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November 19, 2003
Judging from news reports it would seem that the Howard Government is willing to spend big enough on public health (from $917 million to $2.4 billion) to neuter health as an election issue favouring the ALP. By all accounts the revamped package (dubbed MedicarePlus) has enough goodies (paying GPs an extra $5 to bulk-bill children; more doctors and nurses) and concessions (an expanded safety net for low and middle income families) to ensure that it will pass the Senate within weeks.
Health was a key negative issue for the Howard government with voters in the lead-up to the federal election. It has been addressed with buckets of money replacing the old modus operandi of bashing the Senate for its wilful obstruction has been quietly dropped.
Much of the Package will go through the Senate under ministerial regulation rather than legislation. Louise Dodson explains the strategy:
'By using regulation to get key parts of the package through the Senate, the Government has made it difficult for opposition parties to influence the new package because they will be presented with a "yes" or "no" choice on topics such as incentives for doctors to bulk-bill children of low-income families. The strategy does not give them the chance to propose amendments. Saying "no" to many of the proposed changes would be political suicide.'
Despite the modest investment MedicarePlus is a political winner as it leaves the Opposition Labor Party with little room to move.
And so the federal election has begun. Medicare is safe with the Howard Government is the political message.
Given that the incentives for doctors to bulk-bill are restricted to welfare recipients and children, the MedicarePlus package continues the trend towards a two-tiered health system: private health for the rich and public health for the poor. We already have a two tiered health system where wealth does buy better access and the user-pays principle that is replacing bulkbilling.
The long-term strategy of the Howard government is to push as much of health care spending off the federal budget----shifting to private health insurance. That is the right and proper policy intones the editorial in the today's Australian Financial Review (subscription required, 19 11 03, p. 70). The Howard Government is making the shift through a policy of eroding Medicare through shifting costs to patients. It does this in MedicarePlus by refusing to put public money into bulk billing for all citizens and by targeting concessions to specific groups. For the spin on this see Chris Sheils' Back Pages.
It is also doing little to reform the market for health-care services.
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it's the typical honest John strategy - dimsantle by stealth. but if you do the sums, hardly any get the concessions anyway.
i'd like to see him *really* privatize health insurance instead of propping it up with public monies and see how well that will go down with a spoonful of sugar