Hands up who’s thoroughly sick and tired of reading about how Kevin Rudd is John Howard lite, a bloke who substitutes spin for government activity in those times when he’s not actually doing the big “me-too”?

Finally, hopefully, we can all now put that piffle to bed.

The real Kevin Rudd has always been the Goss technocrat, the strategic policy wonk, the careful, cautious planner ad infinitum who draws policy threads together in a coherent broader tapestry, who melds electoral politics around concrete policy goals rather than wrapping convenient policy goals around base electoral politics. Last night the real Kevin Rudd became so obvious that even the laziest journalist should have been able to see it.

The future direction of health policy is a classic case in point. By doubling the threshold for the Medicare levy surcharge, not only will it start to dismantle the private health insurance gravy train as fewer people get penalised for not taking out private health insurance (becoming an effective tax break for those middle income working families to boot – the electoral politics), but it will to some extent increase the demand on public health resources in the future as a result, particularly the resources of the public hospital system. Yet Rudd has been banging on about reforming Commonwealth-State relations over health since he first achieved the Labor leadership. There’s the explicit threat for constitutional change to allow the Feds to take over hospitals if the States aren’t up to the job to implement reform, there’s the COAG health reform agenda and a bucket of upfront money being made available before the budget and now there’s a $10 billion health fund.

It’s not rocket science to see how it’s playing out – for those that say the budget lacked reform, open your eyes and stop looking at the world through a Howardian prism.

Rudd knows the demand shift consequences of moving the Medicare levy surcharge up the income ladder, he’s banking on at least the first tranches of reform, the low-hanging fruit – be it the increase in aged care beds to free up hospital beds, the construction of GP clinics to take weight off hospital emergency departments and the dozens of smaller front line reforms scattered through more than a dozen documents – to provide the hospital system with the increased capacity to absorb the consequences of this initial reshaping of how private health insurance works in practice. As time moves on, private health insurance will be further reformed with the broader health system as a whole – the scene has been set and the trajectory pretty much laid out.

Too often we all seem to expect reform to come in some big-bang document titled “Reforming Policy X” where we can all follow the flow chart. A sort of idiot’s guide to policy change where winners are easily determined and losers are identified in bright red circles.

Undoubtedly there will be some of those in the future (the not quite so root-and-branch tax review springs to mind) but there’s a whole lot more going on in this budget below the headlines and the PR management. We might all need to start thinking in more complex ways on how government initiatives interact with one another if we are to get to the bottom of the deliberate, broader sweep of government policy direction because Kevin Rudd and his government certainly are. The Opposition is certainly not and governments need to be kept under credible scrutiny.

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Peter Fray
Peter Fray
Editor-in-chief of Crikey
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