Let's first deal with the rank hypocrisy. The opposition is up in arms over the decision to abolish free medical cards for the over 70s. Chief fulminator is Fine Gael health spokesman, James Reilly.

This is the same James Reilly who had much to say about the introduction of the scheme in 2001. Back then, he wasn't a politician, but the president of the Irish Medical Organisation, representing most of the country's GPs.

Reilly's view on the scheme then was that it represented the "handing out of free medical cards to people who can afford golf club fees". He was also quoted as being "angry" at the government decision. Within months, he and his colleagues got over their anger.

With the government over a barrel, the IMO negotiated a deal that saw doctors receive four times what they were getting for normal card holders. The 'gold card' was a bonanza for doctors and a disastrous deal for the state, primarily because Bertie Ahern and Charlie McCreevy were focused on pushing it through for maximum electoral gain. The state, not for the first time, was badly served by both politicians and the medical profession.

Here's what Reilly said in the Dáil on Thursday about his role in the deal back in 2001: "I can't help it if government ministers are so incompetent they can't count or don't know how to do deals."

Was he speaking here as a politician concerned with the welfare of elderly people and the state of the nation's economic health? Or as a doctor's representative who saw the potential to exploit state incompetence and went after it?

The opposition has a job to do – but the main opposition party's spokesman is completely compromised.

Reilly's former colleagues in the medical profession were also to the fore on the airwaves last week. Repeated­ly, when confronted with the terms of the deal they negotiated, they have spun the line that the sacks of money garnered from the scheme were reinvested in their businesses.

So what? Unless they are running not-for-profit practices, it doesn't matter a damn what they did with their money. None of them deny that the deal they managed to negotiate was extremely generous. And it is the terms of that deal that prompted the government to move to abolish the scheme. If, as projected, the cost of introducing the scheme had been £20m, Lenihan would have left well enough alone last week.

As a policy on paper, the abolition looks justified. In a society that has embraced capitalism with a vigour over the last decade, the notion of universal coverage for anything is simply untenable.

There are at least 33,000 millionaires in the state and hundreds of thousands more – in public and private sectors – who have done very well.

But up to 300,000 people remain in consistent poverty, around twice that figure in danger of falling into poverty.

Irrespective of how well the economy is doing, there are but limited resources. In such an environment, no excuses can be made for subsidising the well-off, whether it be through universal health cover, college fees or child benefit.

The problems in this instance arose when the policy was made flesh. Elderly people are vulnerable when it comes to health. Fear of deteriorating health is very real because most likely health will begin to deteriorate in the near future.

Fear itself can hugely exacerbate health at that station in life, when even the most distant rumble of trouble is likely to be amplified. Brian Lenihan's pre-budget submission that we have nothing to fear but fear itself rings hollow with a constituency which is accustomed to fear's chilly presence.

There are also more grounded reasons for the fear and panic that has spread since Tuesday. The introduction of this scheme was laced with incompetence and cynicism. There is no reason to believe efforts to replace it won't be equally scary.

Through last Wednesday, the HSE website provided four different versions of the new threshold of income for over 70s seeking a medical card under the new regime. The government has given out different figures – ranging from 14,000 up – representing the number of people who will be left to their own devices.

When introducing the scheme in 2001, McCreevy declared that only 30,000 people would benefit from it, an estimate that turned out to be grossly inaccurate. How can anybody have confidence in either the HSE or the government to properly implement a new regime in light of their respective form in this area?

Now Cowen has lobbed the ball into the doctors' court. Form suggests there will be no shifting them, certainly not by next January. Maybe the government could enlist James Reilly to give them a dig-out in negotiations with his former colleagues.

Meanwhile, lying up in Brussels and Drumcondra, the real architects are far from the maddening crowd. Don't expect Ahern or McCreevy to come out and admit that their cynicism in ransacking the state coffers for electoral gain has landed their successors in serious trouble at the worst time possible.

The long, bumpy ride through recession has hit its first deep pothole.

mclifford@tribune.ie