CHARGES:SIGNIFICANT INCREASES in health charges and the abolition of an automatic entitlement to medical cards for all those over 70 years, including those who have such cards already, were among the key health service changes announced in yesterday's budget.
The charge for patients attending AE without a letter from their GP or a medical card is being increased from €66 to €100.
The cost of private and semi-private beds in public hospitals will go up by 20 per cent, which Minister for Health Mary Harney admitted will result in a 4 per cent increase in health insurance premiums in due course.
From January 1st all over-70s will have been means tested for their medical cards, Ms Harney said. Their means test will be the same as for other age groups and based on income after expenses such as rent and medical costs.
At present there are some 355,000 people over 70 with medical cards. It is estimated that some 140,000 of these are entitled to them because of their age only. When the means test for this age group is introduced, Ms Harney said she estimated some 14,000 of this 140,000 will get full medical cards, another 35,000 will get doctor-only cards, 20,000 will end up having to pay for all their medical bills and the remaining 70,000 or so will get an annual grant to help offset their medical bills. The grant for those qualifying will be €400 for a single person and €800 for a couple.
"The health support payment will be available to those currently aged 70 and over who do not qualify for a medical card or a GP visit card and whose gross weekly income is less than €650 for a single person or €1,300 for a couple," Ms Harney said.
The HSE is to write to all card holders in coming days to advise them of the changes. It will also set up a helpline. The changes to the free over-70s medical card scheme, which was introduced in 2001, is expected to save €100 million a year.
"In tougher times, we can't ask the community, particularly low-income taxpayers, to provide the substantial benefit of a full medical card to everyone over a particular age, even to some of the wealthiest in our society," Ms Harney said.
There will also be limits on spending for discretionary medical cards for all others.
Meanwhile, the threshold for the drug refund scheme is being increased from €90 to €100 per month and the public hospital statutory inpatient bed charge per night is being increased from €66 to €75. Long-stay charges will also increase by about 28 per cent.
Overall the HSE's budget for 2009 will be €14.7 billion, an increase of €454 million or 3.2 per cent on this year's allocation. Some €15 million of this has been ringfenced for the cancer-control programme, €55 million to implement the "fair deal" scheme, and €340 million for pay increases including pay rises for consultants who opt for new higher paying contracts. There is also €1.7 million for initiatives in relation to suicide prevention and €10 million to fund extra therapists for children with disabilities.
In real terms, given that the HSE is already running a multi-million deficit for this year, its allocation for next year is likely to result in service cuts. It is being asked to find €115 million in savings next year by reducing travel, overtime, consultancy, administration and management costs. Ms Harney admitted the HSE will be "challenged" to meet its commitments.