The Expert Panel on Medical Need for Medical Card Eligibility (Keane Report) says the system should be made sufficiently flexible and attentive to the most vulnerable individuals and those with critical needs.
It notes that many of the respondents to the public and patient consultation process indicated that the current system for allocating medical cards did not discern the true cost of chronic illness.
It says that many patients with chronic conditions, who do not have medical cards, pay up to the maximum of €144 a month for prescription drugs and visit GPs more often, which causes undue financial hardship.
In addition to paying the maximum for prescribed medication, some patients may often have to pay for other therapies.
The report says that legislation governing the award of medical cards does not mention the terms 'medical card' or 'discretionary medical card.'
It says that controversy over the withdrawal and subsequent reinstatement of a number of discretionary medical cards between 2012 and 2014 was due to several factors.
It says these factors included a long-established political and public level of dissatisfaction with the medical card system, perceived complexity and operational inefficiencies, a lack of understanding of the term 'discretionary', inconsistency in the assessment for medical card eligibility, and the inflated value of a medical card arising from the automatic entitlements to a range of non-medical benefits.
The report also says there was a lack of appreciation of predictable consequences arising from the 2001 centralisation of the administration of the GMS scheme in the HSE.
As previously revealed by RTÉ News, the report does not support having a list of conditions in priority order for medical card eligibilty, given the absence of international objective and reproducible methods of measuring the burden of disease and illness.
It says that the current system, as it stands, is not without its merits for the great majority.
