Patients cough up €1,000 for week in hospital and two A&E visits a year
A patient who has to spend more than a week in hospital and attend A&E twice in the course of a year will face a personal bill of €1,000.
It comes as patients are still paying out-of-pocket health fees of more than €125m to the State for basic drugs and hospital care.
Although some of the charges have come down in the lifetime of the current Government, others remain at the same high level and none has been scrapped.
The unpopular prescription charge for medical card holders costs €2 an item for people aged under 70 and €1.50 for older people.
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The charge is a big generator of income for the HSE, bringing in €93.5m last year.
Health Minister Simon Harris announced a 50c cut in the prescription charge in the October Budget and these reductions are due to come in next July.
However, the previous Fine Gael-led government, during which Taoiseach Leo Varadkar spent time as health minister, had promised to abolish it altogether.
Public hospital charges also leave patients with a financial burden and those without a medical card are shelling out €80 daily, capped at €800 a year, for an overnight or day case service.
This brought in €16.5m last year and the charge, which was increased six years ago, remains unchanged.
Patients without a medical card or GP referral letter pay out another €17m in A&E charges annually, despite the overcrowding and trolley waits.
These charges are separate to upfront private fees of around €60 to see a GP.
The Drugs Payment Scheme subsidises the cost of medicines for private patients.
But the 195,425 people who avail of it will pay out around €24.3m from their own pockets in a year.
Sláintecare, the blueprint for the overhaul of the health service, wants these charges to be reduced or removed in the coming years.
Asked to comment on the charges, Prof Charles Normand, emeritus professor at the Centre for Health Policy and Management, Trinity College Dublin, said: "We need to remember that the only good reason for user charges in healthcare is to raise money."
Prof Norman warned that the evidence is clear that they deter use for all services, and not specifically for those services that are less important.
"The reduction in prescription charges for medical card holders is very welcome, but it is still unusual in Europe for people on low incomes to pay anything for their drugs," he said.
"When charges were first introduced it was shown that they did put off some people on low incomes from getting necessary drugs, such as those that lower blood pressure.
"Even with lower drug prices and the lower thresholds for the Drug Payment Scheme, the burden on families just above the limit can be very heavy," he warned.
The number of people with medical cards fell by around 200,000 to 1.5 million between 2016 and 2017 as more people got jobs and went over the income threshold.
At the same time, the number who have GP visit cards has increased from 431,306 to 515,909.
Prof Normand said the falling numbers with medical cards is understandable, given the general rise in incomes and the decrease in unemployment.
"More people are now getting free GP consultations, but this is of more limited value since they still have to pay for their drugs, and cannot access many of the public services outside hospital.
"For the Sláintecare reforms to work we really need to remove financial barriers to treatment in the community," he added.