September 07, 2004
Health: negating ALP advantage
This captures the pressure the ALP is under:
The missing page is the underfunding of Medicare and the public health system.
Hence this. The Coalition will extend the Medicare rebate for visits to general practitioners from 85 per cent to 100 per cent of the scheduled fee. This will play well in those marginal electorates with a shortage of doctors, where health is one of the top two issues, and doctors already charge $15 to $20 above the bulk-billing rate.
Labor owns the health issue and it should be able to win a debate on health, given that the Coalition once promised to dismantle Medicare. Yet what we see is the continual chipping away of the ALP advantage by spending big money on health. Howard is determined to own health as a political issue for the Coalition by tightly squeezing the ALP.
So it comes as no suprise to me that the Coalition has come from behind in the polls and is now in a dead heat with Labor on a two-party preferred basis.
The ALP is currently talking about restructuring the federal compact with a pooled funding arrangement between the states and commonwealth. It is a limited redesign with a technocratic focus on change management and big system expertise.
Neither political party is addressing GP shortage (more university places) or competition to GP's and specialists from a variety of alllied health professionals. There is a huge workforce shortage. As the Australian Medical Association president, Bill Glasson, says:
".... unless we can get more doctors into the system, particularly general practitioners, there are not going to be the doctors there to see the patients of tomorrow...We have got to make general practice more attractive - it is the cornerstone of the medical system in this country."
As Glasson points out, there are limitations to the ALP's concern with bulk billing (eg., getting the bulk-billing rates in Australia back up to 80 per cent):
"Bulk-billing is not a measure of the health of the medical system in this country. Bulk-billing is just a means by which doctors can bill the government for the service that they provide."
But it is good cash flow for the GP and specialists all the same.
However, Glasson is right about the need to focus on workforce issues. There is a big doctor shortage, especially in the regions outside the capital cities.
What Glasson does not do is to talk about general practice in terms of a diversity of health professionals. If the ALP is obsessed with bulk billing rates of 80%, then the AMA is obsessed with doctors running the health system.
Posted by Gary Sauer-Thompson at September 7, 2004 03:28 AM
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