Editor—Health politicians in Slovenia introduced an identity health card for almost the same reasons as described in the article by Pollard and Savulescu.1 Four years later, I have to admit that this has some benefits for the healthcare providers. With a patient's valid identity card you do not ever have problems with billing patients' visits to the insurance fund, because the validity of the card is a guarantee that you will get the money.
On the other hand, a legal or human rights question arises, which should be addressed in addition to ethical questions. Is presentation of a valid card on the occasion of the visit to the practice more important than the insurance status of a cardholder? If patients cannot provide a valid card at the time of the visit they have to pay, despite having valid insurance. Such cases are rare, perhaps one in 100, but nevertheless difficult for general practitioners, who became public insurance servants. The profession and public should be vocal while this instrument is introduced into the NHS because later those who have problems will not be heard. Legal experts and patient representatives should be consulted.
Identity cards are not a panacea for the financial problems of healthcare systems. They are more or less a cosmetic attempt rather than some breakthrough innovation in how to collect enough money to deliver quality services.
Competing interests: None declared.
References
- 1.Pollard AJ, Savulescu J. Eligibility of overseas visitors and people of uncertain residential status for NHS treatment. BMJ 2004;329: 346-9. (7 August.) [DOI] [PMC free article] [PubMed] [Google Scholar]