Dublin Opinion

There is something about the present government and their inability when under pressure that makes satirizing them impossible.

How can you take the piss out of a government that announces this?

At a news conference this morning, the Taoiseach said people who are over 70 will not be automatically entitled to a medical card, but will undergo a means test.

However, income eligibility limits are to be significantly increased to ensure that around 95% of those who currently have cards will retain them.

You just can’t take them seriously. Personally though, I’m not laughing. What this amounts to is a desperate attempt to retain authority just when power is seeping away from them, and to preserve the right to get rid of universalism despite the fact that it will provide no real saving for the exchequer. As Michael Taft has said, the historical reason why the universal medical card was brought into effect doesn’t matter at this point. Whatever the motivation, it was a step in the right direction and to get rid of that right means that the gains for the population in health terms between 2002 and 2008 are now in danger.

Maev-ann Wren illustrated this convincingly in her article last Sunday, when she used the census figures to show that the level of disability among the elderly has been reduced since the introduction of the universal medical card.

In addition, she makes the point, as does Michael, that arguing that those who are better off should pay for certain public services doesn’t take account of the fact that those who earn more at the moment benefit from plenty of public services – without that right being means-tested.

The Taoiseach defends ending universal medical cards for over 70s on the grounds that public spending should be targeted to those most in need. There is another way of viewing this. Universal medical cards are a form of targeting of public spending just like universal national school education.

With each, spend¬ing is targeted on what society values. Of course people on higher incomes should pay more for public services but the European way to achieve that is via tax or social insurance, so that we collectively fund services according to our ability to pay but, crucially, access them equally according to need.

No matter how high the income of a person, young or old, they should not fear illness, or the costs that it will bring. Without medical cards, many public services are really not on offer. To remove access to them for those on higher pensions is to remove access to forms of care essential for every frail, older person. As in many spheres of public service, private may not be better nor even available. That is why we do not tell higher-earning parents their children may no longer enrol in national schools.

And it is interesting, in the context of education, that the government still chooses to continue the subsiding of private secondary schools. It has also chosen not to change inheritance tax. It has also chosen to retain co-location which uses tax payers money to subsidize private investors and to make the health service worse, as Gerry Burke has shown in his piece on co-location.

So Finian McGrath has crossed the house, but John Gormley has stood by Cowen as he announces that he is retaining the budgetary decision to scrap the provision of a public service that has enormous social value.

No doubt, Gormley will insist that this will only affect 5% of current medical card holders and that the Green’s expression of concern within government ensured that the social benefit was lost in order to save the contining privatization of an essential public utility.

Update: I’ve calmed down and I now forgive the Green party, because apparently I was wrong. The government have actually backed down. Finally, we have government that gives into public pressure, one that chooses to do the right thing. So, if we look at the detail we’ll see that new medical applicants will be means-tested from the 1st of January 2009, and while it’s “unclear what penalties, if any, will apply if people do not give proper notification of their means” Mary Harney assured us that “normal control measures” would be used by the HSE.

A funny way of backing down.

This will cause considerable stress to elderly people who will have to humiliate themselves by providing documentation to prove that they don’t earn enough to get a medical card, and the government will have to put in place a ‘control mechanism’ to make sure that the state isn’t being defrauded - that means more money to pay for inspectors, combined with the fact that now people’s personal income will have to trawled through.

And all this to save how much exactly?

Damn, I’m angry all over again.

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Ahhhhh, fuck it!