23 July 2003

To prevent Medicare hit, senators must not fall for the myths

"Subsidising the private system takes the pressure off public hospitals." This is a Howard favourite. Despite its commonsense appeal, it's rubbish. Private hospitals carefully cherry-pick the most profitable patients, services and locations. Howard's 30 per cent health insurance rebate is wasting $2.5 billion dollars a year on the private health-care industry.

Poor people's taxes are subsidising wealthier people's private treatment. The Government and the private sector tell us the rebate is worthwhile by repeating how busy private hospitals are, but the pressure on public hospital emergency departments and operating lists hasn't fallen. Let's hope the senators aren't fooled by these myths.

Far better than destroying Medicare, they could focus on the Commonwealth and state governments developing a national health plan to provide high-quality, publicly funded health services for all Australians; increasing bulk-billing by GPs by increasing the Medicare rebate; encouraging the development of primary health-care centres where GPs work with other health professionals to provide a comprehensive service; increasing the funding for Aboriginal health; residential care for older people; dental care; community health services and health promotion; and also possibly public hospitals.

This sounds expensive but much of it could be funded by abolishing that ineffective private health insurance rebate. Perhaps we also have to increase the Medicare levy, something surveys have repeatedly shown Australians would be happy to do.

Howard's Government wants low taxes so you'll vote for it again. The private health-care industry cares more about its profits than your health. A strong, well-planned, adequately funded Medicare is the best and cheapest way to provide first-class health care for all Australians.

My only disagreement is that I think calling the non-Medicare health industry 'private' is ridiculous. They are entirely dependent on federal subsidies and without those subsidies they would disappear. Now the Howard government allegedly believes in the market, but not if it means allowing the non-Medicare funds to go under.

The real solution to Medicare's problems is to increase the bulk-billing rebate paid to doctors by Medicare. The current plan does not do that and merely offers a top-up far short of what the medicare rebate should be.

Further, by introducing categorical payments the Howard plan drives a wedge through medicare as a universals service and that wedge will presumably allow them to campaign on the future on overuse of medical services by evil dolebludgers. It's wedgefare not welfare - social policy as a campaign tool.

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