May 2013        

Medical cards under savage attack


The latest “austerity” measure is the attempt to remove medical cards from citizens. And money saved from robbing the ordinary person will be used to pay for the life-style of the local bourgeoisie, and pay their odious debt to their Troika masters.
     The latest figures show that there are 1.8 million people covered by medical cards and another 130,301 by GP-visit cards. Medical cards are now to be removed from 40,000 people, and more drugs are to be removed from the medical-card scheme.
     According to the government, cuts totalling €721 million are being made to the budget of the health service this year to meet the financial limits imposed on them by the Troika. At the same time, demographic pressures and the growing demand for medical cards and drugs will push existing costs up by €748 million.
     The HSE says medical cards account for €100 million of this year’s budget excess. The HSE overspent by almost €400 million last year. A spokesperson, Tony O’Brien, says he expects the service to keep within its spending targets in 2013.
     The new curbs will mean that some holders of medical cards may no longer qualify for a full medical card; and it will be more difficult for others to get the benefit.
     These moves come as thousands of people are to be affected by a tightening up of eligibility for medical cards, beginning this month, which excludes them from claiming for certain outgoings. For instance, funds for hospitals are being increased by 3½ per cent to ease their financial pressures, but this means the brunt of cuts being directed to medical-card schemes and services for the disabled and older people.
     With €721 million to be cut from the Department of Health this year, the medical and GP-only card scheme is now in line for cuts.
     At first there were moves against pensioners over the age of seventy. Now all medical card holders find that they are liable for review, with the slightest error in their extended application forms being used to cancel their cards.
     With the new landlord class feeling the pinch of the cut-backs, they queue up for services that used to be the preserve of the poor and working poor. Half the population have medical cards as the unemployed and other victims of austerity continue to swell the ranks of the working poor. The cards will help compensate those who find the cost of private schemes, such as the VHI and Aviva, prohibitive.
     By creating spare capacity among medical card holders it will be easier for the maintenance of the new elite, who will more easily maintain their economic dominance by screwing the poor.
     All these planned changes are estimated to save the taxpayer €60 million. Some politicians have warned of a “secret clampdown” on “discretionary” medical cards, traditionally given to those with cancer or other serious illnesses. “There are huge numbers who are not getting cards but need them.”

20,000 pensioners to lose medical cards

The HSE plans to meet its target through extra scrutiny of medical-card entitlements and by cutting back on the cover for high-tech drugs. The additional measures will bring the total reduction in this area to €323 million next year and leave a budget of €2½ billion.
     However, the HSE’s plan for 2013 says there are risks associated with its strategy, because its actual expenditure will be based on the number of medical cards available and the amount of drugs prescribed.
      An additional 125,000 medical cards have been issued this year, bringing the total number to 1.8 million. Each card is estimated to cost the state an average of about €1,000 a year.
     The Government’s decision to consider “reforming” the eligibility criteria is revealed in a draft of the latest review of Ireland by the European Commission under the bail-out scheme. It outlines how the Government has struggled to contain the overspending on the health service this year and has resorted to a number of one-off measures that “may need to be replaced with permanent structural measures” in the budget.

EU report reveals Government policy

A draft report by the European Commission circulated to TDs revealed that the Government had agreed to consider “reforming” eligibility for medical cards in the forthcoming budget. This means that the entitlements of existing card-holders will be assessed.
     “The Troika raised the issue with regard to the costs associated with medical cards and the PCRS [Primary Care Reimbursement Service] area within Ireland,” a spokesperson said. This means there’s going to be a full review of these schemes, their cost-effectiveness, and their equity. “In the first instance, what has to happen is a review of the medical card scheme, which has to involve the medical card and GP-only card.”
     With the pressure to cut costs, the HSE has confirmed that even medical card holders may find their free entitlements cancelled, despite having cards. An official stung by criticism (and who is opposed to many of the new measures) said: “In view of the long delays being experienced by people around the country in having their medical card renewals being processed, I felt it was very unfair for people on low incomes having to pay to see their doctor or to pay for medication that they are dependent on.” The HSE said that eligibility for free health services under the medical card scheme was based on financial circumstances.
     At a recent hearing of the Dáil Public Accounts Committee, examples were given of people waiting nine months for a medical card, when three weeks was the supposed time limit. There were also first-time and renewal applicants whose details repeatedly went missing.
     These cut-backs in the service, coupled with increased charges and privatisation, are the result of a situation where we have a very speculative, parasitic ruling clique, wedded to the needs and interests of international capital. Politically they are now typified by Blueshirt scoundrels like Enda Kenny and James O’Reilly.
     Locally we are still in the days of Fine Gael influence in health, education, and social services, while the Labour Party, under pressure, occasionally genuflects in the direction of Connolly.
     The Government, the EU and the IMF have all identified repayment of the debt as the most important priority. To achieve this they tell us we need to do a number of things:
(1) cut government spending;
(2) reduce the role of the state in the economy;
(3) further deregulate the economy;
(4) privatise state-sponsored companies—that is, hand them over to foreign capital, which sees its task as taking back what it was once forced to concede to health, education, and trade union rights.

Unceasing attacks

Despite resistance from the unemployed and the working poor, the attacks by the rich are unceasing. The next rounds are believed to be water taxes. A new broadcasting charge, costing in the region of €180 per annum—even if you have no television!—is being proposed. It is the old “drip” medicine: the addition of small quantities of pain until qualitative change is reached.
     The rich and their hangers-on see the attack on the poor as essential to their survival. I have heard budding fascists complaining about communists owning houses; for them, the side of the road in a tent is more than adequate. To have a “free” medical card (said with venom) is unthinkable.
     For us the immediate struggle is against “austerity,” to oppose and repudiate the odious debt and to resist privatisation—the robbery of the people’s wealth.
     It is up to communists and their allies to defy the colonial collaborators and their Troika masters in the fight for real control of our economy and politics in the people’s interests.
[MA]

Home page  >  Publications  >  Socialist Voice  >  May 2013  >  Medical cards under savage attack
Baile  >  Foilseacháin  >  Socialist Voice  >  Bealtaine 2013  >  Medical cards under savage attack