Many people without medical cards are not going to their family doctors with health problems due to the cost, a new study by primary care researchers has found.
The researchers from the Republic and Northern Ireland have urged the Government to introduce 750,000 additional medical cards for people who cannot afford to pay their GPs. They have written to the Minister for Finance, Mr Cowen, and the Minister for Health, Ms Harney.
They say they have taken the unusual step of revealing their results in advance of academic publication because of their relevance to the current healthcare debate and because the results are "so striking".
The researchers matched 12,000 patients from 20 general practices in the Republic and 20 general practices in Northern Ireland, and questioned them about a number of socio-economic and health status markers.
Asked "during the past 12 months was there a time when you had a specific medical problem and did not visit the doctor due to cost?", 25 per cent of private patients in the Republic said there was. The figure rises to 40 per cent in the 20-29 year age group.
"Worryingly, those who are affected most are those in poor health, those with long-term illness and those in younger age groups," the authors said in the letter to the Ministers seen by The Irish Times.
"On more detailed analysis of our data it is evident that the deterrent effect of cost is widespread throughout income groups, and not just those who are above the medical card limit.
"Our conclusion is that a large proportion of people in the Republic of Ireland are deterred from seeing their general practitioner because of cost," the researchers, who include professors and senior lecturers in general practice and public health, stated.
"This inevitably results in the delayed presentation of acute conditions, poorer control and management of chronic conditions such as asthma, diabetes and hypertension and reduced opportunities for prevention and health promotion."
Asked why they had taken the unusual step of writing to Mr Cowen and Ms Harney in advance of academic publication, Prof Tom O'Dowd, professor of general practice at Trinity College Dublin, said the research put a figure for the first time on the amount of financial distress people have in going to see a doctor.
"It explains some of the queues seen at accident and emergency, where these people will often get inappropriate medical attention. The research shows there are not enough medical cards in the system, and that the ambition to add another 200,000 GMS cards is too modest," he told The Irish Times.
Ms Harney is focusing on increasing the eligibility limits for the general medical services based on income and not on a specific number of additional medical cards.
She is also to examine ways of increasing free medical care for children.