For the Department of Health and Children, the scandal is that 1.15 million people used the scheme instead of roughly 700,000 in 1999. The way this is written one would think there was something wrong with this. An otherwise very intelligent man, the Minister of State stated the Department "considers it reasonable that the contribution by those benefiting from the scheme should reflect that high increase in spending." Why? Why should the fact that it costs more mean that people should pay more for it, given that most of the increase in spending is caused by the fact that more people are using it? Why are more people using it? Because the number entitled to medical cards has been reduced by 30% in five years. The Department penalises the people concerned for being sick.