Medical card means test is unfair, claims new report
People who have substantial savings and assets are qualifying for medicals card while families only slightly over the income limit are being turned down.
The issue has been highlighted by the Citizens Information Board, which received more than 56,300 queries to its information offices last year about medical cards - more than about any other health matter.
The board said a common difficulty people experience with the means test for medical cards is the fact that many families are struggling to pay bills, and in many cases are only slightly over the income limit for their circumstances.
"On the other hand, many people are qualifying for medical cards who have savings up to and over €36,000 for a single person and €72,000 for a couple. They also can have additional property, not impacting negatively on their assessment for a medical card," it said.
"Feedback from our service delivery partners is that the current system of means testing can be unfair and inequitable, and it may be more balanced if a capital assessment for medical cards was more in line with the means assessment used by the Department of Social Protection."
It also called for administrative delays in processing health-related entitlements to be addressed through the allocation of adequate resources that will meet the demands of the application system.
"This may include the introduction of higher numbers of deciding and medical officers to meet the current and anticipated ongoing demand for medical cards," it said.
The HSE also needs to speed up its plans to introduce a single "one-stop" application form for medical cards, GP visit cards, the long-term illness scheme and the drugs payment scheme.
And it must continue existing plans to establish access points in health offices across the country, which will have a role to support and help people.
A spokeswoman for the Department of Health said that as of October 1 there were 1,729,000 medical cards, of which 94,614 were discretionary. This is where people were over the income limit but had particular financial needs due to a medical condition.
She added that there was a deliberate relaxation of the rules for discretionary medical cards last year for reasons such as people being slightly over the income limit.
"The system is now operating in a much more sensitive manner with greater discretion being exercised by the HSE," she said.
"This follows the publication last year of the Keane Report of the Expert Panel on Medical Need for Medical Card Eligibility. There are more discretionary medical cards in place now than ever before.
"On foot of the report, a Clinical Advisory Group (CAG) was established to provide clinical oversight and guidance to the operation of a more compassionate medical card system."
"The group, which reports to the National Director of Primary Care, has met regularly since.
"It completed its interim report in June and, following a review of the report, an interim recommendation to award medical cards to all children under 18 years with a diagnosis of cancer was accepted. It is to report with more proposals as part of its review."