An Irishman's Diary

Nobody so far seems to have applauded the recent drop in the number of medical card-holders, which entitle their holders to completely…

Nobody so far seems to have applauded the recent drop in the number of medical card-holders, which entitle their holders to completely free health treatment, writes Kevin Myers.

So, let me step up to the crease and declare that this is splendid news, but only the beginning. The Government should now embark upon a ruthless campaign to confiscate as many medical cards as possible, from old people especially.

It won't, of course, because we have sentimentalised what we laughingly call our health service even as we have poured a Pacific Ocean of money into it. We have simultaneously created an entirely fictitious class of alleged paupers - the over-70s - who are entitled to every class of medical assistance free of charge, regardless of their income and assets. This is not protecting the old from the vagaries of age and illness, but instead ensuring that their children inherit the full value of their estates: less patient care than patrimony protection.

As a group, and with many individual exceptions, the old are now among the richest people in Ireland. They might not have huge incomes, though the vast army of retired public servants on their index-related pensions and free transport probably have more disposable cash than they had when they travelled to work. Moreover, very many old people are incredibly asset-rich, largely through property ownership. Why should the State pay the full cost of their medical treatment merely in order to guard their children's inheritance? Why should these people not raise loans against their assets to contribute towards their medical treatment, to be paid off after their deaths?

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Possibly, such a scheme would apply only to a widow or a widower: this is, after all, only a proposal for discussion, not a plan of action. But even married couples should have their assets viewed closely before a decision is taken to give them entirely free medical treatment. There is surely something absurd about a retired Supreme Court judge or property developer or financier being entitled to a free medical card - never mind the free travel, the free telephone, the free television licence bestowed by vote-hungry, junketeering governments of the past - while the lower middle-class couple struggling with a young family has to pay for the full cost of every single visit to the GP, and for every drug. Which is why Mary Harney's plan to issue 200,000 doctor-only medical cards is good - provided they are for such young families and the chronically ill.

Of course, the suggestion that the affluent over-70s should be made to cough up for their medical treatment will probably be as welcome among our left-liberal classes as a rabid dog in a Montessori for asylum-seekers. And maybe our lefty friends are right. Maybe it is a very bad idea to make the capital-owning classes pay for the incredibly expensive medicines required to keep them alive and their existence endurable. But first of all, should we not give the subject some careful consideration?

However, the Taoiseach's recent embrace of socialism suggests that we have entered a sentimental and intellectually frivolous bien-pensant cycle of politics. Within such a cycle, a language that should be as extinct as the mating cries of pterodactyls will once again echo over our political swamps. So the very suggestion that the elderly should pay for their incredibly costly medical services will probably be dismissed out of hand in the predictable populist cant as fascist, reactionary, right-wing, Thatcherite, Victorian, workhousian. What next? Child chimney-sweeps and bailiffs evicting gibbering nonagenarians from their deroofed cabins?

Actually, we haven't got a single health service, but many, some of them so deplorable that they should actually open people's minds to alternative solutions; but instead, minds are actually being closed as our shirt-cuffs are becoming conspicuously cardiac-embroidered. Poor Mary Harney knows better than any that in such matters, intellect is swiftly discarded and sentimental solutions lauded, regardless of cost, effectiveness or outcome. Extravagant expenditure itself is seen to be the primary virtue, not inventiveness of mind or medical efficacy.

We could look at the experience of others, but we probably won't: we apparently regard learning from others' mistakes to be rather similar to be cheating in our finals. The French, for example, have created a welfare state that now sits on their economy like a big beaming elephant in the passenger seat of a small glider. Not merely does the elephant refuse to get out of the plane - but it insists on savouring the fragrance of the wild blue yonder, and now. So our first priority in our present virtuous cycle will probably be to try to build our own glider, and then go ransacking the health service zoos of Europe looking for a big enough elephant to put in it.

The truth is that health is fabulously expensive, yet our existing - though voluntary - medical "taxes" are fabulously low. My annual personal VHI bill of about €500 - €10 per week - is far less than I spend on newspapers every weekend.

Yet the one thing that will consistently cause the bien-pensants to howl at the innate iniquities of our capitalist society is any proposed increase in the "high" price of VHI coverage. Welcome to the world of medico-fiscal insanity.

For our bien-pensants have inhaled the ludicrous heresy from the European air that medicine can and should be free at the point of delivery, available everywhere, on demand - even though in reality, our own medical services actually resemble the San Francisco public transport department, with everyone on a trolley. So, instead of serious, challenging discussions, arid and impractical pieties everywhere.