Comments on: Medicare’s future is at stake

By: Tim Woodruff

Tim Woodruff — Fri, 23 Oct 2009 19:09:54 +0000

We’ve been told by the Prime Minister that the old pubic private debates should be a thing of the past. In a speech in August 2009 the Health Minister said ‘We asked for a comprehensive root and branch review of the health system from Dr Bennett and her team of experts, and we got it.’ But we all know that leaving out the PHI rebate exposes that statement as, at best, political spin. Instead of an extensive review into the whole health system, we have a review which ignores the major problem of PHI and then proceeds to advocate an expansion of the inefficient and inequitable private health insurance industry, firstly in Denticare, a very definite proposal, and secondly in Medicare Select, a proposal for further consideration. This does indeed set the scene for the demise of Medicare.
I agree that the NHHRC and the Government have largely ignored the idea of consumer and citizen engagement in determining the principles upon which our health system should be based.
But even with principles like equity and efficiency advocated by and supposedly guiding the NHHRC, it managed to propose Denticare, which may partly address gross inequity but will ignore and entrench the structural inequity inevitable in such a system.
If you think we have two tiers of care now, be prepared for worse to come and for continued political battles about how to provide the best safety net for the deserving poor. This will be all about charity which, in a rich country like Australia, should be reserved for emergencies and disasters, not for everyday health care.

By: john2066

john2066 — Fri, 23 Oct 2009 12:50:24 +0000

Its amazing that every single other job and profession is open to competition, but medical specialists with their disgusting multi million dollar incomes, are simply allowed to restrict the numbers with no action taken.

And naturally every time the doctors whinge for yet more money, their mates in the conservative parties slobber all over them. They are Australia’s most powerful trade union - and enough is enough.

By: john2066

john2066 — Fri, 23 Oct 2009 12:15:14 +0000

Yet another example that Rudd has identical policies to Howard. There is no difference, and anybody who thinks so its just kidding themselves. Just like Howard, he’s trying to eliminate medicare and bring in an american style ‘death’ system.

Private health insurance is a useless product we are forced to buy, forced upon us primarily by greedy medical specialists. Its not enough that they run the most disgusting closed shop in Australia, restricting specialist numbers, but they have to also kill Medicare, which they’ve always hated.

By: Anthony

Anthony — Fri, 23 Oct 2009 07:05:13 +0000

Given all the problems the U.S. is having with its junkyard of a health system, why are we pushing towards a similar model? The answer is simply because private health insurance companies want to make bigger profits here, like they or their counterparts do in the U.S. On every other measure, a private health insurance dominated health system leads to massive financial costs to individuals, families, and the country as a whole as well as poorer health outcomes.

Any government that directly or indirectly contributes towards weakening universal, public funded health care is serving nobody but the greedy and immoral interests of a few corporations and therefore acting against the financial and health interests of the community.

The Howard government did this to their shame. The Rudd government has also continued many of Howard’s policies to their shame and if Rudd tries to go down the Medicare Select path, then all his talk about the neocon era being over will be nothing but empty, hollow words - a case of yet another government in servitude to corporate profiteering at the expense of our individual and collective wellbeing.

By: jeebus

jeebus — Fri, 23 Oct 2009 06:36:07 +0000

Very important article, John.

We need to stop subsidizing private insurance companies immediately, and redirect that money back to the public system. The absence of a viable public option for dental procedures has resulted in a conspiracy between dentists and private insurance to gouge the public. The gap fees are chasms, and whenever a benefit is raised, the prices get bumped up to gobble it up.

Private health companies are corrupting the principles and cost effectiveness of universal health-care provision, and they are providing little benefit to the majority of Australians for what we pay them.

By: Julius

Julius — Fri, 23 Oct 2009 06:12:38 +0000

It would be valuable to have John Menadue’s analysis and opinion of a consequential that needs to be faced. To require people who have incomes on which they pay high marginal tax rates to pay for anything they want in health care (or education) beyond what the public sector provides to pay for it all out of after tax income with no government subsidy just as we would think it right to require them to pay for their film going or tropical holiday surely depends on some odd assumptions.

Is it to be assumed that there is only a limited quantity of good health care or education so that no financial inducements by the spending of private money can improve either its total quantity or its quality? Surely not. Is it to be assumed that the community interest is best served by medical and educational priorities being determined by the professional providers alone, perhaps simply on technical grounds which don’t stack up against any rational assessment of community interest, or perhaps on more-or-less undisclosed private ethical grounds - at all events without the chance for those strongly motivated to know why they are spending their own money to affect the way resources are used by their input?

Perhaps the case for encouraging people with high incomes to put their own money into education is even stronger than for health care though there is the additional consideration in the case of health care that getting the CEO of an ASX 300 company back to work quickly, or even a run of the mill QC, is a better outcome for the community as a general rule than allowing an 80 year old retired person equal priority.

By: Gavin Mooney

Gavin Mooney — Fri, 23 Oct 2009 03:42:43 +0000

Agreed totally John but where the NHHRC really fails is in not having or stimulating a national debate about what principles we want to underpin our health services. That should have been their starting point. We lurch from one proposal such as Medicare Select to another without any elaboration of what we as citizens want the guiding principles of our health care system to be - and it is ours, we Australian citizens. We need these guiding principles before we can judge comprehensively different proposals. I agree very much with you on Denticare and Medicare Select and I am also confident that if we had these ‘people’s principles’ they would not support Denticare or Medicare Select either. But we need them rather than having to speculate about them.

Yes ‘now is the time for all good people to come to the aid of Medicare’ and the emphasis must be on ‘all’ and the people must be citizens.

Is it too late? NHHRC did recommend citizens’ juries for priority setting. What about for principles?