Medical card figures

[Retired Tallyman]

There has been a little talk in the media over the past few days of well to do people who are healthy, getting medical cards but never attending their GP. This prompted some anger on these boards and on radio that GP's were being paid massive amounts for these people that they were not seeing. I have discussed this in other places on the boards but i want to deal with the numbers here

On the PCRS (GMS) website the 2006 annual report shows that 406133 people over the ages of 65 were paid for under the GMS in that year.

In the same year the census reported a total of 467,926 people over the age of 65. Now we know that Gay Byrne and Mary O'Rourke are 2 of the missing 61793 but even allowing for statistical errors a lot of people, presumably healthy and maybe wealthy, have never applied for their cards. This probably means that the Government made an even bigger error in their calculations when they introduced the cards in 2001.

[Petrus]

On the PCRS (GMS) website the 2006 annual report shows that 406133 people over the ages of 65 were paid for under the GMS in that year.

I don't know where you are getting this fiugure from, I presume it is from Table 9.1 page 45

Here is the info
65-69 years both sexes 68,138
70-74 years both sexes 119,474
over 75 years both sexes 216,729
Total of 404341

If you look at over 70's we have a total of 336203
From CSO.ie 252,729 over 70's were included in the census see here

That means the HSE paid for 83,474 more over 70's in 2006 than were included in the census. Thats about a 30% error.

To put in context, there were 27,479 deaths in Ireland in 2006 see here
19,848 of which were over 65.

If we take an average capitation figure of €150 per patient, 80,000 patients or so.
Thats €12.5 million spent on patients the CSO did not think existed.

[Retired Tallyman]

And add in approx 1790 patients from 60 - 65 who had GP Visit cards.

The figures from the census page here shows 467000 (i dont know how you got your figures)
Beyond 20/20 WDS - Table View. I know how the GMS pays for people and it is not that loose to have 50% overpayment. More likely underpayment is possible I promise you.

So they have NOT overpaid. The figure in PCRS is the average figure for the year so would allow for deaths and people reaching 70. I believe this shows that all the talk about the number of people who will not qualify for medical cards of the current holders is overstated and that a lot of the high earners may have not applied for them. But definitely there are 60,000 people over 70 who had not applied for medical cards in 2006

[Petrus]

I don't understand how the CSO database works.
I search Table: Population (Town and Rural) by Five Year Age Group, Year, Statistic, Sex and Marital Status
for over 70's in 2006 and get 252932

I follow you link Beyond 20/20 WDS - Table View
for 0ver 70's and get 324530.

Which is right?

However the PCRS / HSE paid for 336206 over 70's in 2006.
So presumably your link has more accurate info or I am doing something stupid.

[myksav]

There has been a little talk in the media over the past few days of well to do people who are healthy, getting medical cards but never attending their GP. This prompted some anger on these boards and on radio that GP's were being paid massive amounts for these people that they were not seeing. I have discussed this in other places on the boards but i want to deal with the numbers here

On the PCRS (GMS) website the 2006 annual report shows that 406133 people over the ages of 65 were paid for under the GMS in that year.

In the same year the census reported a total of 467,926 people over the age of 65. Now we know that Gay Byrne and Mary O'Rourke are 2 of the missing 61793 but even allowing for statistical errors a lot of people, presumably healthy and maybe wealthy, have never applied for their cards. This probably means that the Government made an even bigger error in their calculations when they introduced the cards in 2001.

Between 65 and 70, the medical card is not an automatic issue, a means test applies.
The numbers you need are the payments to GP's under the GMS for the age groups. Over-70 patients are paid for at four times the rate of a 60 year old, near 500 euro difference.
A parent with three children could actually have more need for seeing a doctor than a pensioner. In a year, the GP gets more for the over-70 than for the parent and three children. Which do you think the GP's would prefer to have more on their register, young people or over-70's?

I keep hearing the phrase "it's not fair..." on the rescinding of the automatic medical card. Last I checked, life ain't fair.

I was against this rescinding when I first heard it mooted during the Dáil budget announcement but couldn't hear much beyond the first few words with the screaming and shouting from the Opposition. When I heard there was a limit of 205, (i think) AFTER expenses were accounted for, I thought it wasn't high enough. Nor was the 240 limit.
Then I heard the 700 limit for a single person, 1400 for a couple, it struck me that I knew people with family who barely got that much in income and they do not qualify for a medical card, just maybe the GP Visit card.

The behaviour in that church threw a lot of sympathy for the over-70's over the side. That minister was invited to speak to the protesters and all that happened was they shouted him down, refusing to let him speak. Very democratic, that. No respect of a house of prayer either, which I'm hearing from their peers around where I live. The disgust at the behaviour is quite strong on that aspect and it effects sympathy.

Most of the hysteria about now can be directly attributed to opposition people whipping it up.

[myksav]

I don't know where you are getting this fiugure from, I presume it is from Table 9.1 page 45

Here is the info
65-69 years both sexes 68,138
70-74 years both sexes 119,474
over 75 years both sexes 216,729
Total of 404341

If you look at over 70's we have a total of 336203
From CSO.ie 252,729 over 70's were included in the census see here

That means the HSE paid for 83,474 more over 70's in 2006 than were included in the census. Thats about a 30% error.

To put in context, there were 27,479 deaths in Ireland in 2006 see here
19,848 of which were over 65.

If we take an average capitation figure of €150 per patient, 80,000 patients or so.
Thats €12.5 million spent on patients the CSO did not think existed.

Actually, that €150 figure is about the rate for an under-65, at least. The over-70's capitation is 640.

[Petrus]

Actually, that €150 figure is about the rate for an under-65, at least. The over-70's capitation is 640.

There are different capitation rates for over 70's.
1. new medical cards for over 70's not means tested, automatic entitlement.
Page 26, 2006 PCRS Annual Report PDF Here
"The Capitation rate is €627.13 per annum for persons aged 70 years and over in the community issued with a medical card for the first time
regardless of income."

2. Means Teasted Medical Cards
Capitation ranges from €136.85 for a male living within 3 miles to €239.84 for a female living over 10 miles away from the surgery.

I was using the lowest reasonable number €150, the cost may have been higher.
I am not happy with my figures that I originally got from the CSO.
So the entire idea may be wrong.

[Retired Tallyman]

Actually, that €150 figure is about the rate for an under-65, at least. The over-70's capitation is 640.

I would like to correct. The figure of €640 is for non means tested over 70's only. the other 60% of over 70s who are means tested generate an annual payment to GP's of about €150 only!!! I gaurantee you that this is 100% right. I will post the link later.

[myksav]

I would like to correct. The figure of €640 is for non means tested over 70's only. the other 60% of over 70s who are means tested generate an annual payment to GP's of about €150 only!!! I gaurantee you that this is 100% right. I will post the link later.

That would be nice because from what I gather once one reaches 70, you're automatically entitled to the medical card. There is no means test for that.
As non means tested, this means the 640 euro capitation applies to all over-70's on a GP's register.

I wasn't sure if the means test applied between 65 and 70. It does.
There are some caveats. Pre-existing qualification, pre-existing medical condtition, etc. that negate the need for means test.

The "60% of over 70s who are means tested"? Here was I, thinking that this furore was about the removing the automatic entitlement of over-70's to a medical card and applying a means test of 700 euro limit for qualification. How silly of me.

[Retired Tallyman]

That would be nice because from what I gather once one reaches 70, you're automatically entitled to the medical card. There is no means test for that.
As non means tested, this means the 640 euro capitation applies to all over-70's on a GP's register.

I wasn't sure if the means test applied between 65 and 70. It does.
There are some caveats. Pre-existing qualification, pre-existing medical condtition, etc. that negate the need for means test.

The "60% of over 70s who are means tested"? Here was I, thinking that this furore was about the removing the automatic entitlement of over-70's to a medical card and applying a means test of 700 euro limit for qualification. How silly of me.

Look , if a person had a medical card at 69 they carry that into their 70s and retain the medical card for life. These people are paid at a rate of €155 per anumn to the GP and NOT €640. check the GMS website further up the thread for that.