||Issue No. 204||21 November 2003|
Holes in the Net
Interview: Union for the Dispossessed
Unions: Joel's Law
National Focus: Spring Carnival
Bad Boss: Fina and Fiends
Industrial: The Price of War
Economics: Who's Got What
History: Containing Discontent
Review: An Honourable Wally
Poetry: The Colours of Discontent
Public Transport A Bit Rich
Holes in the Net
Tony Abbott's 'Medicare Plus' fix, for all its window dressing of fairness is based on the Howard Government's ideological opposition to bulk billing - or free health care for all.
It could be better described as 'Medicare Plus Money' because it is all about promoting user pays - unless your health costs will be so high that you would be good talent on A Currant Affair.
Tony Abbott talks about 'taking the losers' out of the system, when in reality he is creating a system of up-front fees for medical care, but with some support once you are seriously ill.
At the same time, he intends to increase the number of doctors and nurses in the system, on the old and flawed free market theory that more providers will equal more competition which will in some way encourage some doctors to offer cheaper services.
What he is attempting to do is entrust health care to market forces; ignoring the reality that the health provider market is as likely to support bulk-billing as the property market is to support public housing.
Under Labor, Medicare and bulk-billing was and remains a social policy response to a major social problem - the inequality of health care. It is an area where market mechanisms are destined to fail, so the government steps in to construct a system of universal service.
The big concern is that the Abbott model is likely to lead to significant 'market failure' with patients who should be seeing doctors lining up in the emergency wards where the service is free. This represents a drain on casualty wards and a massive exercise in cost-shifting from the Commonwealth to the States.
These fears are backed up in a recent Newspoll conducted by the Health Services Union. When asked what would happen if the government stopped bulk-billing, nine per cent said they would go to a public hospital, while 30 per cent said they would put off care if at all possible.
The second statistic points to another market failure - when people do seek health care they will be sicker, with ailments that are more costly to address. Goodbye preventative health, hello higher health costs all round.
In Abbott's hands we have a political fix, that fits the Prime Ministers's view of Medicare as ideologically repugnant, while minimising potential for short-term damage leading up to the election.
Our real problem is that in the long-term, we are seeing the beginning of a US style system when health is a private problem not a public issue.
Drawing down Medicare to a 'safety net' is fraught with danger - after all, everyone knows that what defines a net is its holes.
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