THE sick and the elderly are shelling out nearly €100 extra each a year for basic health needs, a new report has revealed.
It claims the Government has quietly shifted the burden of paying for healthcare back to these vulnerable groups.
The elderly and sick are paying more through lower subsidies in areas such as drugs cost, and hikes in prescription charges.
The report from the Centre for Health Policy and Management in Trinity College looked at the performance of the health system during the economic crisis. It warned that the health system has moved from doing "more with less" to "less with less".
Dr Steve Thomas, associate professor, who headed the Resilience project which investigated the issue, said the new Government came to power in March 2011 "with the most radical proposals for health system reform in the history of the Irish State".
Proposals included improving access to healthcare, free GP care for all by 2015 and the introduction of Universal Health Insurance after 2016.
"All this was to be achieved amidst the most severe economic crisis experienced by Ireland since the 1930s, resulting in severe cuts to the health budget," he said.
However, it is now clear that the successive cuts in funding and staff have reached a point of diminishing returns since last year – with reductions in hospital patients, a rise in waiting times and reductions in homecare hours.
Meanwhile, there are increased out-of-pocket costs which have arisen since the start of the recession. These are due to pressures such as cuts in subsidies under the Drug Payment Scheme, a rise in prescription charges and higher levies for a day or overnight stay in a public hospital bed.
Prof Thomas said it was also linked to an increase in the A&E charge and the clawback in medical cards from the over-70s.
"It works out at nearly €100 per person if you divide it by 4.5 million. The weight of that will not equally fall. If you are sick, the burden will be more."
The report, which was also compiled by Dr Sara Burke and other health research fellows in Trinity, pointed out that despite a falling budget and staff numbers, the health service did manage to do more with less between 2008 and 2012.
"Hospital inpatient cases increased by 10,000 between 2010 and 2012; day cases increased by 193,000 between 2008 and 2012," it says.
"However, from the end of 2012 and through 2013 and 2014, there was a decrease in inpatient activity, a levelling off of day cases despite increased demand and an increase in emergency admissions."
The findings revealed:
* About €2.7bn has been cut from the Irish health system since 2009 and staff numbers have fallen by 12,000.
* Hospitals had 21,000 fewer inpatient admissions between 2012 and 2014, while day cases fell by 30,000 between 2012 and 2014.
* The cost of the Drugs Payment Scheme more than halved from €311m in 2008 to €127m in 2012, "driven by declining numbers using it due to hefty increases on the reimbursement threshold".
* There has been a trebling of those waiting over six and 12 months for treatment in the year to November 2013.
* The number of patients who remain occupying acute hospital beds when they should be discharged remains "chronically high" at 718.
* The number of home-help and homecare hours for the elderly and disabled has been in "steady decline" and in 2013 there were fewer than nine million homecare hours provided, compared to more than 11 million in 2006.
Ms Burke warned that the "system's ability to pull off the reform programme is in question".