Madam, - Maev-Ann Wren (Opinion, November 17th) and people who, like myself, agree with her have to face some very unpalatable truths in putting forward a health agenda based on equity and justice.
The people of Ireland do not want such an agenda as they have voted for an administration that promised us low income tax. Subsequent opinion polls show people remain fixed in that view. While health spending is viewed as a drain on the economy this Government will always be a reluctant spender.
When our health as a nation is viewed as a national asset and spending on health is seen as guarding our wealth, attitudes will change.
Our recent wealth creation has moved a large chunk of our population into low-paid employment. Many such people are now losing their medical cards and are beginning to experience the costs of visiting their general practitioner. For a young family of four, visiting a doctor with typical acute illnesses and paying pharmacists' bills, amounts to over €1,000 a year, or 5 per cent of gross income on an industrial wage. Not a lot for a country to bear, but enough to persuade a family in need to delay seeing the doctor. My own experience of such families is that they get a real shock on having to pay for their medicines and deeply miss the excellent medical card service.
TDs and councillors do not expect a high voting turnout from the poor, but we now have a cohort of low-paid workers who long for the day when a government will restore their medical card entitlement.
The tight electoral nature of Irish politics means they will matter in the next election. If I know this, I expect the Government has spotted it too - but as a "stroke" and not as a strategy that will view health as wealth.
However, politicians are the easy target in this debate. As a nation we must face an unpalatable truth: we cannot have low income taxes and adequate healthcare. - Yours, etc.,
Dr TOM O'DOWD, Professor of General Practice, Trinity College, Dublin 2.