Thursday, 23 October 2008

Suggestion for Medical Card Means Test – And a Postscript

Now that it seems certain that we are to have means testing for medical cards for the over 70s I thought I might suggest the following (which was in a round about way inspired by this post from Grannymar) to make the experience as simple and painless as possible.  After all if we are to believe various reports, once we hit 70 we spontaneously loose all our faculties and become blubbering eejits wandering around terrified of anything that involves putting  pen to paper.

So what can we do to spare our poor helpless pensioners from the government’s latest tool of oppression, the medical card means test form, soon to be released into the wild?  There is an alternative and it is not just for the sake of the pensioners that we should be glad of it – Can our capital city withstand another attack by the Grey Panthers? The debris is still being cleared up from the storming of the Dail.  The remains of improvised weapons made from zimmer frames, false teeth and knicker elastic litter our streets.  St Andrew’s Church on Westland Row is being re-consecrated after the shocking behaviour of our senior citizens who had the audacity to use the Church for political ends! (Nobody has ever done that before – have they?)

This is the alternative: The two Brians will go on an all-Ireland tour where they will grab all our senior citizens by the ankles and turn them upside down and shake vigorously!  Using a previously prepared formula, based on the contents of the pockets of each pensioner they will determine their eligibility for THE CARD.  Any evidence of foreign travel (an unnecessary luxury), such as non-Irish Euro coins will mean instant disqualification.  Any pensioner with one cent coins will also face disqualification, as the ability to pick these up off any surface known to humanity is indicative of a dexterity and fitness most gymnasts could only dream of!  Pills will also mean no card – we certainly don’t want to give the card to druggies! Where tissues are found in a pensioners pocket a very dim view will be taken and unless evidence of a medical allergy to Lidyl’s budget 1 ply toilet roll can be produced this will usually result in refusal.  Though this process will cause temporary discomfort and a rush of blood to the head it will be less stressful than the ordeal of filling out the proposed means test form.   And like the proposed means test the ratio of 20:1 will be preserved, the only difference being that only one in twenty will qualify! Now isn’t that much better?

 PS: On a more serious note:

What the government did re the Medical Cards was monumentally clumsy and stupid!
 For a very small financial saving the government have lost all the political capital and credibility they had. However I think common sense would say that the universal medical card for 70+ should never have been introduced. It was a cynical ploy to buy an election and poor stewardship of the nations resources no matter how well off we thought we were!
 People are too angry at the moment to listen to reason and I think the Grey Panther march yesterday was about more than medical cards - I think it was more about a sector of the population who are increasingly invisible in our rapidly changing and disconnected society. However there are better ways of making them visible than giving free medical care to those who can easily afford it themselves. There is a lot of talk about rights, but our rights are of necessity affected and circumscribed by the rights of others who also deserve a piece of a shrinking economic pie. There is scandalous wastage in our welfare and health delivery systems and these need to be addressed but the reality is that if we give out free medical cards to the wealthy there will be less beds in our hospitals and less resources to help those who are really needy and marginalized.  Taken to its extreme people who need resources will die if some of these resources are given to those who don’t need them. If we all got what we deserved we might have even more to complain about!

UPDATE: Check out the excellent editorial in the Irish Times (Saturday 25th October) which puts all of this in its proper context.


Bock the Robber said...

Let me ask you something.

If they can afford universal access to healthcare in Spain, Canada and New Zealand, why can't we afford it here?

Grannymar said...

What rights do I have with my European Health Insurance Card?

Stephen Neill said...

Bock - Because we have a 2 tier system and as long as that is in place universal access is not viable!

Grannymar: The same rights as any public patient but you will still have to pay for GP visits, specialist consultations and drugs up to a certain limit as far as I understand it

Bock the Robber said...

That's right. The entire problem lies with the vested interests: GPs and consultants. What was wrong with the dispensary system we used to have? What would be wrong with putting doctors on a generous salary and having them work as employees in clinics open to everyone?

That's what they do in the countries I mentioned and it works. Everyone gets looked after equally and efficiently, but of course I forgot. This is Ireland, and an idea like that would be too sensible.

Stephen Neill said...

Spot on - All the evidence says that is the way to go. Even if it involves some handsome payoffs it would be worth it in the long term. The fiasco over the location of the proposed National Childrens' Hospital is another example of the mess that results from the politics that is intertwined through the medical system. The Medical Card fiasco was a result of the government going through the old folks to hit the GPs. Nobody seems to have the balls to challenge the vested interests!

steph said...

Hi! Stephen

Grannymar sent me over so I did what I was told ;-)

I love your alternative solution to the means test and indeed, your more serious comments on the whole fiasco.

The government made a complete mess of bringing in the automatic right to an over-70's medical card and now they've made an even bigger mess trying to take it away again. You have to wonder if the small financial saving to be made from the wealthy over-70's will actually cover the bureaucracy the HSE will create to administer the means test!

As long as Mary Hardneck remains holding the reins at the Dept of Health, we haven't a hope of getting a universal system of healthcare. It's not about patients or equity of access, it's all about handing over responsibility to vested interests.


ronwan said...

check out michael moores "sicko" I know he's a bit of a pain in the arse but...

Stephen Neill said...

Steph - welcome over to my place. I think you have hit another nail on the head there re the additional costs of administering this scheme. How many more administrators will they claim to need to do this extra paperwork? And yes Mary Harney is the real stumbling block - one would have to wonder what she has on Fianna Fail that makes them so wimpish in her presence?

Ronwan - I haven't seen it but if its like his other stuff then it has a lot of truth albeit presented in his sometimes irritating manner. I will have a look for some clips on youtube

C'est La Craic said...

Good Post. I especially like the last line. As they say, you get the government/police force/whatever, you deserve.
As regards the grey panthers and their medical cards, I fear all they have won are tickets to join the queue.

Stephen Neill said...

Yes - a hollow victory - as will become clear in the not too distant future

Póló said...

Love your means test, particularly the foreign euro coins.

Can you imagine insisting on only Irish euro coins in your change. You'd get free accommodation fairly quickly in one of our remaining asylums.

I agree with your comment on resources and we should not be subsidising the rich. However, I see this particular case as a breach of trust and that has contributed to the anger.

Hope you're backing Fr. Gilligan in this case. He sounded like a rational innkeeper in the old Dublin city centre publican tradition.

Bock the Robber said...

Why do we think of primary healthcare as subsidising the rich?

Would we take the same attitude to primary education? Would we turn a child away from school because their father was too rich?

Why not regard health and education as entitlements for all, instead of benefits?

Stephen Neill said...

Póló - thanks for your kind comments - I also enjoyed your post and am glad you made the point re Westland Row - I think he did the right thing letting people in and if the Church cannot let the voiceless be heard one must wonder what it is there for - some people on Liveline got very worked up about people being 'angry' in a church! What are they protecting God from?

Stephen Neill said...

Bock - Yes it is the only way forward but it cannot be done piecemeal. Somehow the vested interests have to be paid off so we can start again!