Possibly solution to the over 70s Medical Card mess

I’m talking out of turn here, but if anyone is interested in a practical solution to the over 70s medical card fiasco, there’s my tuppence worth.

I might be asking a rather obvious question here but if the GPs charge the state €640 (the figure itself isn’t really relevant at the moment) for giving people over 70 a level of card consistent with a medical card then shouldn’t it be possible to set a number of bands of support and tailor the subvention from the state towards that 640 annualised figure that would relate to your income (we could look to factor in assets too but that would be really messy to administrate).

So let everyone under 17K (or whatever the annualised figure for the minimum wage is) per annum get 100% of that GP yearly charge paid by the state,
those between 17K and the average industry wage gets 75% of the figure paid by the state and pays 25% themselves (which at 100 odd quid for as many visits as you like isn’t very bad value.)
Those at the 130% of the average industry wage pay 50%
those at 150% of the AIW pay 75% and
those on pensions over twice the AIW can pay the full whack or pay per visit.

I wonder if anyone will take the idea up, I’ve also no idea how much it would save. But this is the sort of pragmatic idea that our politics lacks. I believe that the government has acted in bad faith by removing the cover, but it also acted badly by providing the cover in such a profligate manner by giving the cover to all and sundry irrespective of income or wealth. I’ve long believed that the all or nothing status of the medical card is just plain wrong.

Perhaps someone from the department of finance might look to run the numbers…

This entry was posted in brian cowen, brian lenihan, Fianna Fail, mary harney, medical cards, over 70s. Bookmark the permalink.

1 Response to Possibly solution to the over 70s Medical Card mess

  1. Mark Dowling says:

    Dan – here's how I'd do it.

    Terminate the VHI as a private insurer. Create "VHI" accounts for all State residents which cover all emergency treatment, all medically necessary treatment and an annual medical, dental and opthamological checkup. Nobody would ever pay an A&E fee or doctor visit fee unless they were not a resident of Ireland – obtaining a "VHI Card" would entail proving residence not merely citizenship.

    With VHI out of the market and necessary medical care covered in totality, leave the private insurers to provide cover for medical/dental/opthamological services which are of a "premium" nature (orthodontics, private rooms, etc) but dump community rating and dump tax-deductibility of both insurance premiums and medical expenses (which would be covered by "VHI" card anyway).

    The cost of it beyond the savings on existing tax credits and the administration thereof could be absorbed by changing the PAYE and PRSI bands and ceilings to meet the required income. There should also be a cost reduction on acute care based on people not choosing to defer treatment on cost grounds.

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