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The Budget war

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Dust from the explosion of the Budget bomb has yet to settle. It is hard to see what buildings remain and what the final body count will be.

Co-payments for bulk-billed consultations will preferentially affect those least able to pay – the less well-off and the self-funded retiree struggling with the costs of diabetes and heart disease. Co-payments are the biggest bomb craters immediately visible that distress and upset just about everyone.

As in war, logic and truth were early casualties. We were told for months before the Budget that the health system was unsustainable, yet the evidence suggests otherwise.

The argument was economic, meaning that we are running out of money, which is nonsense. The determination of sustainability is political – as a rich society we can sustain what we want to sustain, be it war or peace. We can buy jet fighters, detention camps or hospitals at will.

Co-payments were touted as a way to make us all pay more at the point of use of health care and so rescue health care from bankruptcy. But in general practice? This is not where the big costs are. Co-payments were dropped from the sky.

Smart bombs at that – not blitzing the wealthy but those who are bulk billed – served by the least politically powerful medical craft group. Massive opportunities for efficiency savings in hospitals and the pharmaceutical supply line were ignored, presumably because they would require intelligent analysis, political effort, recruitment of the medical profession to formulate policies, and guts.

Then, miraculously, when the budget was released like a missile from a drone, the sustainability of health care was no longer a reason for attack. Instead, (taking a page from the Gospel of Bush and Blair, like the missing weapons of mass destruction in Iraq), the unfindable unsustainability crisis did not deter those with their fingers on the buttons.

Co-payments, now rebadged as a revenue stream to fund a Medical Research Future Fund that the College of Physicians – perhaps with irony or perhaps not – termed “visionary”, were fired off to the amusement of the Prime Minister sitting listening to Budget. Funny weird, yes, but not funny funny.

The Medical Research Future Fund will support research decades hence that, the Treasurer believes, will enable us to cure diseases such as dementia and the degenerative disorders that are now epidemic worldwide. Oddly, the fact that these diseases can be prevented was not only dismissed, but the money for preventive programs – and a national agency designed to deal with the forces such as food, alcohol, tobacco and urban design that cause these problems – was removed, much to the delight of the brewers and the food industry. Too much prevention would mess with the profits of these corporations and diminish the market for pharmaceutical cures for the diseases researched in coming decades with money from the research fund.

The lack of logic and policy manifest by the recent health budget is not just breathtaking. It is asphyxiating.

The jumble of ideas is haphazard, insensitive to (one must charitably assume) unintended but fully predictable side effects, and disingenuous in its use of erroneous scare tactics about sustainability.

Strong resistance to its more ethically objectionable elements, of which the co-payment is paramount, is surely justified. We deserve much better than this.

This Budget is a disastrous beginning for the new government.

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