On Medicare
David Edmunds writes: Re. “All aboard the ghost train for Labor’s Mediscare campaign” (yesterday). Medicare is at risk. Over the last couple of years the coalition has introduced the co-payment, the huge forward cuts to hospitals, maintained the ridiculous private health insurance rebate, failed to take on the pharmacists or the drug companies over the use of generic medicines, then morphed the co-payment into the freeze on GP visit payments, a co-payment by stealth. It was vehemently opposed to the super clinics that would have actually reduced the pressure on hospitals and therefore costs. It appears to have no plans to redress its hospital cuts, nor real plans to introduce efficiencies such as capitation payments that may help contain costs. It has no plans to address the increased health cost burden that we will see in the near future.
Its approach to Medicare is very similar to its approach to public education. In this case it lavishly supported private education while playing a dead bat to public school issues. The result is a decline in education standards, arguably in part due the residualisation of some public schools as families chose better-funded private schools. The reduction of standards is then purported to be evidence that increased funding is not related to education standards, therefore providing cover for a policy of funding cuts. The analogy is clear.
Mr Turnbull may well be speaking honestly about his intentions, but he has not been able to convince his colleagues on any of the more centrist policies he once espoused, and it is unlikely that he will be able to on this issue. The ascendant conservative wing of the coalition is deeply opposed to Medicare, and unusually dismissive of policy promises made before an election. There is no doubt that any cost increases required to support Medicare will be declared unaffordable, all Labor’s fault, we live in tough times, and so on. No doubt Labor is running a scare campaign, but that does not mean there is no reason to be scared.
On Labor
Hugh McCaig writes: Re. “Rundle: Is Labor actually throwing the election?” (yesterday). Guy’s take on the Labor campaign launch at Penrith on Sunday night seemed intentionally negative , I thought. There can be no doubt that Bill Shorten has narrowed the gap between the Coalition and Labor over recent months and his performance on Sunday gave the party faithful and any others a look at an alternative possibility. Guy’s final para with his off-hand conclusion, “but we are all hedging our bets now” was meaningless.
I agree that we have reason to be scared over the end of Medicare as first rate treatment for all. The blocks put in place to be developed later are the limitation of tests to what the government approves for bulk billing, rather than what a doctor asks for. So far, people can have a barely adequate list of tests bulk billed but the Coalition government, if reelected, can simply fail to add new reasons for tests to the schedule of acceptable reasons for a test to be bulk billed, thus freezing the tests available to the poor without substantial out of pocket expense.
The freeze on the scheduled fee is also a death blow to medicare. That there are record levels of bulk billing now does not mean that there will be in future. The record overall levels conceal also inequities in local areas. Bulk billing for people who are not on pension cards of one kind or another is rare in the regions and in some areas in cities. But to cite present overall record levels as a reason to remove the reasons there may be overall levels is the greatest gCoalition deception.
In the end, decent health care will only be available to those with private health insurance. The only way to stop that is to refuse to give Malcolm Turnbull the chance to make the death of Medicare for ordinary Australians a stable part of Australia and to give him the chance to make the business tax rate for businesses on turnovers of 50 million 25%. By then, it will be arbitrary to withhold tax cuts from businesses like the banks with billions in turnover.