Medical cards should be made available on a phased basis to all workers and their families, according to the Irish Congress of Trade Unions. It calls for a radical reform of the existing system and says initially everyone on the national minimum wage should receive a card for themselves and their dependants, followed by those on average industrial earnings.
In its submission to the Minister for Health and Children on the Government's new Healthcare Strategy, the ICTU says there is an urgent need to establish "objective transparent criteria" for issuing medical cards, with "simple and standard medical guidelines".
The guidelines should be "reviewed and published annually".
While health boards should retain some discretionary powers over who receives medical cards, the ICTU says an independent appeals structure is needed for people wishing to challenge a decision not to give them a card. Medical cards should be extended in the next Budget to all children under 16, all pensioners over 66 and all people with disabilities.
The ICTU welcomes the Government's decision to extend the scheme to over-70s but argues that younger pensioners face similar problems of ill-health and reduced incomes. Congress also calls for a review of the range of illnesses covered by the long-term illness card scheme.
The proposals are contained within a wide-ranging submission aimed at influencing the health strategy document due to be released by Mr Martin next week. The ICTU argues that research has consistently shown low-income groups are most at risk from health problems and need better services.
It also says healthcare provision and funding are structured in an "extremely complex" way that makes reform difficult. However, workers provide the bulk of funding for building, equipping and staffing public hospitals and should benefit fully from that investment. Forty per cent of them pay private health insurance on top of income tax and health levy contributions.
The ICTU says priority must be given to restoring and maintaining health expenditure to the 1980 level of 8.7 per cent of GDP. It also calls for bed-capacity ratios to be raised to 9.7 beds per 1,000 population rather than the current 3.7 beds. There should be significant increases in staffing levels attached to the bed increases.