Medical cards could badly burn Coalition
The term is used to describe an issue that is as charged as a high-voltage power cable — touch it and get singed.
There were plenty of warnings for this Government, from the experience of its predecessors that medical cards fall into this politically untouchable category.
Removing the automatic entitlements for over-70s provoked a response that almost toppled the Cowen government in 2008.
This Government’s chosen process for removing medical cards was far less sudden — but so too was the public backlash which crept up, unannounced, to slowly burn the coalition parties.
Now, Health Minister James Reilly and junior minister and Labour leader hopeful Alex White have two weeks to come back to cabinet with a solution.
Their options are limited and their task is complicated. The Government is promising those who lost their cards since the latest ‘probity’ exercise got under way will have them restored.
This amounts to about 10,000 people — around 3,000 who had them removed on review and 7,000 who lost them because they did not properly complete the review process.
Of the 3,000, not all will get them back and the Government may come in for further criticism if cases emerge of seriously sick people being left without.
Some ministers have claimed the other 7,000 did not “bother” filling out the HSE forms, but health practitioners say they may not have the capacity to do so due to dementia, intellectual disability or being too sick.
A significant question for the coalition will be whether those who lost their cards last year — before the ‘probity’ process was announced including 8-year-old Ronan Woodhouse and others covered by this newspaper — will have their cards restored.
Finance Minister Michael Noonan told the Dáil yesterday legislation might be necessary to restore cards to those who lost them “in the recent review” but there is no clarity on what happened to those affected in previous reviews.
Plans to list a range of conditions that would entitle people to a medical card could also cause headaches for Government, when certain groups inevitably feel aggrieved if left out.
Furthermore, the Department of Health might meet similar legal obstacles to those that got in the way of plans to provide free GP care for those with long- term illnesses.
If all of these issues can be ironed out, the Cabinet still has to find the money to pay for an expanded system. Some €113m of savings were envisaged through the ‘probity’ exercise in last October’s budget — a figure later pared down to €23m when Mr Reilly told colleagues it was unachievable.
Straight after the initial figure was announced, Mr Reilly immediately distanced himself from it.
He told the Oireachtas Health Committed days later the figure was based on Expenditure Minister Brendan Howlin’s “deliberations” of a PwC consultancy report that said between €60m to €200m could be achieved through identifying waste from ineligible cards.
“That report is from 18 months ago and obviously a lot of action has been taken since then,” said Mr Reilly at the time. “I am — frankly speaking — concerned about what can be achieved here,” he said.
It is understandable that he is now so annoyed that his job is on the line over a political crisis which he forewarned about only to be ignored by the Cabinet.
With this crisis far from over, it is clear the Coalition has been more than just singed by its approach to medical cards. The chances of it finding a way out of the danger zone are far from certain.
