Medical cards

THE GOVERNMENT’S loss of nerve and authority can be traced to last October’s Budget when it was forced to back track on a number…

THE GOVERNMENT’S loss of nerve and authority can be traced to last October’s Budget when it was forced to back track on a number of measures designed to repair a growing hole in the public finances. Chief among its political miscalculations was the decision to withdraw a universal medical card entitlement from the over-70s. By the time the protests subsided, qualifying income limits had been raised twice. And the number of people likely to be affected had been reduced to 20,000. The new arrangements take effect this month.

The impact of those concessions can be traced through opinion polls. People over 65 years of age are now more supportive of the Government than any other age group. That may not mean much, given the unprecedented unpopularity of the Coalition. But it does suggest the fire has gone out of the controversy. An income limit of €700 a week – double that for a couple – will provide automatic qualification for an over-70s medical card. The qualifying income for other people is €100 a week lower. In addition, in cases of hardship or where there are large medical expenses, discretionary cards can be awarded.

Taking away a benefit is always difficult. If the Government calculated that the elderly and the low-paid were soft targets it was wrong. Failing to communicate the severity of the economic downturn in advance was its greatest mistake. In this case, up to 140,000 elderly people, who would not otherwise have qualified for medical cards, were being threatened. And public opinion was on their side. The idea of universal medical entitlements was attractive in a society with a dysfunctional, two-tier health system.

In recent weeks, the Health Service Executive (HSE) has written to those who were granted automatic medical cards on reaching the age of 70 and inquired whether they exceeded the new income limit. Last October, Ministers suggested this disclosure of incomes would be largely voluntary and that, in any event, older people were “honest”. It represented typical sleeveen politics. But, a cash-strapped HSE is now talking about running “spot checks”. There has been far too much casual abuse of tax measures and social entitlements. People have sent their money off-shore, evaded tax and claimed undeserved benefits. With rising unemployment and a growing demand for services, the HSE should recognise hardship cases and apply income limits across the board.