Dan Boyle (Green Party)

No. Since 1908, people have been living longer and healthier lives, fortunately, but their health needs and the cost of meeting them are also increasing. The Government is committed to introducing the best possible public health care service for the maximum number of people in society. Where that cannot be met from public resources — it must be remembered we are dedicating €16 billion of very scarce public resources a year to the health services — there is a contribution principle for those who can afford to pay. More than half of adults have chosen to do this by subscribing to private health insurance. Other people have other means at their disposal.

The introduction of universal medical cards for the over 70s was badly handled. It was ill-thought out and quickly put in place with no real assessment of its likely costs. As a result the scheme's costs became far higher than ever anticipated, however much political argument can be made that it was good for those who benefitted from it.

It has been forgotten that a small but significant group in this age group have resources. The State has been subsidising many of them twice, once in the form of a free medical card and then in the form of tax relief on their medical insurance should they choose to remain in the private health insurance system. This whole area, therefore, needs to be examined.

Undoubtedly, this process could have been handled better. The ultimate result, however, has been the setting of limits that reflect the incomes of the majority of people in this age group and the meeting of their health care needs through a cost to the public purse. I find it shocking that the average income for people in this age group is €260 a week. That is a wider issue and reflects badly on the society in which we live and how wealth is distributed. People from this age group are among the poorest people in our society, albeit still a wealthy society. We need to come up with a political response that addresses their needs in the best possible way.

I do not believe universality is the best way of doing that. If someone in this age group can meet health care through their personal resources, the State should stand aside. We know this is not the case for the majority in this group. The Government has now set benchmarks to meet their needs. The responsibility will be for whoever is in government in the future to assess those benchmarks, keep them apace with the prevailing cost of living and ensure this age group's needs are being met.

The programme for Government seeks to increase medical card entitlement across the population — for example, extending eligibility for children under five years and for those with an intellectual disability under 18 years — but not in the form of universality. It is a source of disappointment that this has not been achieved as it is resource linked, but it remains the Government's intention. It also means the existing criteria for medical cardholders need to be examined.

It is also unacceptable that resources have not allowed us to examine general eligibility levels for medical cards for the wider population. Up to €16 billion is spent annually on the health service. Either we make the difficult choices that need to be made to allow those resources to be better used or we limit the eligibility to an entitlement many of us believe should be more open and widespread.

I want to hear from the Opposition — those who aspire to being or could possibly be in government shortly — how it would answer these questions.