The chairman of the Irish Medical Organisation's (IMO) general practitioners' committee has called on the Government to immediately double the income limits for medical card eligibility.
Dr James Reilly said many patients just outside the General Medical Scheme (GMS) eligibility limits were unable to access primary healthcare.
"These patients are waiting until the last minute before seeing a doctor. They are then acutely ill, with no option for the GP but to admit them as emergencies to hospital."
The upper limit of weekly income for a single person under the age of 66 to be eligible for a medical card is £93.50. Dr Reilly was critical that the married limit was £150 which, being less than double the single limit, was iniquitous, he said.
Referring to the falling percentage of the population covered by the medical card scheme, Dr Reilly said any savings the Exchequer might make on the 150,000 people no longer covered by the scheme were negated by the much greater costs associated with acute hospital admission.
Latest figures show the percentage of the population covered by medical cards has fallen from 37.45 per cent in December 1988 to 30.94 per cent in June 2000.
Within the Eastern Region Health Authority (ERHA) area, the percentage of medical card holders is 25 per cent. Referring to speculation that the Government might be about to grant medical cards to all children under the age of 12, Dr Reilly said such a selective expansion of the GMS would be socially and morally unethical.
The IMO also pointed to a key objective of the Programme for Prosperity and Fairness which was to "improve access to quality healthcare services in order to strengthen social inclusion and cohesion . . ." It said the real decline in the number of people covered by medical cards meant there was a substantial segment of the population for whom access to the most basic level of medical care was now unaffordable.