Issue 28 / 25 July 2016

THERE has been much conjecture since election night about the significance of health policy, and the use of a “scare campaign” in changing votes.

The Coalition attacked Labor over its “Mediscare” campaign, which deliberately painted a picture of a fully privatised Medicare. The Prime Minister subsequently called it an “extreme act of dishonesty”.

The Australian Medical Association (AMA), too, was critical of the opposition’s Medicare privatisation claims. There is, and was, no move to privatise Medicare. All that was announced, and later withdrawn, was a plan to look at outsourcing some backroom administration arrangements in the antiquated payments system, something that the AMA would still welcome and support.

Nevertheless, the political reality is that health played a major part in this election, and it was the Coalition that created and nurtured the fertile ground that allowed the scare campaign to grow and thrive.

The seeds of Medicare uncertainty, and fear, were sown more than 2 years ago with the Abbott government’s 2014 Budget and the birth of the copayment bogeyman.

For almost the entire term of the last government, the Coalition lacked a cohesive health policy narrative. The successive copayment nightmares, followed by the Medicare freeze debacle, were succeeded by a series of reviews which, while worthwhile, were never going to report or translate into policy until well into a second term.

As a result, the Coalition did not have a coherent health message to take to voters at the election. This played into the opposition’s hands.

The AMA, the Royal Australian College of General Practitioners and other health groups campaigned on issues that have a direct impact on patients – the freeze on Medicare patient rebates, the need for more public hospital funding, and the impact of cuts to bulk billing incentives for pathology services and x-rays.

These are issues that Australian families can relate to from their everyday experience. These are all issues that impact negatively on patients, doctors and other health care providers. But they were not issues that appeared from nowhere in the final fortnight of a long election campaign. They have been around since the 2014 Budget, and the Coalition did not acknowledge them as electoral threats, vote losers and game changers.

The AMA warned the government, under both Tony Abbott and Malcolm Turnbull, and directly to Health Ministers Peter Dutton and Sussan Ley, that the health policies from the 2014 Budget were bad and had to be changed.

When Prime Minister Turnbull met with the AMA Federal Council in Canberra just prior to the election, he was told firsthand by doctors from all states and all specialties that the Coalition had to change course on health policy.

During a meeting with the Prime Minister in Perth just weeks ago, in the middle of the campaign, I issued similar warnings.

But that is all now in the past. The election has been run.

The Coalition has been returned for a second term, albeit with a wafer-thin majority in the Lower House, and a potentially difficult mix in the Senate to deal with.

There is no doubt that the Coalition will take health policy very seriously ahead of the next election. The Prime Minister has made that clear, saying that “… a material number of Australians were sufficiently concerned about our commitment to Medicare that they changed their vote and that is something we need to address”.

The first bit of advice we offer the new government is to approach health policy as a means to improving public health and saving lives, not as a way to save money for the Budget bottom line.

Health policy must be driven by people who know health intimately, people with skin in the game, not bureaucrats from treasury and finance.

Investing in preventive health measures and in primary health care is not only a moral imperative, it is an investment in the economic productivity of our nation. Recent experience shows that it is also one in political survival.

Dr Michael Gannon is the President of the Australian Medical Association. This article first appeared in The Australian on 11 July 2016.

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One thought on “Time to take health seriously

  1. Dr Louis Fenelon says:

    Absolutely health must not be considered a budgetary problem. The budgetary issue within health expenditure is how much money never makes it to patient care, or makes less than a positive difference to public health.

    Process has overtaken provision and now defines health care. How do you make it clear that muddling over $$ removes $$ from medical care and meaningful action? Voters can’t convince pollies, so who?

    Primary care is about to take a huge hit from this or any government that won the election. There will be no undoing the rebate freeze, removing pathology/imaging bulk-billing incentives, or the forced implementation of MyHealth Record because of Health Care Homes conditions denying funding to patients without it. We are being played. A week before the election Turnbull (Q&A) stated GP salaries for complex, chronic care would be paid quarterly. How could he say that when the trial of Health Care Homes just started? Because it’s not a trial, but a mechanism to boost MyHealth record uptake prior to closing public health checkbooks to those without one, starting next year.

    If having another health budget monitoring tool isn’t bad enough, how do you “pay” GPs quarterly blocks of income? Answer – Practice Incentive Payments (PIP), easy for government. However most GP contracts exclude PIP payments. Can you sense an impending disaster?

    As a career GP I need to see a lot more than pondering over the election details. This is more important. Talk less. Fix more.

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