Use it or lose it: Your Medical Card.

Condatis · 05-05-2012 05:06PM #1

According to the Irish Times this morning Health Minister James Reilly is to review entitlement to Medical Cards which have not be used in the last five to twenty four months.

http://www.irishtimes.com/newspaper/ireland/2012/0505/1224315650608.html

So: If you decided not to bother your GP with some minor affliction and subsequently become seriously ill you may find that you have been decarded.

Will this mean that that you must visit your GP twice a year, even though you have no health issue – join a queue so that a consultation is recorded affecting the waiting time of others and putting pressure on the practice.

Otherwise, if you do become ill and your Card has been been cancelled, you would have to go through the application process afresh.

I suppose that the motive is to ensure that GP are not being paid capitation fees for people who have died or emigrated but really; this seems to be an extraordinary way to ensure that.

Reilly said that up to 119,000 people who have not used their Medical Cards recently are to be "reviewed". Fifty thousand people have already been written to THREE TIMES in this context.

That must be causing quite some trauma for elderly people who are healthy most of the time – are proud of that – but derive comfort from the knowledge that they have the Medical Card should they need it.

Dannyboy83 · 05-05-2012 05:11PM

I assume this is a reaction to the recently discovered €210 million medical card fraud
http://www.irishexaminer.com/ireland/ghost-medical-card-bill-costs-us-210m-192190.html

This is the lazy way of tackling it I guess.

Kinski · 05-05-2012 05:22PM

Will this mean that that you must visit your GP twice a year, even though you have no health issue – join a queue so that a consultation is recorded affecting the waiting time of others and putting pressure on the practice.

Sounds like more of a once-off measure to me. Anyway, the article says that GP visits which don't result in a prescription being issued wouldn't show up anyhow.

Fifty thousand people have already been written to THREE TIMES in this context.

I took that to mean they'd written to them three times without adequate reply, not that they were badgering people.

How long are medical cards issued for? Would have thought it was less than 24 months...

Dannyboy83 · 05-05-2012 05:35PM

Kinski wrote: »

I took that to mean they'd written to them three times without adequate reply, not that they were badgering people.

This is probably because:

A HSE spokesperson said the figures in the report, obtained by the Irish Medical Times, are an estimate only "and cannot be relied on for any purpose other than providing a broad understanding of the potential scale of excess expenditure".

This is because a full audit of all people who have medical cards did not take place — meaning it is not known exactly how many people still have cards despite having died, left the country or being no longer eligible.

Read more: http://www.irishexaminer.com/ireland/ghost-medical-card-bill-costs-us-210m-192190.html#ixzz1u1AEEuw7

Only in Ireland:rolleyes:

Suryavarman · 05-05-2012 07:54PM

So the people that are abusing the medical card system and going to see the doctor every time they sneeze won't lose their medical cards but the people who only go to the doctor when they genuinely need to are going to lose their medical card? And if this system is used on a continual basis people will be incentivsed to go to the doctor regularly even if they don't need to just to keep their medical card thereby putting more strain on the healthcare sector. This has to be one of the most ridiculous welfare reforms I've ever heard of in my life.

woodoo · 05-05-2012 10:18PM

From the irish times article:

'Minister for Health James Reilly last night said 50,000 people who had not used their medical cards in the last five to 24 months – having neither received a prescription nor a special consultation from their GP – had been written to three times by the HSE to check their current status.'

There will be no need to go to the Doctor every 5 months. They are only using this to identify people who have left the country or are otherwise ineligible. They will be contacted by the HSE and have their card removed if they are out of the country, RIP, etc.

Kinski · 05-05-2012 10:41PM

Suryavarman wrote: »

So the people that are abusing the medical card system and going to see the doctor every time they sneeze won't lose their medical cards but the people who only go to the doctor when they genuinely need to are going to lose their medical card? And if this system is used on a continual basis people will be incentivsed to go to the doctor regularly even if they don't need to just to keep their medical card thereby putting more strain on the healthcare sector. This has to be one of the most ridiculous welfare reforms I've ever heard of in my life.

Doctors in the GMS scheme are paid capitation each year for every eligible patient on their books (the exact level of the individual payments is based on the age and sex of the patient, and on how far they live from the GP's surgery.) Regardless of whether a medical card holder goes for two or twenty check-ups a year, the GP recieves the same annual payment (assuming the patient is fine and the doctor doesn't have to do anything else.)

Bearing all that in mind, what kind of "abuse" of this system do you think is happening? If a medical card-holder goes to the doctor regularly when there is nothing wrong with her, the HSE still pays out the same as it would have even if she never went. Other than the doctor's time (and these are private practitioners, so don't say "They're putting strain on our public health system, grrr!!!"), what has been wasted?

woodoo · 05-05-2012 11:01PM

Kinski wrote: »

Doctors in the GMS scheme are paid capitation each year for every eligible patient on their books (the exact level of the individual payments is based on the age and sex of the patient, and on how far they live from the GP's surgery.) Regardless of whether a medical card holder goes for two or twenty check-ups a year, the GP recieves the same annual payment (assuming the patient is fine and the doctor doesn't have to do anything else.)

Bearing all that in mind, what kind of "abuse" of this system do you think is happening? If a medical card-holder goes to the doctor regularly when there is nothing wrong with her, the HSE still pays out the same as it would have even if she never went. Other than the doctor's time (and these are private practitioners, so don't say "They're putting strain on our public health system, grrr!!!"), what has been wasted?

Reilly should be introducing a €5 charge per visit for Medical Card Holders and €10 per GP Visit Card holder imo.

mathepac · 05-05-2012 11:20PM

woodoo wrote: »

Reilly should be introducing a €5 charge per visit for Medical Card Holders and €10 per GP Visit Card holder imo.

I'd suspect you're not a medical-card holder so.

woodoo · 05-05-2012 11:25PM

mathepac wrote: »

I'd suspect you're not a medical-card holder so.

I have the GP Visit Card

Kinski · 05-05-2012 11:29PM

woodoo wrote: »

Reilly should be introducing a €5 charge per visit for Medical Card Holders and €10 per GP Visit Card holder imo.

Why?

K-9 · 05-05-2012 11:29PM

woodoo wrote: »

From the irish times article:

'Minister for Health James Reilly last night said 50,000 people who had not used their medical cards in the last five to 24 months – having neither received a prescription nor a special consultation from their GP – had been written to three times by the HSE to check their current status.'

There will be no need to go to the Doctor every 5 months. They are only using this to identify people who have left the country or are otherwise ineligible. They will be contacted by the HSE and have their card removed if they are out of the country, RIP, etc.

Makes more sense.

I assume if you haven't replied after 3 letters they would scrap the card.

micko123 · 05-05-2012 11:34PM

Bearing all that in mind, what kind of "abuse" of this system do you think is happening? If a medical card-holder goes to the doctor regularly when there is nothing wrong with her, the HSE still pays out the same as it would have even if she never went. Other than the doctor's time (and these are private practitioners, so don't say "They're putting strain on our public health system, grrr!!!"), what has been wasted?[/Quote]

woodoo · 05-05-2012 11:57PM

Kinski wrote: »

Why?

Its too expensive for non MC, GP Visit card holders, if they were charged they could lower the private rate to 30 or so. I know plenty of people with no card and they wouldn't go to the doc until they are in a real bad way and that is not good imo.

The government could drop the capitation fee to doctors too if they got some money of medical card holders. Also it may make people think twice about going up unless they need too. Not running up with every sniffle.

oppenheimer1 · 06-05-2012 12:18AM

Kinski wrote: »

Why?

Why... because the vast number of hypochondriacs and lonely old people are putting a great strain on the system. They wouldn't behave like that if it was costing them €5 a pop. A nominal charge would free the system of the time wasters whilst not preventing those that actually need to see the doctor from seeing him/her.

Einhard · 06-05-2012 02:30AM

oppenheimer1 wrote: »

Why... because the vast number of hypochondriacs and lonely old people are putting a great strain on the system. They wouldn't behave like that if it was costing them €5 a pop. A nominal charge would free the system of the time wasters whilst not preventing those that actually need to see the doctor from seeing him/her.

If you have a chronic condition and have to visit the doctor say, four times a month, then a fee of €240 per annum isn't exactly nominal.

mathepac · 06-05-2012 08:53AM

woodoo wrote: »

I have the GP Visit Card

I'm a new medical card holder, but I rarely visit my GP.

I had a long-term illness card, LTIC, for one condition for about 5 years but since being upgraded to a full medical card last year the medicines that were free on the LTIC now cost me 0.50 per item dispensed.

I attend regular appointments with the specialists that look after the conditions requiring medicines. They each write a prescription which I take to my GP to have the GMS prescription made up and issued which I then take to the chemist.

Are you suggesting that I now pay for these GP visits where absolutely nothing of a therapeutic nature takes place? - it is a purely clerical / administrative exercise between me and the receptionist, the GP 'merely' appends his signature to the forms we define the contents for.

I never actually see the doctor on these visits and attend him once a year for a 'flu shot.

The doc is well paid by the HSE for the service he supplies to me - I would not even countenance a token payment on top of what they already pay.

murphaph · 06-05-2012 09:05AM

Kinski wrote: »

Why?

Because the stats prove that medical card holders are much more likely (I think it was 8 times more likely) to go to their GP than non-medical card holders.

Now, whilst I believe the entire system in Ireland is a shambles and that GP access should cost less for the poor feckers with no medical card, I don't believe it should cost nothing at the point of delivery for the patient, precisely because people go to their GP for very minor ailments that a pharmacist or their own commons sense could advise them on.

Many medical card holders just go to their GP for a head cold so they can be prescribed their medication, which is then almost free, whereas if they bought a pack of Lemsip over the counter, they'd have to pay like the rest of us.

Germany has compulsory health insurance (employee pays 15.9% of income, employer pays a bit more). If you are unemployed, you get your insurance paid for you, but there is a nominal €10 per quarter fee for seeing any doctor or dentist. This was introduced precisely to curb the numbers of people clogging up the system with minor ailments. IMO they could make it €10 a month if they could reduce my insurance premium to 13% with the saving.

zef · 06-05-2012 09:08AM

I am in the same position, I have had a med card since oct '11, but have yet to visit my doctor other than for administrative stuff- my LTI med being put onto a GMS script, I just drop it in in the morning & collect from secretary in afternoon. Never met the Dr yet!
I have had plenty of 'sniffles' in the past 6 months, but personally I would not go to a dr unless it was really neccessary, not because i could and it would be free- i don't understand people like that.

murphaph · 06-05-2012 09:11AM

zef wrote: »

I am in the same position, I have had a med card since oct '11, but have yet to visit my doctor other than for administrative stuff- my LTI med being put onto a GMS script, I just drop it in in the morning & collect from secretary in afternoon. Never met the Dr yet!
I have had plenty of 'sniffles' in the past 6 months, but personally I would not go to a dr unless it was really neccessary, not because i could and it would be free- i don't understand people like that.

No charge should apply for any administrative only visits and tbh a patient with a diagnosed long term/chronic illness should be exempt. The visit fee should tackle abuse of the system by people looking for cheap prescriptions rather than paying for an OTC medication or "just getting on with it".

Kinski · 06-05-2012 10:23AM

woodoo wrote: »

Its too expensive for non MC, GP Visit card holders, if they were charged they could lower the private rate to 30 or so. I know plenty of people with no card and they wouldn't go to the doc until they are in a real bad way and that is not good imo.

The government could drop the capitation fee to doctors too if they got some money of medical card holders. Also it may make people think twice about going up unless they need too. Not running up with every sniffle.

GPs enter the scheme voluntarily. There are practices which don't accept MC holders, but which charge similar fees for a visit. I don't think that the GMS scheme is responsible for the fee doctors charge private patients.

And I still don't get the "going with every sniffle" problem. It doesn't cost the HSE any extra if someone constantly goes with minor complaints.

oppenheimer1 wrote: »

Why... because the vast number of hypochondriacs and lonely old people are putting a great strain on the system. They wouldn't behave like that if it was costing them €5 a pop. A nominal charge would free the system of the time wasters whilst not preventing those that actually need to see the doctor from seeing him/her.

I already anticipated a response like this ("putting strain on the system!!!") There is no shortage of GPs in this country. There is strain in the public system - if you need a bed in a public hospital, to see a specialist etc., then you may be waiting. But seeing a GP? That's not a problem. If any patient, medical-card holder or otherwise, is attending a clinic too often, that's between the doctor and the patient.

murphaph wrote: »

Because the stats prove that medical card holders are much more likely (I think it was 8 times more likely) to go to their GP than non-medical card holders.

That stat is unsourced, and lacks context.

Now, whilst I believe the entire system in Ireland is a shambles and that GP access should cost less for the poor feckers with no medical card, I don't believe it should cost nothing at the point of delivery for the patient, precisely because people go to their GP for very minor ailments that a pharmacist or their own commons sense could advise them on.

Many medical card holders just go to their GP for a head cold so they can be prescribed their medication, which is then almost free, whereas if they bought a pack of Lemsip over the counter, they'd have to pay like the rest of us.

I can only repeat the points I've made above. It doesn't cost the system any extra (unless the GP is handing out scripts for nothing, which they shouldn't be doing), and is an issue between doctor and patient.

This was introduced precisely to curb the numbers of people clogging up the system with minor ailments. IMO they could make it €10 a month if they could reduce my insurance premium to 13% with the saving.

Show me the evidence that our network of private GPs is "clogged up."

zef · 06-05-2012 10:38AM

It's pretty busy though, my local surgery is quite large (3-4 drs) and it is full up to med card holders, so had to choose one about 1km away.
It has 3 drs, and I was warned one needs to make an appt at least a day in advance.
I have been in there a couple of times to drop off/ collect a script, and it's always claustrophobically packed.
It's true what one poster wrote about going to the dr with a cold/ flu. They will prescribe paracetamol etc. And I see MC patients getting bottles of Gaviscon as well. I don't think otc drugs should be on the GMS.

Kinski · 06-05-2012 10:58AM

zef wrote: »

It's pretty busy though, my local surgery is quite large (3-4 drs) and it is full up to med card holders, so had to choose one about 1km away.
It has 3 drs, and I was warned one needs to make an appt at least a day in advance.
I have been in there a couple of times to drop off/ collect a script, and it's always claustrophobically packed.

We could swap anecdotes all day. Where I live there are plenty of GPs, including a walk-in clinic that's open on weekends; AFAIK, they all charge 50euro a visit (I think the walk-in place charges more.) Some areas are probably better served than others, but I'm asking for evidence that shows this problem is systemic.

It's true what one poster wrote about going to the dr with a cold/ flu. They will prescribe paracetamol etc. And I see MC patients getting bottles of Gaviscon as well. I don't think otc drugs should be on the GMS.

If someone has a medical need, then why not?

christmas2012 · 06-05-2012 11:04AM

Im a medical card holder and i only visited my GP once this year,does that mean im up for review?
Its an unfair system when the people who genuinely get sick once are up for review..
Some one should kick reilly out,its not a good idea..

Kinski · 06-05-2012 11:11AM

christmas2012 wrote: »

Its an unfair system when the people who genuinely get sick once are up for review.

If someone "genuinely" got sick, then presumably they were prescribed something, or referred to a hospital, so some activity will show up on the HSE's records, and the cardholder will not be reviewed. They're just trying to find out if they're paying doctors for patients who are no longer eligible for the card, have emigrated, or died (though how someone could die without it coming to their GP's attention I don't know.)

It should also be noted that "being sick" is not the sole reason why someone might consult their GP - there are all sorts of other reasons (e.g. for vaccinations) why a person might seek an appointment.

woodoo · 06-05-2012 11:35AM

mathepac wrote: »

I'm a new medical card holder, but I rarely visit my GP.

I had a long-term illness card, LTIC, for one condition for about 5 years but since being upgraded to a full medical card last year the medicines that were free on the LTIC now cost me 0.50 per item dispensed.

I attend regular appointments with the specialists that look after the conditions requiring medicines. They each write a prescription which I take to my GP to have the GMS prescription made up and issued which I then take to the chemist.

Are you suggesting that I now pay for these GP visits where absolutely nothing of a therapeutic nature takes place? - it is a purely clerical / administrative exercise between me and the receptionist, the GP 'merely' appends his signature to the forms we define the contents for.

I never actually see the doctor on these visits and attend him once a year for a 'flu shot.

The doc is well paid by the HSE for the service he supplies to me - I would not even countenance a token payment on top of what they already pay.

I would favour a system where you are looked after on an upgraded LTI card.

couch_dweller · 06-05-2012 11:55AM

Kinski wrote: »

GPs enter the scheme voluntarily. There are practices which don't accept MC holders, but which charge similar fees for a visit. I don't think that the GMS scheme is responsible for the fee doctors charge private patients.

And I still don't get the "going with every sniffle" problem. It doesn't cost the HSE any extra if someone constantly goes with minor complaints.

I already anticipated a response like this ("putting strain on the system!!!") There is no shortage of GPs in this country. There is strain in the public system - if you need a bed in a public hospital, to see a specialist etc., then you may be waiting. But seeing a GP? That's not a problem. If any patient, medical-card holder or otherwise, is attending a clinic too often, that's between the doctor and the patient.

That stat is unsourced, and lacks context.

I can only repeat the points I've made above. It doesn't cost the system any extra (unless the GP is handing out scripts for nothing, which they shouldn't be doing), and is an issue between doctor and patient.

Show me the evidence that our network of private GPs is "clogged up."

you are greatly mistaken in stating that thier is no shortage of GP,s in this country , we dont have half enough , why do you think its so expensive to go and see one ? , thier is no competition in the sheltered GP sector and thats the way the docs like it

in rural ireland , they have an unoffical unwritten policy known as NO POACHING amongst the GP community , baschically , if i live in maynooth and i dont particulary like my doctor , i need not try and make an appointment with a doctor in kilcock over the road as they will refuse to see me , ive experienced this myself , doctors dont compete against each other in this country , the sector operates like a cartel

woodoo · 06-05-2012 11:57AM

couch_dweller wrote: »

you are greatly mistaken in stating that thier is no shortage of GP,s in this country , we dont have half enough , why do you think its so expensive to go and see one ? , thier is no competition in the sheltered GP sector and thats the way the docs like it

in rural ireland , they have an unoffical unwritten policy known as NO POACHING amongst the GP community , baschically , if i live in maynooth and i dont particulary like my doctor , i need not try and make an appointment with a doctor in kilcock over the road as they will refuse to see me , ive experienced this myself , doctors dont compete against each other in this country , the sector operates like a cartel

If you could spell their properly bob you would sneak back in no problem.

Its their not thier

ronano · 06-05-2012 12:10PM

woodoo wrote: »

If you could spell their properly bob you would sneak back in no problem.

Its their not thier

It's

if you're going to be anal about it :P

Delancey · 06-05-2012 12:12PM

woodoo wrote: »

If you could spell their properly bob you would sneak back in no problem.

Its their not thier

Actually in the context the word was used it is spelt there :D

06-05-2012 12:14PM

MOD REMINDER:
Please be advised that some posters have been getting away from the thread topic and focusing on each other; e.g., grammer, spelling, etc. Getting "too personal" specifically violates our Politics charter.

Use it or lose it: Your Medical Card.

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