The Silver Revolution
RTE broadcast a documentary in the past few weeks about Ireland’s student ‘revolutionaries’ of the late 1960s. Once they finished university, three of the four (Ruairi Quinn, Una Claffey and Kevin Myers) began a journey that is all too familiar in the west… from left wing to centre (and to the right in once case) and from outsiders to pillars of the establishment. Anyone who flicked through at the CVs of the New Labour frontbench during Tony Blair’s first two terms would have discovered a rag bag of communists, hard-left student politics leaders, Marxists and Trotskyite (Jack Straw, John Reid, David Blunkett etc) who had back-flipped totally.
The Budget-day decision on Over 70s medical card has proved to be a fiasco. The idea to introduce cards was a noble idea. The problem is that the then Finance Minister Charlie McCreevy (him again! All of his chickens are now coming home to roost!) didn’t bother consulting with doctors before introducing it. That was a big mistake. The medical profession as an interest group is hard-core… just look at the marathon hold out over a new contract by vastly over-paid consultantans. They knew they had their hand on the tiller when it came to the hard-chaw negotiations.
The IMO went in and got a golden deal for GPs and a lousy deal for the taxpayer. Just look at the math. For over 70s, there are two ways of getting a medical card. If you already have a medical card – or qualify for one on grounds of pay – you keep it. That accounts for the bulk of pensioners – 215,000. For each medical card, the GP gets paid a flat fee of €161 a year.
However, the new medical card (an additional 140,000 people over 70 qualified for it irrespective of means) was of a different order. GPs got paid an annual fee of €640 for every one, over four times higher than the means-tested medical card.
There was a grotesque imbalance here. The 215,000 who were actually entitled to a medical card cost the State €161 each per year while the 140,000 who qualified on age grounds cost the State €640.
Essentially GPs made a lot of money out of this scheme. There was a doctor on Joe Duffy (who wasn’t challenged by Duffy) who said that his practice had expanded from five doctors to seven, from one nurse to two or three, and from two secretaries to five in the interim. In other words, he was saying he invested the extra money in his practice. That’s not a justification. If he expanded his practise, he expanded his income. Sure if I got an extra €30,000 a year from my employer, chances are that I would invest it in building an extension to the house to accommodate a snazzy office.
Cleary there was an inequity at the heart of it that had to be tackled. The likes of Tony O’Reilly having a medical card is almost preposterous.
But the Government’s decision showed that Fianna Fail’s boast of staying close to the heartbeat of ordinary people has deserted it. The announcement was flagged in the run-up to the Budget but was done in a cack-handed way. Pensioners everywhere panicked, irrespective of whether they were losing the card or not. The communications was abysmal. Fianna Fail TDs were not briefed for 24 hours. There was uncertainty over who would keep the card and over who would lose it. The Governmen took two days to pony up the thresholds.
By that time the damage was done. The chat shows and phone shows were over it like a plague. How did the Government not know, for godssake. Joe Duffy ran with the medical card story EVEN BEFORE theBudget was announced. And it was only when FF TDs started getting swamped with calls (one man told his TD that he was going to kill himself – that’s how emotional it was) that the Government started to act.
Last night’s clarification on thresholds was being played as a bit of a climbdown. But the story is not going to rest there. I’d say that FF TDs will get in their ear at their constituency clinics this weekend and this controversy – people-led- will rumble on for weeks.
The inequity of the system needs to be tackled. The Government will just have to break the contract and tell GPs they can no longer get €640 per patient. But to do it in a way where over 70s don’t lose out. There are working class areas without proper GP cover now. The reason for that is simple. Doctors won’t get there when they know that the over 70s there will be worth only €161 to them. Much better to go to more affluent middle class areas where they will be guaranteed a glut of patients in the €640 class.
And make no mistake about it, this is people red. Revolution and reactionary tactics are not just the tactic for protected university students.