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August 11, 2005
Health is one of those public policy issues that sits in the political background and then hits the media headlines with high costs, budget blowouts, long hospital queues, poor services, bad administration and death. Behind the media headlines the Howard Government has undertaken some useful reforms of the health system. Tony Abbott, the current Minister of Health and Ageing, describes these reforms this way:
"...the Howard Government has rescued the private health insurance system, lifting coverage from 30 per cent to 43 per cent of the population and taking pressure off the public system. The Government has introduced a new Medicare safety net, based on the fee charged, to protect people with high out-of-pocket costs who are not covered by private insurance. The Government has boosted bulk-billing from 66 per cent to 73 per cent of GP consultations; increased medical student numbers by 30 per cent; introduced much longer medical consultations for the chronically ill; and given allied health professionals access to Medicare for the first time."
It's a good description of what has happened. The Minister then says that the conservative principle is not "states' rights" but "if it ain't broke don't fix it" - or more of a concern with right outcomes than right theories. He rightly says that there are no panaceas for addressing the current flaws in the health system:
"..the trouble with reform talk is the underlying assumption that there is some comparatively straightforward change, usually a philosophical one, that, once implemented, will make the problem swiftly and painlessly disappear. Market-oriented reformers assume that price signals will solve all problems.
Admirers of Britain's National Health Service think that planning and co-ordination are the universal remedy. There's much to be said for more price signals (even in health) as well as for good planning, but neither is a panacea if only because what's a solution to an economist is usually a problem to a consumer."
Alas, the minister then contradicts himself.
He reckons that:
The only big reform worth considering is giving one level of government, inevitably the federal government, responsibility for the entire health system. It won't resolve the eternal conundrum of how to provide better services while keeping costs down. It probably won't save the $2 billion a year predicted by some modellers but it will, at least, mean that there are clearer lines of responsibility and less incentives to make decisions on the basis of who pays rather than what's best.
However, he realizes that this kind of centralism, which deguts federalism, is not politically realistic. What is suprising is the Minister's lack of awareness about the way that he has dumped his conservative principles, and been seduced by big reform and sided with big theory. He has forgotten his Hayek and fallen to the fatal conceit of the socialists.
What is even more suprising is what the Minister does not say: that the importance of primary health care is to help reduce public hospital costs and the increasing costs of PBS. That approach to health care, with its diverse GP and wellness pathways, can give us right outcomes without worrying about right theories.
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Gary,
Thought you may be interested to see what Senator Milne said in her maiden speech:
"How can we protect global biodiversity if our own Environment Protection and Biodiversity Conservation Act fails so abysmally to protect biodiversity and fails so spectacularly to authentically domesticate our global obligations under the convention on biodiversity and the World Heritage Convention?"
Ahh, even after Brown uses the act, the greens STILL refuse to give credit where due!