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Issue No. 204 21 November 2003  
E D I T O R I A L

Holes in the Net
The Medicare debate may be clouded by the minutae of the health delivery system, but it really boils down to an old-fashioned ideological battle between user-pays and state responsibility.

F E A T U R E S

Interview: Union for the Dispossessed
The Welfare Rights Centre's Michael Raper on 20 years of activism, the politics of punishment and how to make Australia egalitarian again.

Unions: Joel's Law
Building Workers have overcome powerful forces to push workplace safety back up the national agenda. But, Jim Marr writes, their "success" has come at an unacceptable cost.

National Focus: Spring Carnival
It must be spring: punting in Victoria, singing in South Australia, fighting in America. It’s all there in the national wrap from Noel Hester plus an Australian union movement rugby world cup class consciousness poll.

Bad Boss: Fina and Fiends
They sacked the job delegate, reinstated him after an IRC hearing, and sacked him again two weeks later. But that was just the beginning.

Industrial: The Price of War
Mass industrial action is brewing in Israel as the policies of the right-wing Sharon Government come home to roost, writes Andrew Casey.

Economics: Who's Got What
Frank Stilwell pours over the latest BRW Rich List to build a picture of the increasing gap between the haves and have-nots.

History: Containing Discontent
Racism against minorities has always been a stock in trade of politicans, writes Phil Griffiths

Review: An Honourable Wally
Most Australians probably look at our politicians and feel they could do a better job but when redundant meatworker Wally Norman gets the chance to find out he realises getting elected is a major hurdle, writes Tara de Boehmler.

Poetry: The Colours of Discontent
A thousand blossoms bloomed during the US President's spring-time colonial visit last month.

N E W S

 US Giant Attacks Aussies

 Exposed – OEA in Kids Scandal

 Left-Right Flattens Abigroup

 ANZ Cops Fine Over Robbers

 Classroom Stoush Gets Personal

 Seven Workers Pass "Intelligence" Test

 Stop Press: Coal Strike

 Nurses: MedicarePlus Points to America

 ‘Joel’s Law’ Gathers Momentum

 Skilled Picketers Confront Patrick’s

 Yahoo Censors Union Ad

 Labor’s Cotter Court ‘Faking’ It

 TAFE Puts Best Foot Forward

 Wharfies, Actors, Seafarers Unite

 Debus Gives Up On Lawyers Picnic

 Nelson Backdown Not Enough

 Online Pay Check

 Activists

C O L U M N S

The Soapbox
Bush's Faith-Filled Life
The President's conversion, 'sense of divine calling' and struggle with sobriety are subjects of a forthcoming book, writes Bill Berkowitz

Sport
The Not So Smart Money
Phil Doyle is sick of big money ruining grass roots sport, and he’s taking his bat and going home.

Politics
The Westie Wing
The ongoing challenge for Labor members of parliament is to make what the Premier calls the ‘creative partnership’ between the Government and the union movement a reality, writes our favourite MP Ian West.

Postcard
Behind the Junta
Saw Min Lwin, Secretary for Trade Union Rights/ Human Rights for the Federation of Trade Unions Burma (FTUB), outlines the struggle for workers in his country.

L E T T E R S
 Jack Lives Here
 Saving Jobs
 Public Transport A Bit Rich
 The Smirker
WHAT YOU CAN DO
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Editorial

Holes in the Net


The Medicare debate may be clouded by the minutae of the health delivery system, but it really boils down to an old-fashioned ideological battle between user-pays and state responsibility.

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.

Peter Lewis

Editor


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