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One Term Tony?

10 Jun 2014

Considering there was no genuine consultation with doctor representative groups, and no sound input from the medical coalface, regarding proposed changes to health care financing, this was indeed an “enlightened” Federal Budget.

The litmus test for me was to see if our ‘brave’ new government embraced the deregulation of pharmacy advised by the National Commission of Audit. They did not, so I will not use the word brave in regard to this Budget again.

Though, thankfully, it is hard to picture many of the proposed Budget changes getting through the Senate in their current form, it is worth having a look at them in detail.

The first is to apply a GP tax, imposed on those who actually use health care most frequently: the aged; those stricken with cancer; children; chronic disease sufferers; residential aged care facility residents; the Indigenous; plus those who want to embrace preventative care.

In brief, it will most heavily on those most often unable to pay, and also penalises those most prepared to seek help to stay healthy (and thus reduce downstream tertiary care costs where the big dollars go). The wealthy, who could and should make co-payments, are not targeted.

Such a simplistic policy smacks of a philosophy which is un-Australian. Aussies are generous people. We care. We are not a nation of bean-counters. We value mateship, not elitism. We value caring more than costing. We are proud of our current universal access to quality health care.

Encouraging preventative health care, not discouraging it, is where the savings lie.

The $2 "bonus" for GPs is no such thing. It will be eaten up by tax collection administration costs.

Secondly, the Budget slashes public hospital funding for the states.

Indeed, if we pursue this line of thought that less is more then, rather than embracing as heroes those citizens shaking collection cans at the roadside to support their local children's hospital or other hospitals, perhaps we should denigrate them.

But let us get focussed.

Apparently, in the eyes of this removed-from-reality Budget, it makes economic sense to let the ill perish with minimal care. Perhaps charities focussed on expanding health care should be banned, and the seriously ill and poor not offered care but be publicly belittled and expeditiously removed. Such thinking is immoral and unsound nonsense.

Thirdly, the Budget freezes Medicare rebates for specialist consultations.

Specialists are already being hit with the Budget bail-out tax levy. Now those compassionate enough to bulk bill will see their incomes slide. Patient gaps will grow, resulting in less private care, and more demand for public care.

What is the philosophy underlying these changes? Is it stupidity? Or worse, does it reflect a desire to see persecution of the unwell who seek taxpayer-funded care?

It certainly embraces use of barriers to the access of care, which in turn creates cost shifting to the states via public hospitals.

Fourth, the Budget applies harsh new eligibility criteria for youth unemployment benefits.

As a wealthy society with no real budgetary crisis, we do not want or need the divide between rich and poor to be accentuated.

We do not want the young unemployed persecuted and denied support.

We must realise that if we do cut this support, we will force some into crime and extremism, and many others will suffer worse mental health outcomes.

These are not attractive outcomes for society. Why cannot our elected representatives realise this?

What are the options?

These are clear.

If we must choose enforced medical co-payments, providing we seriously believe there is a fiscal crisis facing Australia, then for heaven’s sake, let’s have payments confined to those who can afford them.

That is, let them be targeted, not just applied as a blanket thrown over all and suffocating the most needy.

Secondly, cost-shifting between the states and the Commonwealth must end.

It all too often pervades and perverts policy. Perhaps a single funder of health care is the only way to be rid of it.


Published: 10 Jun 2014