess of £100 for an individual and £200 for a family against income tax as at present.
"Given the existing income level restrictions is it any wonder there is such pressure on the secondary care (hospital) system? At present 31% of the population, that is 1,158,589 people are covered by a medical card at an average cost of £291 per patient per year, a total of £337 million.
"Increasing this by 450,000 people to 1.6 million, or just over 40% (up from 31%) of the population would cost an estimated extra £130 million gross. The existing agreement between the IMO and the Department of Health allows for up to 40% population cover. The net cost would be much less because those not currently covered by the GMS can claim a refund in excess of monthly expenditure of £42 for medicines, and all medical expenses in excess of £100/£200 (individual or family) per year against income tax.
"A disproportionate number of those to whom extended cover would apply will be younger on average and therefore less likely to impose a full cost on the Exchequer. Furthermore, the gross cost to the Exchequer would be reduced as less people would present at hospitals and there would be a saving in secondary care costs.
"The reality is poor people suffer more and die younger. According to ESRI research for Irish men aged 55 to 64, higher professionals have a death rate of 13 per 1000, for semi-skilled this rose to 22 per 1000 and for unskilled manual groups 32 per 1000, i.e. the mortality rate was almost three times higher among lower income groups than better paid professional groups.
"Medical Card numbers in the Midland Health Board has dropped by almost 10,000 in the last decade," says Deputy McGrath, "and Westmeath at 33.08% has the lowest proportion of Medical Cards in this area".
"We propose the immediate introduction of the above interim measures as an increment on the way to extended and targeted GMS spending as set out in our policy document, Restoring Trust," said Deputy McGrath.
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