THE IDEA of imposing prescription charges on medical card holders was widely supported at yesterday’s Fianna Fáil parliamentary party meeting, which was addressed by Minister for Health Mary Harney.
Wexford TD Seán Connick said he supported the option outlined by Ms Harney on Sunday that “something like 50 cent” could be applied to each item prescribed.
He said he told the gathering of TDs and Senators such a charge would be “win-win” in two ways, as it would discourage the over-prescribing of medication as well as raising money.
“If the Minister for Finance came into me and said: ‘Here are the options: I’m going to put a fee on prescriptions or cut the pensions, which would you go for?’ I’d say prescriptions.”
However, the chairman of the parliamentary party John Browne, who also represents Wexford, told the meeting he would be against imposing prescription charges on medical card holders.
Mr Browne is understood to have told the meeting he was concerned that while a 50 cent charge was small, that might increase in subsequent years, and he was worried about the impact on people who did not have much money.
Observers said Ms Harney made clear that no final decision had been taken.
Concerns about the size of the health service wage bill were expressed by other members of the parliamentary party, including Senator Larry Butler. He said he told the meeting frontline services should not be cut in any circumstances.
There was also a discussion on introducing a system of “reference pricing” to increase the use of generic drugs by setting a price for common medicines beyond which additional costs would have to be met by patients.
The meeting, which ran from 11.30am until shortly after 1.15pm, was also addressed by three Ministers of State at the Department of Health. John Moloney spoke about his areas of responsibility, which are mental health, equality and disability, Áine Brady spoke about issues affecting older people and Barry Andrews about children.
Forty members of the parliamentary party are understood to have attended.
The recent McCarthy report had suggested charging medical card holders a €5 flat fee for prescriptions to achieve €70 million in savings. If Ms Harney’s plan to impose a lower fee on each item prescribed is implemented, the savings would be substantially less.
Drug prescription charges: what they pay elsewhere
UK
Just 11 per cent of people in the United Kingdom pay drug prescription charges under National Health Service rules due to a host of exemptions that are based on age, medical condition and income.
People do not pay if they are under 16, or up to 18 if they are in full-time education, or if they are aged 60 or more; or if they are pregnant, or coping with cancer or other diseases or if they are a military veteran. Equally, charges are not imposed on those receiving unemployment benefits, or income support, if their wages are below £15,000 or so. MARK HENNESSY
ITALY
Essentially, there is no prescription charge in Italy. The extensive national health service (Servizio Sanitario Nazionale) not only provides registered patients with free prescriptions, it also provides for a whole range of free drugs.
Basically, the state decrees fundamental levels of care, covering a wide variety of treatment (and drugs), which must be guaranteed for free for all those registered with the state health system. PADDY AGNEW
FRANCE
In January 2008, the French government introduced a 50 cent charge for every box or packet of a prescription drug.
The charge is not universally applied, however, with exemptions for those aged 18 years or younger, pregnant women, irregular and destitute migrants and low-income families registered for the couverture maladie universelle, a type of health insurance given to more than 5 million people who do not have any other form of mandatory cover. RUADHÁN Mac CORMAIC
GERMANY
Some 90 per cent of Germans are in the public health system, paying their insurer 14.9 per cent of their monthly income (joint employer- employee contribution).
That entitles them to buy subsidised medication for a minimum of €5 and a maximum of €10. Insurers refund pharmacies the difference between co-payment and end price. Excluded from co-payments are all medications for children under 18.
Co-payments cease for anyone who has made payments more than 2 per cent of their gross income; the chronically ill cease co-payments after reaching 1 per cent of gross income. DEREK SCALLY