Medical card savings ? Where ?

[wysiwyg]

I know there are a few threads regarding the removal of the universal medical card from over-70's, and some might argue that there is no need for another one.. but I'm hoping that this one will get past the hysterical reaction, the hyperbole and the ideology.. and focus on the actual economics of the decision..

It's just that something has been nagging me over the weekend regarding the monetary figures and projected savings...

Ok, here's my point ..

When this was announced, the Government claimed that we were dealing with 140,000 over-70 medical card holders.. and that the changes would realise 100million in savings...

The breakdown for the changes were then announced

(a) 15,000 people were to remain in the scheme as it was currently

(b) 85,000 would lose the full medical card, but would go to the doctor only medical card

(c) 25,000 would lose both cards, but would be entitled to a €400 euro grant in lieu of the medical cards

(d) 15,000 people would lose all current benefits

This would presumably realise €100 million in savings, with 85% i.e. €85 million, being clawed back from the GP's...

ok

(a) no savings at all

(b) doctors visits remain free, so no savings from doctors

(c) doctors are currently being paid €640.. will now be paid €400. Savings of €240 per patient ... 25,000 * €240 = €6 million

(d) full saving to State

So.. looking at those figures.. assuming that 85 million is expected to be saved from doctors... and so far only 6 million in savings is already guarenteed... the remaining €79 million savings from the GP's would have to be spread across the final 15,000 patients who lose all benefits..

This means that the Government are claiming that they will be making a saving of 5266.66 per patient... which is impossible... because for only €640 per patient, they would be getting free access to the doctor

So, the figures simply do not make sense on any economic level... there simply cannot be savings of €85 million from doctors on these figures..

In fact, if you calculated that whole 140,000 pensioners, at €640 per patient, you only pay €89.6 million. So how can leaving 15,000 on the card make a saving when it will still cost €9.6 million.

The only other thing in my head.. is that while the Government are blaming the removal on this scheme on the doctors.. they know that they will not make savings from the scheme off the doctors... where they will make the savings from the scheme.. is off the prescription medicine payments

This scheme is about removing medicine.. not GP visits..

The figures make no other sense otherwise

[kerrynorth]

Well a lot things come with the card. The point of getting the €640 GP cost down is that it will allow them to extend eligibility.

[EoinMn]

This scheme is about removing medicine.. not GP visits..

Great post.
You're correct. Everyone is obsessing about GP visits when the higher cost may be the medicines.

Let's say you are over 70. You go to the GP 6 times per year. That aspect of the medical card is worth €300 per annum to you.

Free medication though could is worth up to €1200 per annum to you. (I'm using the DPS limit here of €100 per month)

[wysiwyg]

Well a lot things come with the card. The point of getting the €640 GP cost down is that it will allow them to extend eligibility.

That's true KN.. but I am trying to get away from the whole elegibility argument because that has been well done on other threads..

I think it's now time we begin to focus on the nuts and bolts of the actual figures of the budget...

What I am saying here, is that for example.. the Government are claiming that the changes will make savings of 100 million.. .

but if you take 140,000 by 640 (which is what the scheme was costing for the GP part) before the budget, then the scheme only cost 89.6 million in the first place... so it would be impossible to save 100 million, even if you scrapped it altogether...

well, impossible to make such savings from the GP's.. which means that the savings are coming from the medicine dispensary part of the scheme..

That's where the focus should be... The Government don't want to pay for medicine

[droghedasouth]

Penny wise - pound foolish.
The best way of keeping health costs down is to keep people out of hospital, and a prompt trip to the doctor without having to worry about the cost and whether it was necessary is highly cost-effective.

As regards medicine costs, someone from a pharmaceutical/medicine economics board was on the radio friday afternoon saying that they were not consulted.

I believe that the markup for pharmacists on the drug refund scheme is about 50% of wholesale as opposed to about 10% for the medical card scheme.

So the whole thing is just crazy.

[wysiwyg]

Penny wise - pound foolish.
The best way of keeping health costs down is to keep people out of hospital, and a prompt trip to the doctor without having to worry about the cost and whether it was necessary is highly cost-effective.

As regards medicine costs, someone from a pharmaceutical/medicine economics board was on the radio friday afternoon saying that they were not consulted.

I believe that the markup for pharmacists on the drug refund scheme is about 50% of wholesale as opposed to about 10% for the medical card scheme.

So the whole thing is just crazy.

Can you explain that please.. are you saying if a particular medicine costs 10 euro from the producer.. it gets sold into the drug refund scheme at 15 euro, and the GMS at 11 euro ?

[droghedasouth]

Can you explain that please.. are you saying if a particular medicine costs 10 euro from the producer.. it gets sold into the drug refund scheme at 15 euro, and the GMS at 11 euro ?

Yes, that is what I understood him to say.

[Bean]

That's true KN.. but I am trying to get away from the whole elegibility argument because that has been well done on other threads..

I think it's now time we begin to focus on the nuts and bolts of the actual figures of the budget...

What I am saying here, is that for example.. the Government are claiming that the changes will make savings of 100 million.. .

but if you take 140,000 by 640 (which is what the scheme was costing for the GP part) before the budget, then the scheme only cost 89.6 million in the first place... so it would be impossible to save 100 million, even if you scrapped it altogether...

well, impossible to make such savings from the GP's.. which means that the savings are coming from the medicine dispensary part of the scheme..


That's where the focus should be... The Government don't want to pay for medicine

Are they taking ancillary health care services such as home help, district nurse etc. into account ? These represent considerable added value to medical cards

[kerrynorth]

Yes, that is what I understood him to say.

Can you explain that please.. are you saying if a particular medicine costs 10 euro from the producer.. it gets sold into the drug refund scheme at 15 euro, and the GMS at 11 euro ?

Thats roughly how it works. Mad isn't it. I wonder if there is a tie in here with the pharmacists. Increase their business at the higher margin DPS but get them to reduce their overall margin.

[droghedasouth]

Thats roughly how it works. Mad isn't it. I wonder if there is a tie in here with the pharmacists. Increase their business at the higher margin DPS but get them to reduce their overall margin.

KN - thanks for the confirmation.
I sometimes doubt my sanity when discussing the alice-in-wonderland-economics beloved of the public sector.