Background: Outdated rules under scrutiny
At a Kerry County Council meeting last week, Councillor Angie Bailey delivered a pointed critique of the current medical card assessment rules. She described them as “fundamentally unfair” and said they fail to protect a growing cohort of young people who need medical support the most. The core concern? The medical card assessment for anyone under 25 is based on criteria that many argue do not account for the complex realities of late-diagnosis conditions or recently identified illnesses.
Councillor Bailey noted that the eligibility rules are stuck in a time warp, not reflecting the modern health challenges faced by young people. “We are asking young people to navigate a maze that does not recognise the realities of illness progression, misdiagnosis, and the sometimes delayed onset of chronic conditions,” she said. The implication, she argued, is that too many in this age group slip through the cracks, leaving them without critical financial assistance for essential healthcare.
The under-25 assessment: what’s changing and what isn’t
The current framework applies a uniform set of medical criteria to applicants under 25. Critics argue this approach fails to account for:
- Unrecognised illnesses that only become apparent after a late or initial assessment.
- The impact of emerging chronic conditions on families already managing tight budgets.
- Delays in diagnosis that can lead to years of untreated symptoms and escalating medical costs.
Advocates say that reform is not about removing safeguards but about modernising the criteria so they reflect contemporary health data, patient experiences, and evidence-based practices. The call is for a more flexible system that can adapt to new medical knowledge without compromising the integrity of the program.
Real-world impact: people living with unrecognised illnesses
Families affected by unrecognised illnesses often face a double penalty. First, the symptoms may be misunderstood or dismissed during early medical consultations. Second, even after a diagnosis, determining eligibility for a medical card may hinge on criteria that do not align with the realities of sudden disease onset or fluctuating health needs.
During the council session, residents shared stories of students and young workers who, despite heavy medical expenses, do not qualify for support under the current rules. These testimonies underscored the broader social and economic costs of an out-of-date system, including missed schooling days, reduced work capacity, and increased debt from medical bills.
What reform could look like
Proposed reforms include:
- Introducing a tiered assessment approach for under-25s that recognises gradual onset and fluctuating symptoms.
- Incorporating patient-reported outcomes and real-world data into eligibility decisions.
- Creating a fast-track pathway for those with uncertain or recently diagnosed conditions to access interim support.
- Adjusting income and asset thresholds to reflect contemporary living costs in Kerry and surrounding areas.
Supporters also emphasise the need for better appeals processes and clearer guidance for applicants to reduce delays and confusion.
A call for broader reforms beyond age lines
Crucially, Councillor Bailey’s remarks framed the issue as part of a larger conversation about health equity and the social safety net. She argued that reform should extend to how medical cards interact with other supports, such as health insurance, employment protections for students and young workers, and access to timely clinical assessments. In her view, a fair system for under-25s would not only be about eligibility but also about ensuring equitable access to prevention, early intervention, and ongoing care.
Looking ahead
While the council has not yet enacted any concrete changes, the debate is likely to influence discussions at regional and national levels. As health systems grapple with rising demand and evolving disease patterns, many communities are watching Kerry’s deliberations as a potential blueprint for fairer eligibility guidelines that protect young people during the most financially vulnerable years of their lives.
