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.


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*Applause*
Well said Sir. It’s wonderfull to see someone blogging about the principles involved rather than just examining the bottom-line figures (of which I’m as guilty as anyone else)…
Agreed – that is probably one of the most eloquent and articulate arguments I’ve read – Dermod – are you still a green party member? How do you think they could handled this better
Thanks Neil and Ian,
Yes, I’m still a green party member, and I’ll be very interested to hear what other members think at our next constituency meeting next week.
The nature of Harney’s influence is unmistakeable and understandable. The curious nature of collective cabinet responsibility and confidentiality, especially in the run up to a budget, means cabinet members are in a hot house with each other, and grassroots opinions do not enter into the picture.
In that atmosphere, which seems to have been one of utter dismay over the past few months at how little money there is, that’s when ideologues sound most attractive, because they sound like they know what they’re talking about, and offer direction. As I’ve said above, there aren’t any socialists in the cabinet, so there’s no one to challenge the assumptions that Harney is making. I suspect the Green ministers were just as taken in by everyone else in the cabinet.
Today on the radio she said that the increase in the cost of the over-70s medical card over the next few years would be “unsustainable, and that’s a fact.”
The truth is, it’s not a fact, it’s an opinion, based on the assumption that to increase tax to pay for a vital service is bad. Whereas I believe that Irish people would be only too willing to pay more tax during these hard times, as long as it’s fair and equitable and doesn’t unduly cause hardship to the poor.
Why not hypothecate? A new tax directly to pay for the over-70s card, that is directly related to the cost of providing the service. It would change every year. That way, people will know exactly how much it costs. And they will pay it because they know that, that way, they will be guaranteed the service themselves when they are old. What is wrong with this proposal?
A right-wing ideologue would never entertain that idea, because taxation is bad. It’s the same argument in the US election at the moment. Let’s hope that the Republicans lose in the States, and the PDs get evicted from government in Ireland.
Actually, Colm Rapple says it all much better than me, and he did it ages ago. I just don’t read the Mail on Sunday, that’s why I didn’t see it before.
http://colmrapple.com/?p=75
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