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"...public opinion deserves to be respected as well as despised" G.W.F. Hegel, 'Philosophy of Right'

the politics of health « Previous | |Next »
March 23, 2010

A health debate will take place between Rudd and Abbott today at the National Press Club, and it will be broadcast on national free-to-air television and Sky. The Canberra Press Gallery is delighted. More grist for their standard political frame of a Rudd v Abbott contest and they hope that there will be fireworks so they have something to write about other than who won.

So far it it has been less of a debate about health and more of a debate about public hospitals and the states. Rudd has provided increased funding for the hospitals, proposes to link the hospitals into local area networks and to fund them by taking 60% of the GST revenue from the states and introduce casemix hospital funding. Abbott's policy is local control of hospitals, more beds and, probably, federal funding for the local hospital boards.

So the "health " debate has been about who runs/funds the hospital system: the states, the commonwealth government, or local communities. It is hospital centric (more beds etc) despite the importance of community based services for mental health and aged care. Hospital centric is also how the Canberra Press Gallery frame the health debate.


What is not being addressed in the policy debate is the issue of how do we keep people health and out of hospital in the first place. These would include initiatives that will contribute to the prevention of chronic disease; better integrated, more flexible and comprehensive primary healthcare services; initiatives to enable health consumers to become better informed about how to stay or become healthy; integration of mental health into heal care and the modernization of health work force roles.

It is unlikely that these issues will be considered in the " great health debate" since Abbott is primarily interested in scoring points off Rudd---Rudd a policy ''fraud, fake and phoney'' etc -- than exploring how to address largely preventable chronic diseases associated with smoking, obesity and alcohol abuse – diseases such as cancer, heart disease, stroke, diabetes and kidney disease.

| Posted by Gary Sauer-Thompson at 8:56 AM | | Comments (12)


Its obvious that this thread continues from the previous," Playing doctors and nurses"- I think that's what he entitled it- since it has included the cartoon featuring results of this conduct with two contemporary proponents of this sort of behaviour.
Definitely playing "doctors and nurses" can have dire down stream health consequences, as the cartoon demonstrates, re Rann.

You can't have a debate about anything other than hospitals and hospital funding when that's all one side has, and the other side doesn't have anything at all. And both sides have said they won't be talking about anything that isn't already on the table.

John Doyle was right on Q and A last night. It will be a short entertainment to provide soundbites for the evening news. The format isn't even designed to allow debate. It's more an opportunity for media to set up a squabbling match.

The most rational thing to do is accept it for what it is and indulge in a bit of worm watching. Hoping for anything else will just result in disappointment.

I watched the ABC's live feed of the health debate--Abbott was handicapped by his strategy of being health policy light. He didn't really have a vision of how health system would work apart from a reference to local hospital boards and strong private health insurance, and so he attacked Rudd's policies.

The core line of the negative card on the health issue was the great big Canberra bureaucracy talking point. It was part of his general point that the PM could not be trusted (reinforced by continual references to pink batts and school halls). The talking point was "More beds not more bureaucrats".

So we have the core Abbott attack line--a bad plan from an ineffective prime minister--coupled to a strategy of tearing Rudd down from his technocratic pedestal into the boxing ring.

On the other hand, though Rudd was all about governance and financing and though he mentioned primary care he doesn't doesn't know what primary care is.. for him its all GP related services. There was really nothing about how his hospitals plan is going to link in with primary care, or improve community based care for mental health and aged care?

Then again no questions were directed at this point, indicating the Canberra Press Gallery's limited knowledge about health about the significance of community based care for an ageing population or health inequities. The gallery reports on health as a political contest rather than as health policy.They have no interest in health policy.

That weak point in Rudd's plan doesn't matter because the mainstream "health" media debate is locked into public hospitals (more beds and elective surgery waiting lists) not health. Even so, there wasn't even a question of the extent of the ineffective and harmful treatments....(Jayant Patel)

I started watching the ABC feed, but when I realised 9 was broadcasting live in Qld, opted for the worm instead.

"On the other hand, though Rudd was all about governance and financing and though he mentioned primary care he doesn't doesn't know what primary care is.. for him its all GP related services."

That, and getting aged care people out of public hospitals. He also didn't explain how these local networks are supposed to work or who would be accountable for anything other than funding decisions, but I guess that's as far as the policy's got so far.

On the shiny bits, if that's how Abbott is going to approach the campaign, things are looking even better for Rudd. Abbott's obviously popular with the gallery, but that doesn't mean much. Rudd's policy is popular with voters, and it's one Abbott probably would have proposed himself.

As expected, the media is all over who won and whether the worm is biased. The debate might as well have been over fence palings where media is concerned.

I didnt see it. Who won?

One interpretation from The Age. And another from the Australian. There's balance.

Some say that Rudd Kevin Rudd talked in focus group clichés to drive the Worm in his favour. Abbott's target was the Prime Minister's political credibility. Laura Tingle's judgement on Lateline.

Abbott has decided that it is easier to run a negative campaign than a positive one in the run up to the election. He has a problem with criticizing Rudd's hospital plan because, when he was health minister, he wanted John Howard to take over responsibility for hospitals.

In the Age Shaun Carney observes:

the probable shortcomings of the opposition's political approach in this election year were on display. They are threefold: that Abbott is overly reliant on Rudd to make mistakes; that he misinterprets the public's lack of affection for Rudd as a sign that they have no faith in the PM to do the job; and that his incompetence argument against Labor is more suited to a tired government in its third or fourth term rather than an administration in its first term, when there is still some residual public goodwill despite its failings. In essence, Abbott's message yesterday was that the Rudd government cannot be trusted to do anything because the home insulation and school computer programs have been severely troubled. It was not enough. The government has a health and hospitals plan; the opposition does not.

Fair comment. Without a policy Abbott has to remain overwhelmingly negative--just to oppose the Rudd government. So he'll be talking politics rather than policy.

The mainstream media and political insiders like Abbott’s standing and style as a political warrior. Does this negative style appeal to swinging voters in marginal seats?


that the public doesn't share the media's devotion to Tony Abbott is becoming more obvious. Regardless of how gimmicky the worm is, it's one among many and varied indicators of public opinion and probably has some influence of its own. The negative style and aggression are not a winning combination with the public, even though media loves it.

though the public doesn't like the aggressive negative campaigns, political campaign consultants say they are effective in shaping public opinion during an election.

The most recent example was the ‘robocall’ and a similarly themed brochure in Tasmania, in which Labor claimed that “the Greens support a plan to legalise heroin” even though the Green's policy explicitly said the opposite.

Labor’s television attack ad claimed in part that one of the Greens policies was to support the draining of the hydro scheme which flooded Lake Pedder “which provides up to 1/3 of the state’s electricity”. While Greens leader Nick McKim supported the campaign to drain Pedder, Hydro Tasmania’s data indicates that the lake contributes only 5.74% to the state’s electricity supply, an overestimation of the energy output of the lake by 480%.

True, Gary, but there's a difference between attacking the Greens and making aggressive, personal attacks on a still quite popular prime minister. There's also a difference between attacking a person and a policy.

Abbott did make some criticism of Rudd health policies--eg., Rudd's reforms won't end the blame game. But he was very silent on the quality of care issues (those adverse events such as the 200 unnecessary deaths per week) or the effective integration of private health insurance into the health system.