20 Euro cap for GP fees

newparty

For those who is not lucky owner of medical card GP visit could cost up to 65 Euro.
This is hardly affordable.
Government should strike a deal with GPs to limit charges at say 20 Euro.
For example let them have this money totally tax free.

Frynge

newparty wrote: »

For those who is not lucky owner of medical card GP visit could cost up to 65 Euro.
This is hardly affordable.
Government should strike a deal with GPs to limit charges at say 20 Euro.
For example let them have this money totally tax free.

But they are not paying in excess of 60% tax to make that comparison. Also there are a lot of bills that are quite frankly not being considered for such a suggestion to be taken seriously. All that aside from the fact that they are entitled to earn as much money as they can.

hmmm

But GPs are part of "the rich" who are already paying most of the taxes in this country. If you let them live tax free, who else is going to pay for all the free stuff everyone else demands?

endacl

newparty wrote: »

For those who is not lucky owner of medical card GP visit could cost up to 65 Euro.
This is hardly affordable.
Government should strike a deal with GPs to limit charges at say 20 Euro.
For example let them have this money totally tax free.

You haven't really thought this through, have you...?

Valetta

newparty wrote: »

For those who is not lucky owner of medical card GP visit could cost up to 65 Euro.
This is hardly affordable.
Government should strike a deal with GPs to limit charges at say 20 Euro.
For example let them have this money totally tax free.

How is it "hardly affordable"?

By all means call for the eligabity limits for medical cards to be reviewed, but why should doctors subsidise anyone's medical needs.

Also, you say "up to €65".
Shop around. I pay €40 in west Dublin.

Banjoxed

Any cost levied for GP fees blows any argument for a United Ireland out of the water.

efb

Doctors' fees are tax deductible with Med1 form

efb

Sure isn't Sky €45-105 per month, and not many go to the doctor more that once a month who have to pay

Frynge

efb wrote: »

Doctors' fees are tax deductible with Med1 form

But I'm confused...... Does that mean you have to pay tax to avail of it?

efb

If you don't earn enough to pay tax you WILL qualify for a medical card

Markcheese

Wouldn't be a bad idea to offer medical cards to all ... But not free just subsidized , so maybe a fiver a visit to those currently getting medical card, 20 a visit to those working ... The gp practice gets cash per visit, and a yearly fee per patient ...
Can't afford it .. Political suicide anyway ..

Geuze

People with med cards should pay 5 euro to discourage frivolous visits to GPs.

In France, GPs fees are based around a fixed fee set after negotiation with insurers.

That fixed fee is 23-25 euro, and the insurer reimburses 70% of it to the patient.

Note that France is a high cost society, in general.


Nobody has convinced me why they are 50 here.

That gap is so wide.

Cookie_Monster

how do you continue run a practice when you're mandating income be cut by 60%+?
The practice may not pay any tax anyway if it's not making a profit so the tax free bit is redundant.

quadrifoglio verde

Geuze wrote: »

People with med cards should pay 5 euro to discourage frivolous visits to GPs.

In France, GPs cost about 30-35euro.

Nobody has convinced me why they are 50 here.

Because the state payments to gps for their medical card patients really are sweet feck all, so your subsidising this low payment.
The amount you pay doesn't go to the gp. He has to pay rent, rates, utility, pay for equipment, cleaners, practice manager, maybe a practice nurse.
When you're getting 300 euro to see someone over 70 for the entire year ( there's many who'll be in the surgery every second day) you soon realise that it's not an awful lot once the bills are all paid.

Geuze

So private patients are paying more per visit, as the capitation fee from the GMS means a low-per-visit fee paid by the State for GMS patients?

freqeunt_guest

Frynge wrote: »

But they are not paying in excess of 60% tax to make that comparison. Also there are a lot of bills that are quite frankly not being considered for such a suggestion to be taken seriously. All that aside from the fact that they are entitled to earn as much money as they can.

its not that simple , GP,s are sheltered from competition , their is no cap on the number of hairdressing salons which can be openned , not the same with a GP clinic

freqeunt_guest

efb wrote: »

If you don't earn enough to pay tax you WILL qualify for a medical card

or if your over seventy and yourself and your spouse earn less than 900 euro per week combined

freqeunt_guest

quadrifoglio verde wrote: »

Because the state payments to gps for their medical card patients really are sweet feck all, so your subsidising this low payment.
The amount you pay doesn't go to the gp. He has to pay rent, rates, utility, pay for equipment, cleaners, practice manager, maybe a practice nurse.
When you're getting 300 euro to see someone over 70 for the entire year ( there's many who'll be in the surgery every second day) you soon realise that it's not an awful lot once the bills are all paid.

all business people have to pay various bills , utility , insurance , staff wages etc

unlike GP,s , a mechanic or a shop owner is not operating in a sheltered sector of the economy , we have an extremely low number of GP,s who practice in this country , the IMF recomended that this sector be liberalised , unfortunatley for us the doctor lobby has the ear of goverment

GP fees did not drop at all during the recession , if you exclude the rise in income tax , GP,s had no recession despite their protestations

percy212

Hmmm. Well my gp charges 50 per visit and he only takes cash. I bet he pays loads of tax.

freqeunt_guest

quadrifoglio verde wrote: »

Because the state payments to gps for their medical card patients really are sweet feck all, so your subsidising this low payment.
The amount you pay doesn't go to the gp. He has to pay rent, rates, utility, pay for equipment, cleaners, practice manager, maybe a practice nurse.
When you're getting 300 euro to see someone over 70 for the entire year ( there's many who'll be in the surgery every second day) you soon realise that it's not an awful lot once the bills are all paid.

all business people have to pay various bills , utility , insurance , staff wages etc

unlike GP,s , a mechanic or a shop owner is not operating in a sheltered sector of the economy , we have an extremely low number of GP,s who practice in this country , the IMF ( during our time in the bailout programme ) recomended that this sector be liberalised , unfortunatley for us the doctor lobby has the ear of goverment

GP fees did not drop at all during the recession , if you exclude the rise in income tax , GP,s had no recession despite their protestations

quadrifoglio verde

freqeunt_guest wrote: »

all business people have to pay various bills , utility , insurance , staff wages etc

unlike GP,s , a mechanic or a shop owner is not operating in a sheltered sector of the economy , we have an extremely low number of GP,s who practice in this country , the IMF ( during our time in the bailout programme ) recomended that this sector be liberalised , unfortunatley for us the doctor lobby has the ear of goverment

GP fees did not drop at all during the recession , if you exclude the rise in income tax , GP,s had no recession despite their protestations

Their state fees (which makes up the bulk of their work) has been cut.
Unlike gps, the mechanic doesn't have to provide maintenance at cut price rates to the majority of their patients.

freqeunt_guest

quadrifoglio verde wrote: »

Their state fees (which makes up the bulk of their work) has been cut.
Unlike gps, the mechanic doesn't have to provide maintenance at cut price rates to the majority of their patients.

the average medical card holder lands the average GP 700 euro per year regardless of how many visits that medical card holder makes , now granted some recently practicing GP,s tend to receive more but to say medical card holders are worth nothing to GP,s is a nonesense

GP,s in ireland are far and away the best renumerated in the EU

efb

yeah and they know their apostrophes from their commas!

freqeunt_guest

efb wrote: »

yeah and they know their apostrophises from their commas!

im raising a glass to your devastating wit

bbsrs

efb wrote: »

yeah and they know their apostrophes from their commas!

Have you tried reading a prescription ?

medicine12345

freqeunt_guest wrote: »

the average medical card holder lands the average GP 700 euro per year regardless of how many visits that medical card holder makes , now granted some recently practicing GP,s tend to receive more but to say medical card holders are worth nothing to GP,s is a nonesense

GP,s in ireland are far and away the best renumerated in the EU

Nonsense. They get around 300 euro per year for those over 70 but for most people they only get around 50 to 100 euro per year and the person can then go to the GP as many times as they like.
Where did you get the idea that irish GPs are the best renumerated in Europe? That is also nonsense. GPs have had cuts of 40percent in recent times from the govt. They couldnt even get aGP to take over a practice in Clare there recently. A lot of GPs are leaving the country, countries like Canada, New Zealand, etc are literally sending people over here to recruit GPs back.
It's unfortunate that private patients have to pay so much but in reality that will be getting worse not better for the foreseeable future with more people going on medical cards and more cuts to the payments for them, practices are literally closing down and they have to do what they have to do to make ends meet.

endacl

If I post it, it's true. GPs get free Easter eggs and rides in helicopters and it's their fault the shaggin' country is in the state it's in, with their five million quid a week per medical card patient even if they're not sick or anything and don't even go to the doctor. And public servants and stuff too. It's everybody that I'm not's fault and bloody government useless shower. Grumble. Blame. Water charge something or other should be free falls out of the feckin' sky state of this kip.

Have I got the gist of it right?

efb

bbsrs wrote: »

Have you tried reading a prescription ?

It's typed and the doctor signed it

morebarn2

My GP runs a system which i find good. I pay E19.50 per month, and then i can make as many visits as I like. It also covers all blood tests, visits to the practice nurses, Heart checks, vaccination fees, hearing tests and a few other procedures. I used to pay E55 per visit,so it is really worthwhile.

Admittedly, it is a large practice with a few doctors,but I always feel that I receive very good care and attention, and have my own doctor,whom i see every time.

Up to a few years ago, I would have been a very infrequent user of the surgery, but a chronic condition means I am now in a position where I need to be seen constantly,and have regular blood tests etc. due to the medications I use.

So I suppose they could be lucky and see someone very little,but get that regular income from the patient anyway. It certainly works for me.

beeno67

https://www.365online.com/online365/spring/moneyTransfer?execution=e9s1#
These are yearly payments for GPs for medical card patients. Works out at roughly €100 a year for every patient under 70 years old. Average patient attends GP 6 times a year so GP takes in about €16 per visit. This is gross income and is obviously not a salary. Out of this money comes expenses that any business has. They get additional payments above this for vaccinations and a few other areas. They also get a grant to help fund admin. staff but this only funds part of the wages of these admin staff.

Despite previous comments there are no restrictions on where a GP can operate beyond planning permission that applies to most businesses. A GP can open a practice next door to an existing surgery if he/she wants.

Markcheese

Gp's costs seem to be way higher than they used to be ,when I was a kid 20/30 years ago you saw the gp in his converted garage on the side of his house.or a small surgery down a side lane, there was rarely a receptionist and you saw your own gp because it was usuy a single doctor practice (who still did the emergency night and house calls)
Admittedly that was 70s 80s cork as I remember it , now it's all huge medical centers , with huge staff and huge costs ... (Often still with 1 or 2 doctors working out of them )

Idbatterim

ridiculous those with a medical card get it free and others who may be struggling as much if not more, pay E45-50 a pop. Medical card holders should be paying at least E10 per visit..

Markcheese

Idbatterim wrote: »

ridiculous those with a medical card get it free and others who may be struggling as much if not more, pay E45-50 a pop. Medical card holders should be paying at least E10 per visit..

Have heard several gps on the radio saying that private patients have effectively subsidised medical card patients... Of course over the past few years there's been a lot more of one and a lot less of the other, so what'll happen when the economic climate changes ??

murphaph

It was reported in the past that medical card holders visit a GP 8 times more often (on average) than non-card holders. If a nominal fee of €5 was charged to such patients I guarantee you their visits would quickly fall into line with everyone else.

This would allow GPs to charge less to everyone else as they'd have fewer medical card holders blocking their surgery with minor ailments.

murphaph

Markcheese wrote: »

Gp's costs seem to be way higher than they used to be ,when I was a kid 20/30 years ago you saw the gp in his converted garage on the side of his house.or a small surgery down a side lane, there was rarely a receptionist and you saw your own gp because it was usuy a single doctor practice (who still did the emergency night and house calls)
Admittedly that was 70s 80s cork as I remember it , now it's all huge medical centers , with huge staff and huge costs ... (Often still with 1 or 2 doctors working out of them )

You have to ask yourself though can a modern GP's surgery provide better care? I think it can. My GP here in Berlin has 2 receptionists who also act as practice nurses. He has all sorts of equipment that I never saw in a GP's surgery in Ireland and it means you don't need to visit a hospital for things you'd need to in Ireland.

When the missus was pregnant she never went to a hospital until the very end. The Gynaecologist down the road has all the ultrasound gear in her practice. It's much more decentralised here in that regard and I think it's right that GPs in Ireland move in that direction.

Godge

murphaph wrote: »

You have to ask yourself though can a modern GP's surgery provide better care? I think it can. My GP here in Berlin has 2 receptionists who also act as practice nurses. He has all sorts of equipment that I never saw in a GP's surgery in Ireland and it means you don't need to visit a hospital for things you'd need to in Ireland.

When the missus was pregnant she never went to a hospital until the very end. The Gynaecologist down the road has all the ultrasound gear in her practice. It's much more decentralised here in that regard and I think it's right that GPs in Ireland move in that direction.

Very good point. Moving the point of care away from expensive hospitals into the community is a good idea so long as you have catchment populations big enough.

Our stupid planning laws allowing a house in every field comes back to haunt us time and again.

murphaph

Indeed, but we can do it in urban areas. To be honest people who choose to live in a field shouldn't expect great medical care in close proximity.

Idbatterim

the time to introduce this charge was several years ago, well before an election and when they could have pushed it through. The same with the free travel passes, there should have been a 50c or euro nominal fee per trip. There has been trouble with Irish rail recently and Dublin bus drivers, and on the one hand you get sick of it and go stuff them, but on the other hand you have people who can travel with no limits and pay nothing, for a creaking service...

john.han

murphaph wrote: »

It was reported in the past that medical card holders visit a GP 8 times more often (on average) than non-card holders. If a nominal fee of €5 was charged to such patients I guarantee you their visits would quickly fall into line with everyone else.

This would allow GPs to charge less to everyone else as they'd have fewer medical card holders blocking their surgery with minor ailments.

No they wouldn't. The reason they go to the GP that much is that medical card holders are typically older/over 70. That's when illness becomes a common occurrence for most people. In addition many medical card holders have a long-term/serious illness. That's why they need to go to a GP often. Not because it's free but because they are sick.

n97 mini

My GP is one of those listed here.
http://www.leinsterleader.ie/news/local-news/top-five-kildare-gp-medical-card-earners-receive-over-2-3m-1-3502053

Despite receiving almost half a million euro for medical card patients he still charges €60 a visit for those unfortunate enough to have to cover their own costs.

quadrifoglio verde

n97 mini wrote: »

My GP is one of those listed here.
http://www.leinsterleader.ie/news/local-news/top-five-kildare-gp-medical-card-earners-receive-over-2-3m-1-3502053

Despite receiving almost half a million euro for medical card patients he still charges €60 a visit for those unfortunate enough to have to cover their own costs.

When you take out the cost of running a medical centre then it itsnt much money. The gp near me earned 400k from the gms scheme. However there's a practice manager, a practice nurse and four doctors there. Add in rent, rate and utilities and he isn't exactly rolling in it.

murphaph

john.han wrote: »

No they wouldn't. The reason they go to the GP that much is that medical card holders are typically older/over 70. That's when illness becomes a common occurrence for most people. In addition many medical card holders have a long-term/serious illness. That's why they need to go to a GP often. Not because it's free but because they are sick.

So medical card holders will just go to a chemist and pay full retail price for a cough mixture rather than going to their GP for a prescription so they can get it for free?

I would say a minority of medical card holders have a long term illness. They qualify on financial grounds, not medical grounds.

john.han

quadrifoglio verde wrote: »

When you take out the cost of running a medical centre then it itsnt much money. The gp near me earned 400k from the gms scheme. However there's a practice manager, a practice nurse and four doctors there. Add in rent, rate and utilities and he isn't exactly rolling in it.

If the GP wants they can go fully private and see how they fare.

john.han

murphaph wrote: »

So medical card holders will just go to a chemist and pay full retail price for a cough mixture rather than going to their GP for a prescription so they can get it for free?

I would say a minority of medical card holders have a long term illness. They qualify on financial grounds, not medical grounds.

For €2.50 you mean. Very few people go just for stuff like that, my point stands, older people, long term illness sufferers and those with serious illness need to go to GPs more often, that explains away most of the 8 times more often thing you brought up.

Everyone over 70 gets a medical card, the census in 2011 showed there was over half a million people over 65 in the country, most medical cards aren't a financial thing, it's mostly to do with age and health.

The solution to your little nugget isn't to charge them to go a GP, it's to allow pharmacists to make a quick judgment, check a person's medical card and give them the power to give out certain medications for the €2.50 fee.

medicine12345

n97 mini wrote: »

My GP is one of those listed here.
http://www.leinsterleader.ie/news/local-news/top-five-kildare-gp-medical-card-earners-receive-over-2-3m-1-3502053

Despite receiving almost half a million euro for medical card patients he still charges €60 a visit for those unfortunate enough to have to cover their own costs.

The govt loves putting these figures out in the public domain so that the public thinks that doctor x earns 500,000 or whatever. The practices with that amount of money would all be employing 4 or 5 doctors, a couple of nurses and a few secretaries etc but all the public think is that the doctor is making half a million profit for themselves..

woodoo

john.han wrote: »

No they wouldn't. The reason they go to the GP that much is that medical card holders are typically older/over 70. That's when illness becomes a common occurrence for most people. In addition many medical card holders have a long-term/serious illness. That's why they need to go to a GP often. Not because it's free but because they are sick.

They do, i know because i was a GP Visit card holder a few years back and i went anytime i had a concern. Now i have to pay 50 euro i put it off and put it off. This is the reality. Also, when i go to pay at the reception the vast majority of people breeze on by flashing the card and many don't even flash there card they just say good bye to the receptionist as they leave.

I have other family with cards and they go to the doctor more than my family that don't have a card. 50 a pop is steep for people so they don't go if they can avoid it. Free is another ball game altogether.

woodoo

murphaph wrote: »

So medical card holders will just go to a chemist and pay full retail price for a cough mixture rather than going to their GP for a prescription so they can get it for free?

I would say a minority of medical card holders have a long term illness. They qualify on financial grounds, not medical grounds.

There is a separate scheme for people with long term illnesses and they get a LTI Card.

murphaph

john.han wrote: »

Everyone over 70 gets a medical card.

No, they don't. My mother is over 70 and doesn't qualify.

You'll say it's just a once off but I know someone in their 30s who acts as a dispensing chemists to the rest of the family. All the medication picked up thanks to a medical card at our expense.

Geuze

john.han wrote: »

Everyone over 70 gets a medical card, the census in 2011 showed there was over half a million people over 65 in the country, most medical cards aren't a financial thing, it's mostly to do with age and health.

Automatic med cards for all people over 70 were brought in maybe 5-10 years ago.


But since then they are now means-tested.

The means-test was very generous, though, at 700pw / 1400 pw, ensuring that 95% of people over 70 continued to get a med card.

The means test has been tightened twice since.

To 600 pw / 1200pw.

2014 = 500pw / 900 pw.

Head The Wall

n97 mini wrote: »

My GP is one of those listed here.
http://www.leinsterleader.ie/news/local-news/top-five-kildare-gp-medical-card-earners-receive-over-2-3m-1-3502053

Despite receiving almost half a million euro for medical card patients he still charges €60 a visit for those unfortunate enough to have to cover their own costs.

So the latest figures are published and they relate to "2010"

Is it any wonder the HSE can't budget properly, you need proper up to date figures for that

Berserker

medicine12345 wrote: »

A lot of GPs are leaving the country, countries like Canada, New Zealand, etc are literally sending people over here to recruit GPs back.

Tell me about it. My OH is a doctor. All bar one of the group who came over here to study with her have moved back home. She is desperate to move back to Canada, for personal reasons and there are plenty of agents willing to facilitate a move back. We will be moving to Canada within the next 1-3 years.

medicine12345 wrote: »

It's unfortunate that private patients have to pay so much but in reality that will be getting worse not better for the foreseeable future with more people going on medical cards and more cuts to the payments for them, practices are literally closing down and they have to do what they have to do to make ends meet.

People seem to have this daft idea that the €60 you pay a GP goes into his or her pocket. They seem to forget that they are running a business. The upcoming surge in rent is going to hit them hard, so the cost per visit is going to rise again.

murphaph wrote: »

It was reported in the past that medical card holders visit a GP 8 times more often (on average) than non-card holders. If a nominal fee of €5 was charged to such patients I guarantee you their visits would quickly fall into line with everyone else.

It would also put a stop to medical card holders going to the GP with every tiny ailment. No chance that would ever be implemented though.