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February 25, 2004
Health continues to bubble along as an central issue in public policy circles. It's an issue that continues to favour the ALP. Bulk billing rates are declining; doctor's costs are rising; and attendances at doctor's practices are down. So what is going on here? What is happening if people are not going to see the doctor when they are sick?
Some---concessional card holders----are accessing the emergency departments of public hospitals. The others? The inference is that many of the working poor are not accessing the public health system. But it is not as simple as bulk-billing rates are disappearing and more people are turning up at hospital casualty departments, placing greater financial strain on a system funded federally but administered at state level. It means that people remain sick until they are faced with an emergency.
Here is the speech of Julia Gilliard, the ALP's Shadow Minister for Health, to the Australian Financial Review's 6th Annual Health Congress.
The AMA says that the key to evaluating our health system for patients, is being able to see a doctor when we need one.
Well, they've got that right. Speaking at a speech to the Financial Review's 6th Annual Health Congress Bill Glasson, the President of the AMA, goes on to say:
"It’s not as easy to get hold of a doctor when you need one these days, especially in country or outer-suburban areas. The concept of universal access to health care has eroded. Many Australians are paying more for their health care because Medicare has been neglected. But it doesn’t have to be that way. If we can find money for border protection and offshore detention centres, we can properly fund our health system."
That is a perspective that is widely shared by public opinion. Whilst the Howard Government talks about spending the budget surplus on tax cuts, the majority of Australians (around 72%) want the budget surrplus to be spent on health and education.
Glasson then socks in the hits:
"Medicine has traditionally been the top of the heap of career choice for our best and brightest students.That reputation is slipping away.
Why?
Too many bloody hurdles. Too much intervention.
The doctor-patient relationship does not want or need a Treasury official as note-taker. The doctor-patient relationship does not need the ACCC to brand rosters and job-sharing as anti-competitive. Student doctors should not be press-ganged into serving in country areas. A doctor should practice where he or she wants to practice, but incentives are needed to attract them to work in more remote areas.Red tape is strangling general practice. The Medicare patient rebate is dudding the patient.
These are causing massive damage to the system."
This is the restrained response by Tony Abbott, the federal health Minister. The Howard Government is doing a good job of managing the massive health system in a responsible and innovative way, despite the expense and cost blowout.
However, Abbott is reported in The Australian as being more provocative. He is reported as saying (p.5) that instead of the states laying blame on Canberra for the things that go wrong, the states should hand responsility for health to the commonwealth in the spirit of co-operative federalism.
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Cracks? Those of us working in it can tell you that there are great gaping crevasses. There's always a temptation to blame the incumbent federal government and to relieve the states of responsibility for any cockups, but when Carr (NSW) pulled $40M from the 2000 health budget handed down by the Howard Government...what can one say.
I am sick to death of successive governments saying one thing and doing another. In NSW even now their public relations say "we are spending more on health" at the same time as every health area has had funding PULLED in its millions this year. They lie and deceive at every level and in every party. And the losers are those at ground zero. The patients.
"more nurses" and "more doctors" is not going to solve the problem.
*mutter*