Government U-Turn on Medical Card 95% to keep them

Villain

Ok I know there is a shed load of threads relating in some way to this topic but since there has been so many changes I thought a new one might be needed, if not mods, please merge.

Ok so the Government have a press conference at 9:45am but RTE are reporting that 95% of over 70's will keep their medical card and they won't mean's test it but will require people to declare if they are above the new thresholds, as it wouldn't make financial sense to means test if only 5% will be saved as the cost of administration for that would surely outway the savings.

The question is will this be enough to calm the elderly?

jhegarty

The first question I have is , if there is 100m to be saved from the doctors why the hell wasn't it done days, months or years ago ?

luckat

If 95%, wny not 100%? This is nonsense.

mike65

and the volte face is complete (well 95% of it).

"Economies in drug useage" ie switch to more generics, the failure to use same has been a gravy train scandal for years.

Mike

luckat

Ohhh, this hasn't gone away yet, believe me.

Economies in drugs use - a friend of mine is on holidays in France. His anti-inflammatories cost him €70 on prescription in Ireland. He ran out and bought a *slightly* weaker version of the same thing over the counter (no prescription) in France, and it cost him - €7 - a tenth of the price!

Why are Irish people, and the Irish Government, paying such prices? Is this another palsy walsy?

ateam

The Green Party are I think trying to claim that they are responsible for this change. They were standing up last week applauding the budget.

Stephen

I'm sure the pharma industry has nice big brown envelopes that kept the health service using those nice expensive brand-name drugs instead of generics for years.

mike65

Any listening to RTE? Deary me, basicly if you have a gross income of more than 700 euro and you want to keep your card then just lie.

Mike

billy the squid

The budget still has a fair number of landmines in it still, the 1 percent levy, the increase in class sizes, and this €10 travel tax which discriminates against Cork Shannon and Knock airports.

All the while the vintners get off without excise on beer, the bush drinkers don't have to pay extra for their cider, and the private jet owners get off without paying the €10 tax per seat on their aircrafts.

Villain

Well it does sound like a joke, but it wouldn't make sense to means test it, the cost of administrating it would be crazy.

This is basically the Government's way of saying it's not backing down by not giving it unilaterally but yet giving it to everyone.

gurramok

Now they've gone to the other extreme taking in people who can well afford to pay their own medical care.
Every worker on less than €36kpa now has a case for a medical card!

is_that_so

GUBU of the highest order but really no surprise at all. It does not bode well for the rest of the budget, never mind the rest of the term.

Providing the "grumpy old men and women" and their families can be made to "go away", they then have to face down the teachers, which will prove just as tough to get round and the unions on the income levy. That is probably the easiest one to row back on. All told it is starting to look as if the Dept of Finance mandarins rode roughshod over the hapless Minister and just gave him numbers to cut.

The net effect of this is the disproportionate power the Greens now wield. We're almost back into that PD tail-wagging trick.
Judging from how they have approached it all to date, in that schizophrenic ways of theirs, FF will need to build half a dozen nuclear power stations for them to let go.

If they do go I'd imagine FF will allow them to be blamed for the collapse of Govt but can't see it happening for a while yet. I reckon this Govt will last into the New Year. After that who knows where we'll be. PP currently has an election in 2009 at 8/1.

mike65

Worth bearing in mind the near certainty of a mini budget in the Spring.

This cock-up may result in a stern half-time team talk but its a question of who will be throwing tea-cups - Biffo or his ministers. Government can make bad decisions are survive only if everyone stays onside, this lot have the whiff of panic rising from every pore.

Still the Greens are bought and paid for as are the rest of the independents I think.

Primary education next.

Mike

ateam

If there is a mini budget next spring, I'd expect the higher rate of income tax to increase.

CtrlSource

Now if the Opposition can't make a good go of this, there's something wrong with them!

So Brian announces a tough budget, to set the country on the right track to weather the global economic storms. And a week later the other Brian does a massive u-turn on an unpopular cost-saving measure. And there's probably going to be another u-turn on the income 'levy' before the day is out.

Did someone say 'credibility'?

Hellrazer

CtrlSource wrote: »

a week later the other Brian does a massive u-turn on an unpopular cost-saving measure. And there's probably going to be another u-turn on the income 'levy' before the day is out.

And another U-turn on the education cuts,maybe the mortgage relief cuts and the 200 euro car parking levy.

DublinWriter

mike65 wrote: »

"Economies in drug useage" ie switch to more generics, the failure to use same has been a gravy train scandal for years.
Mike

Exactly Mike. I heard Noonan this morning saying they could save €140m by switching to generics.

Other passengers of the medical gravy train include members of the IMO and IPU.

DublinWriter

Something about the numbers on this isn't right.

One of the estimates I heard was that there are around 140,000 medical card holders who are over 70.

Soooo....that means they are counting on saving €100m by removing 7,000 OAPs from this scheme?!?

Firstly, I think they've picked the figure of 95% out of the air. I think a greater number of OAPs will be affected.

20goto10

I think people should be means tested to see if they voted for FF over the past 10 years. If so you should have to pay an extra 8% income tax for being a gob ****e. You also lose the right to complain on anything related to politics or the economy.

Can I ask those who are outraged, why does being old make you special? People who live a rock and roll lifestyle and rely on the state in their old age get special treatment over those who work hard and save for their retirement? Thats what I'm outraged about.

bk

DublinWriter wrote: »

Something about the numbers on this isn't right.

One of the estimates I heard was that there are around 140,000 medical card holders who are over 70.

Soooo....that means they are counting on saving €100m by removing 7,000 OAPs from this scheme?!?

Firstly, I think they've picked the figure of 95% out of the air. I think a greater number of OAPs will be affected.

No, now it looks like that they are putting the GP's under pressure to reduce the contract that they got, that gave them 4 times the money for seeing patients on the medical card over 70.

If the government can force the GP's to charge the same as under 70 medical card holders or perhaps just 2 times the norm, then the government can probably make the same €100 million saving there. And rightfully so, the GP's were just hoping on the gravy train.

bk

20goto10 wrote: »

Can I ask those who are outraged, why does being old make you special? People who live a rock and roll lifestyle and rely on the state in their old age get special treatment over those who work hard and save for their retirement? Thats what I'm outraged about.

Because the elderly vote far more then the young and there tends to be a higher proportion of FF supporters amongst the elderly. So they get special attention.

Ludo

20goto10 wrote: »

Can I ask those who are outraged, why does being old make you special? People who live a rock and roll lifestyle and rely on the state in their old age get special treatment over those who work hard and save for their retirement? Thats what I'm outraged about.

Rock and roll lifestyle???? What are you talking about? The outrage is someone who worked very hard all his life on a very small salary with huge taxes while raising a family, becoming old and having to survive on a state pension and then being told (in a very stupid and unclear way) that because he gets a 15 euro pension on top of the state salary that he is no longer entitled to a medical card.
The outrage is not about the people who are loaded getting shafted, it is about the rediculously low bar they announced originally for the means test which cut out practically everyone.

Phototoxin

Because the elderly vote far more then the young and there tends to be a higher proportion of FF supporters amongst the elderly. So they get special attention.

QFT.

Next election no one should vote fianna fail, but of course we have few floating voters... most people are 'raised' in a certain mindset about parties. In addition all the young people should band togetehr and just vote for independants or something to fcuk up the government

Alternatively we look at history, arm ourselves and kick the feckers out of the dail!

is_that_so

20goto10 wrote: »

I think people should be means tested to see if they voted for FF over the past 10 years. If so you should have to pay an extra 8% income tax for being a gob ****e. You also lose the right to complain on anything related to politics or the economy.

Can I ask those who are outraged, why does being old make you special? People who live a rock and roll lifestyle and rely on the state in their old age get special treatment over those who work hard and save for their retirement? Thats what I'm outraged about.

The whole thing has been handled very badly. As a collective group they were targeted, which is where all of this started. As collective group they are one of the most vulnerable. That is not to say there are not some within that group who can comfortably take care of themselves.

Had the Govt had the wit to firstly think it out and then explain it we'd have no need for discussion. In fact had they not gone for the vote buying proposal in the first place we'd be bitching about education cuts.

Even in your "hardworking, hard saving group" many of those could have ended up subject to means testing under the original proposals. Furthermore some of those who are over 70 would have cancelled their VHI on the basis of a free card and now would find it very difficult to get insurance cover. And all for a rumoured €100 million.

Macha

Joe Behan has just ruled out rejoining FF even after the u-turn but maybe I'll wait a few more weeks to see what he does when the cameras have been turned to another story.

The_Minister

Phototoxin wrote: »

Next election no one should vote fianna fail, but of course we have few floating voters...

You do realise that the doctor who negotiated the incredibly high medical card payments is the Fine Gael spokesman for Health?

Boggle

You do realise that the doctor who negotiated the incredibly high medical card payments is the Fine Gael spokesman for Health?

I take it that he was acting on behalf of the GP's so then he did an exceedingly good job. I take it you were getting at how much better FG are than FF/PD at negotiating??:D

nesf

luckat wrote: »

Economies in drugs use - a friend of mine is on holidays in France. His anti-inflammatories cost him €70 on prescription in Ireland. He ran out and bought a *slightly* weaker version of the same thing over the counter (no prescription) in France, and it cost him - €7 - a tenth of the price!

Why are Irish people, and the Irish Government, paying such prices? Is this another palsy walsy?

Eh, shouldn't he be blaming his doctor not the Government for prescribing him brand name drugs? I know with my GP she always inquires about whether my DPS is already maxed for the month or not (in my case it is because of a long term illness that doesn't get covered by the long term illness scheme for free drugs ). If I didn't have my DPS maxed she'd try her best to give me a generic alternative if possible, since I've my DPS maxed already she just prescribes the best drug and doesn't worry about whether it's brand name or not.

John_C

nesf wrote: »

If I didn't have my DPS maxed she'd try her best to give me a generic alternative if possible, since I've my DPS maxed already she just prescribes the best drug and doesn't worry about whether it's brand name or not.

I have no medical training so feel free to tell me if I'm just wrong but my understanding was that generic drugs were identical to the other ones. Is this not the case?

Ponster

luckat wrote: »

Ohhh, this hasn't gone away yet, believe me.

Economies in drugs use - a friend of mine is on holidays in France. His anti-inflammatories cost him €70 on prescription in Ireland. He ran out and bought a *slightly* weaker version of the same thing over the counter (no prescription) in France, and it cost him - €7 - a tenth of the price!

Why are Irish people, and the Irish Government, paying such prices? Is this another palsy walsy?

Maybe because in France I lose 20% of my wages in PRSI/health tax before I pay 20% in taxes of what's left of my salary.

The_Minister

Boggle wrote: »

I take it that he was acting on behalf of the GP's so then he did an exceedingly good job. I take it you were getting at how much better FG are than FF/PD at negotiating??:D

That was Michael Martin's fault. He announced the scheme before negotiating it, which meant that the IMO had him over a barrell (best saying ever:D). A cock-eyed rooster could have gotten a great deal.

EDIT: http://www.independent.ie/national-news/fgs-reilly-defends-imo-fee-deal-on-medical-cards-1502867.html
He spoke on this already.

It just annoys me that the man who fought for the over-priced medical card, and who did his best to scupper the renegotiation of the consultants contract (progress was only made after the election when he had quit) is considered by some to have the best interests of the health service at heart.

djpbarry

John_C wrote: »

I have no medical training so feel free to tell me if I'm just wrong but my understanding was that generic drugs were identical to the other ones. Is this not the case?

It wouldn't be entirely accurate to say they are identical, but they should have more-or-less the same effect. Essentially, you're paying for the brand name.

Think of it like this; if you need paracetamol, there's a whole range of products you can buy at different prices. But at the end of the day, paracetamol is paracetamol (or acetaminophen if you're a yank!).

John_C

djpbarry wrote: »

It wouldn't be entirely accurate to say they are identical, but they should have more-or-less the same effect. Essentially, you're paying for the brand name.

Think of it like this; if you need paracetamol, there's a whole range of products you can buy at different prices. But at the end of the day, paracetamol is paracetamol (or acetaminophen if you're a yank!).

Sorry but I'm still confused about this. If paracetamol is paracetamol, how are the generic drugs not exactly the same? Is the difference psychological with patients trusting the brand name product more?

ceegee

John_C wrote: »

Sorry but I'm still confused about this. If paracetamol is paracetamol, how are the generic drugs not exactly the same? Is the difference psychological with patients trusting the brand name product more?

The drug itself is the same, its what else is included in the preparation that can sometimes affect, for example, how quickly its absorbed.
Different brands can be absorbed at different rates, affecting the blood concentration of the drug.

Its not really an issue with most drugs but can be with some.

John_C

ceegee wrote: »

The drug itself is the same, its what else is included in the preparation that can sometimes affect, for example, how quickly its absorbed.
Different brands can be absorbed at different rates, affecting the blood concentration of the drug.

Its not really an issue with most drugs but can be with some.

OK thanks,
I think my worry is that the government might be saving money by giving out worse drugs. I presume though that the doctor will still have the final say.

The_Minister

John_C wrote: »

OK thanks,
I think my worry is that the government might be saving money by giving out worse drugs. I presume though that the doctor will still have the final say.

The problem is that the average doctor gets several grand worth of freebies from big drug companies per year. We cracked down on it a little, but they still get free golf game+meal+freebies for c€50.

That is a huge influence on what drugs doctors choose.

Mr.Micro

What a real successful first budget Lenihan introduced, not. So the incompetent Government got its sums and PR all wrong. A massive U turn on the medical cards debacle and now dropping the 1% levy on minimum wage workers. What a sham. We are dependent on these clowns to get the country straightened out. So will there be another budget as this one is all wrong? Pity for poor FF as its image of party of the people has taken a massive battering.

nesf

John_C wrote: »

I have no medical training so feel free to tell me if I'm just wrong but my understanding was that generic drugs were identical to the other ones. Is this not the case?

Not all brand name drugs have a generic equivalent. Sometimes the best drug for a condition might only be brand name (because it's relatively new and is still under patent) and to prescribe a generic would be to prescribe the "second best" drug. The question then becomes a conflict between the better option and the cheaper option and there's a lot of factors that come then here and in different situations the generic or the brand name might be the better option.

In a lot of cases it is like where you describe where a generic is as good as any of the brand name stuff and your doctor should be prescribing the cheaper option of the two but some of them don't for various reasons, one of them being the amount of advertising that drug companies do with doctors. Just be glad we're not in the States where the drug companies can advertise to people on the street which is a complete joke.

nesf

Mr.Micro wrote: »

What a real successful first budget Lenihan introduced, not. So the incompetent Government got its sums and PR all wrong.

Honestly I feel a bit sorry for Lenihan (not FF in general). In the job a few months and ends up having to give the harshest budget in well over a decade. It's a pity they didn't give the job to Dick Roche or similar.

Lol

This is a farce.No political professionalism involved in the controversial budget measures at all.Did they not see this coming??!! I mean what sort of gombeens are their parliamentary party? Surely they were told of the proposals on the med card at that meeting they had prior to the budget?
What on Earth were they thinking??!!

I'm not a traditional Labour voter but by Golly they were right in their thinking that there are other ways to hit high rollers that are over 70!
Millionaires and billionaires shouldn't have medical cards mind you but ,there should be no furore if they are given them and hit for extra taxes with their medical expenses deductable.

Thats What they should have done - tax them as much as the market would bear and make their medicine bills and VHI fully allowable for tax purposes.

It's a big thumbs down from me for a lack of innovational thinking by this Government and another big thumbs down for political inexpediency.
They are morphing into a pack of buffoons!

djpbarry

Good (in that it echoes my thoughts on the subject, for the most part) article on the subject in today's Times:

Sarah Carey wrote:

Could we cast our minds back to the budget of 2000 when Charlie McCreevy pulled the automatic medical card for over-70s from his bag of pre-election tricks? Remember the loud cheers from the Fianna Fáil back benches and howls of outrage from every other quarter? The opposition was furious, and not just because McCreevy had secured the next election.

Medical cards are given to those on very low incomes; so low that politicians and doctors constantly plead with the Government to raise the threshold. It's bad enough that those on low incomes worry about doctors' fees, but chronic poverty means they are likely to suffer poor health. Their happily retired counterparts in the upper middle classes can afford to see a doctor, and thanks to a lifetime of good nutrition will need to see him less often. McCreevy's stunt meant a poor but not poor enough 69-year-old couldn't get the card while a wealthy 70-year-old could.

It was wrong then and it's wrong today.

To make matters worse, the Government negotiated the "deal" with the Irish Medical Organisation in which doctors won a payment of €640 per non-means-tested over-70 patient, while they only got €160 for a means-tested pensioner. They got more money for the patient statistically likely to be healthy. What a pity no one saw fit to resign over that rape of the public finances.

Back in 2001, James Reilly, then head of the IMO and now Fine Gael's health spokesman, criticised the move as "handing out free medical cards to people who can afford golf club fees". As late as 2005, the Labour Party said that "the Government's electoral ploy in extending medical cards to over-70s regardless of the consequences has been disastrous in cost and equality terms".

I know oppositions are supposed to oppose, but a little consistency wouldn't go astray.

http://www.irishtimes.com/newspaper/opinion/2008/1022/1224454452792.html

mr kr0nik

I have a feeling the government is looking at the long view (for once). Once you remove the automatic entitlement to the medical card, I would suggest that in 10 - 15 years time a lot more than 5 % of the current population (aged 55 and over) will not be eligible to get it.

The big thing here is to remove the automatic entitlement and then creep in the adjustments to get more and more citizens off it.

Voipjunkie

nesf wrote: »

Honestly I feel a bit sorry for Lenihan (not FF in general). In the job a few months and ends up having to give the harshest budget in well over a decade. It's a pity they didn't give the job to Dick Roche or similar.

I have a feeling that is exactly why Cowen moved him to Finance. He knew the hard decisions ahead and that it would take the shine off the heir apparent.

what has surprised me is that the former top brass in FF under Bertie have been so silent Martin,Hannifan, D. Ahern and Dempsey it seems to me that they have been happy enough to let Cowen Coughlan and Lenihan swing in the breeze for the last week pay back time for the sidelining at the last shuffle

BTW Hard to believe that pensioners are being taken in by Enda Kenny FG were against the over 70s card from the start and only changed their position when FF got rid of it.
If FG were in power they would have done the same thing

nesf

Voipjunkie wrote: »

Martin,Hannifan, D. Ahern and Dempsey it seems to me that they have been happy enough to let Cowen Coughlan and Lenihan swing in the breeze for the last week pay back time for the sidelining at the last shuffle

It certainly looks that way all right. Martin has disappeared into the relative safety of Foreign Affairs. Perhaps that was the juiciest promotion on offer..

podge79

nesf wrote: »

It certainly looks that way all right. Martin has disappeared into the relative safety of Foreign Affairs. Perhaps that was the juiciest promotion on offer..

apart from the lisbon 'blip' lol - tbh honest i'd say michael is rubbing his hands... next few months do a bit of talking with backbenchers... and just slightly off topic i'd say we now know why bertie fell down stairs... laughing too hard at cockup cowen has made

is_that_so

Voipjunkie wrote: »

I have a feeling that is exactly why Cowen moved him to Finance. He knew the hard decisions ahead and that it would take the shine off the heir apparent.

what has surprised me is that the former top brass in FF under Bertie have been so silent Martin,Hannifan, D. Ahern and Dempsey it seems to me that they have been happy enough to let Cowen Coughlan and Lenihan swing in the breeze for the last week pay back time for the sidelining at the last shuffle

BTW Hard to believe that pensioners are being taken in by Enda Kenny FG were against the over 70s card from the start and only changed their position when FF got rid of it.
If FG were in power they would have done the same thing

The problem was caused by its being introduced, which was where the real damage was done by the poor negotiating skills of Michael Martin. Once it was in, they really couldn't keep moaning about it. FG have the political nous to see where a decision like that leads and also to recognise the current Govt shambles in trying to "fix" it.

As for the disgruntled Ministers, D Ahern has his eye on an EU commissioner job and I think the "promotion" of Martin is a relief as it keeps him out of harm's way. Nobody cares what the spectacularly ineffective Dempsey thinks and Hannifin just goes to prove that the wrong Mary was promoted.

Voipjunkie

is_that_so wrote: »

The problem was caused by its being introduced, which was where the real damage was done by the poor negotiating skills of Michael Martin. Once it was in, they really couldn't keep moaning about it. FG have the political nous to see where a decision like that leads and also to recognise the current Govt shambles in trying to "fix" it.

As for the disgruntled Ministers, D Ahern has his eye on an EU commissioner job and I think the "promotion" of Martin is a relief as it keeps him out of harm's way. Nobody cares what the spectacularly ineffective Dempsey thinks and Hannifin just goes to prove that the wrong Mary was promoted.

in fairness to Martin the doctors had him over a barrel and McCreevy put him there by pulling the stunt of announcing it on Budget day with little or no costings and ignoring the warnings from Dept of Health about cost implications of announcing before consulting the IMO.

As for FG O'Reilly is quoted as saying the universal nature of the over 70s card was wrong as late as last December. It is typical cynical politics of FG Yes FF made a balls of it but FG agree with them on ending it or they did up to last Tuesday then when they see FF in trouble they jump ship all are all for universal coverage.
It just proves that there is absolutely no difference between FG and FF to hell with the countries finance if they see political advantage. If FG had gotten into Government last time FF would be saying the exact same things FG are saying now and FG would be saying exactly what FF are saying.

There is no principles in either party just the principle of opposing for the sake of it to gain political advantage

nesf

Voipjunkie wrote: »

There is no principles in either party just the principle of opposing for the sake of it to gain political advantage

You know I can't think of a single political party who aren't like that and I'm including several foreign ones here. FG would be idiots not to go with public opinion on this one. They can always rework it as opposition to "FF's plan rather than means testing in principle" or similar further down the line.

turgon

jhegarty wrote: »

The first question I have is , if there is 100m to be saved from the doctors why the hell wasn't it done days, months or years ago ?

Thats the question we should all be asking.

irish_bob

nesf wrote: »

You know I can't think of a single political party who aren't like that and I'm including several foreign ones here. FG would be idiots not to go with public opinion on this one. They can always rework it as opposition to "FF's plan rather than means testing in principle" or similar further down the line.

im not an fg supporter but fine gael and labour are the only ones who,s position on this issue i can tollerate , i appreciate the cynical nature of politics and i appreciate the oppositions complete cynicism on this issue

The_Minister

irish_bob wrote: »

im not an fg supporter but fine gael and labour are the only ones who,s position on this issue i can tollerate , i appreciate the cynical nature of politics and i appreciate the oppositions complete cynicism on this issue

Sigh
Labour in 2005 "the Government's electoral ploy in extending medical cards to over-70s regardless of the consequences has been disastrous in cost and equality terms".

Look back and you'll find loads more quotes like that.
The Opposition opposed this move viciously for years, but now they smell blood.