I rarely get baldly political in this blog but as the Medical Card fiasco progresses I am picking up one constant theme. The ideological debate is being won constantly at the Cabinet table by Mary Harney, and there isn’t an intellect agile enough to combat her ideologically driven agenda, to tackle her on principle. She’s extremely plausible when she argues that giving a medical card to a wealthy 70 year old means that services have to be cut back for someone else who is younger and poorer.

Nobody seems to think it reasonable to suggest that a wealthy person has probably paid enough, through a lifetime of high taxes, to deserve a medical card when they’re old. What does Pay Related Social Insurance mean, if not that? (The principle of an insurance-based Health service would take it for granted that those who have paid the higher rate over many years would be guaranteed a higher quality of service when they need it.)

But what about those who gave up paying for private Health Insurance because they believed they would be covered by the public health system in their old age? They’ve lost a lifetime of insurance cover, and still have to hand over their medical card in January if they don’t qualify, or lie by saying they don’t earn over the limit.

But the argument is not about penny-pinching, it’s about principle.  Harney is trying to frame health care as a charity, dispensed to help those who need it but can’t afford it. Hers is a right-wing economic philosophy, but it’s warped – it’s a disincentive to work hard, to save, to invest in a good pension. But, much more than that, she’s fighting to eliminate the socialist practice of universality of access in health care from Ireland.

This needs to be named and challenged inside government. Any socialist worth their salt would know how to tackle her, but Fianna Fáil, despite Bertie’s assertion, was never socialist. The Greens come from a different ideological background, neither right nor left, but that doesn’t excuse them for not being alert to the explosive nature of the ending of universality, and not challenging her aggressively, in my mind.

Everyone seems to get persuaded by the numbers she’s giving out, hypnotised even, but the reality is that universal health care is worth fighting for, on so many levels. And it’s worth paying for.

There is only one likely reason that Mary Harney has survived so long as Health Minister, and that is because she is a powerful debater and she has used her skills to persuade all those who sit with her in cabinet how capable she is. No one wants her job, and who can blame them? But when the going gets tough, that’s when a country decides what its values are. People are willing to make sacrifices.  And Irish people will be proud as a nation if we can take care of our old people, even if we are broke. And if it means increasing taxes to Scandinavian levels, so be it.

As per the press conference this morning, 95% of old people getting and keeping a medical card is not universality, and it seems, sadly, that Harney has won the ideological argument, and Brian Cowen and John Gormley are singing to her tune.

Any system which penalizes someone financially for going to their doctor is wrong, in my book. (Yes, I lived in the UK for 13 years and have been corrupted by notions and experiences of fairness.) This is especially wrong for old people. And no matter if they live in a mansion, old people get frightened and insecure. Universality opens the door for preventative medicine, for a more intrusive health monitoring and screening system, to ensure disease is nipped in the bud. In the long run, the health bills are less, because people are healthier. That makes economic and political sense.

Harney and the PD ideology have to go. Their influence is pernicious, anti-democratic, and poisonous to the Irish body politic.