As a result of medical cards issues mentioned in the Summer 2014 Síocháin, Michael Coleman, Branch Chairman for Dublin South GSRMA, made a detailed submission to the HSE to highlight the current inequity in the health system. Michael’s submission which we have inserted below is very clear and addresses the concerns of many retired gardai.
The Office of the Assistant National Director
Medical Needs Consultation
Health Service Executive
Primary Care Division
St Loman’s Hospital
Re HSE Medical Card/GP Visit Card National Assessment Guidelines for People aged 70 years –
1) Restoration of double threshold for couples
2) Assessing Income for Medical Cards on net income for over 70s (currently gross income)
I refer to the recently advertised request for submissions to the “expert panel on medical needs for medical card eligibility” for the HSE public consultation to develop a policy framework for medical card eligibility to take account of medical conditions and wish to make the following submission:-
The members of the Dublin Metropolitan South Branch (DMR South) of the Garda Siochana Retired Members Association (GSRMA) who have benefited from the medical card scheme for many years, has brought to my attention as Chairman of the branch, the current inequity in the health system, which has resulted from the introduction of changes in the Single-V-Couple benefit’s in the 2014 budget, which has had a major impact on the medical services they receive and their limited finances.
The medical card scheme for people aged 70 years and over has been revised with effect from 1/1/14 for people with a gross income not exceeding five hundred euro per week for a single person and not exceeding nine hundred Euro per week for a couple. In those circumstances they are entitled to a Medical Card under the scheme. Those aged 70 years or older with gross weekly income over €500 and not exceeding €700 for a single person or over €900 and not exceeding €1,400 for a couple are entitled to a GP visit card under this scheme. If a person is in excess of the income limits he/she will be assessed under the general medical card/GP visit card scheme in so far as they can, based on the details provided at the time of application.
Gross income from all sources is assessable with the exception of some Social Welfare/HSE allowances and compensation grounds for contracted Hepatitis/HIV and payments from the Residential Redress Board.
General Medical Card/GP Visit Card Guidelines under 70 years
The assessment for medical cards and GP visit cards is based on the combined income of the applicant and spouse/partner (if any), after Income Tax, PRSI and USC have been deducted. Additional allowances in the form of rent, mortgage payments, childcare costs and travelling to work expenses are also deductible. In essence this assessment is based on net income.
As can be seen from these guidelines the Department of Health have departed from parallel situations that has existed in the Departments of Finance and Social Protection for in excess of thirty years, whereby the general proposition that the state recognised that the married couple threshold should be double that of a single person. Circ. 1979 Supreme Court ruling in a revenue case Murphy-V-AG, that a married couple tax credit should be double that of a single person. This ruling was catered for in the Finance Act 1980, Section 8E, by way of Tax Individualisation – for 2014 e.g. Single Tax Credit €1,650 – Married €3,300, age credit – single €245, married €490. Tax band single €32,800 @ 20% – married €65,600 @ 20%. A similar matter arose circ. 1988 in Hyland – V – Minister for Social Welfare, High Court, re treatment of married/civil partners.
On the 18th January 1988 the High Court held, unconstitutional, provisions of the Irish Social Welfare (No. 2) Act 1985 which, in effect, gave lower total unemployment benefits to a married couple than two single people living together in the same circumstances. It ruled that these provisions violated Article 41.2 of the Constitution, which pledges the State to guard with special care the institution of marriage and to protect it against attack. This case was underpinned in the Supreme Court in 1989.
When the two cases are examined then the restoration of the double threshold should be considered by the Department of Health/HSE and the AG in line with previous medical card assessment guidelines of single €700.00, married €1,400.00 (2009) – single €600.00 married €1,200.00 and over 70’s to one of €500.00 single and married to €1,000.00 for the year 2014.
It is further suggested that that the imposition of gross income for medical card assessment eligibility for over 70’s be removed and then be assessed on net income (as for under 70’s) after the deduction of Income Tax and USC.
As the double threshold for couples has been rescinded, many members are losing medical cards and as a consequence have become greatly disadvantaged.
Therefore, I respectfully request on behalf of the GSRMA Dublin South Branch that the points raised be considered during the Public Consultation and forwarded to the Department of Health, and perhaps the AG for consideration.
Thanking you in anticipation
_______________________ Chairman of Dublin South Branch GSRMA
24th June 2014.