May 30, 2014

Co-payments and inept budget messaging put Coalition in a hole

What's the purpose of the Medicare co-payments? It's a good question that not even the government has been able to answer in its shambolic efforts to sell the budget

Bernard Keane — Politics editor

Bernard Keane

Politics editor

Quick, informed, engaged Crikey reader, tell me -- what's the purpose of the Medicare bulk-billing co-payment? Is it to help address the budget emergency? Is it to provide a price signal to change behaviour to ensure Medicare is, in the long-term, sustainable? Is it to fund a vast medical research fund that will eventually, at some point perhaps in the 22nd century, reach tens of billions? Is it because Bob Hawke wanted it and Labor was a proper reformist government prepared to take tough decisions unlike this mob opposite right now, Madam Speaker? If you picked any of those four, you'd be right, because all four have been repeatedly offered by the government as justification in its shambolic efforts to sell the co-payment and the budget more broadly to voters. The government has been ringing the changes this week in its efforts to sell the budget. The fact that it actually still needs to sell it is testimony to how badly it has gone down with voters. By this stage of the political cycle, in recent years, we'd already moved on to other matters --  usually whether Julia Gillard was about to lose her job. But the media cycle stolidly refuses to move on from this dog of a budget. So, this week, Joe Hockey dropped out of the budget sales pitch -- apart from breakfast TV appearances yesterday, he's kept a low profile this week, leaving the selling effort to the Prime Minister. Peter "the black hole" Dutton stepped up his efforts on the co-payment, including with a National Press Club address. Christopher Pyne also tried to lift his game in selling his laissez-faire education changes, only to cause another stuff-up for the government when he opined that it might be a good idea to chase the estates of dead people for their higher education loans. Pyne (and Hockey, who in one of his few outings supported him) is entirely correct -- there's no reason why higher education loans should be treated differently to other loans. No reason except the political reason that it's a shocking look, especially for a government that has already created the impression it views itself as an instrument of Old Testament fiscal justice raining down on the just and the unjust alike. Forget all those nasty, offensive "poodle" references -- in chasing dead graduates and his Gonski debacle last year, Pyne is starting to look a lot like the loaded dog of the government. One of the other changes was in its question time tactics, where the government, via Abbott and Hockey, tried to shift the argument back to the budget emergency (which, actually, the government has already won) by explaining how irresponsible Labor had been and how responsible the budget was for Australians. The result was a blizzard of numbers. Consider this answer to a Dixer from Hockey:
"At the moment we are paying a billion dollars a month—one billion dollars every month in interest on the debt that Labor has left. This would be $2.8 billion a month in 10 years time if nothing is done. That is $2.8 billion a month in 10 years time if nothing is done about the state of the budget. Under the legacy of the previous government, each Australian's share of the interest would be $9,400 over the next 10 years. In four years time alone, if nothing is done, every single Australian will be paying the equivalent of $740 in interest alone on Labor's debt—$740 each."
That's four separate numbers in mere seconds. During the week, the government tried out a variety of figures. Hockey talked about "$25,000 for every man, woman and child in Australia" the following day, as if holders of Australian bonds would be coming a'knockin' on the door of every house to demand repayment of Labor's debt, or they'd send the bailiffs in. Abbott tried "$1 billion a month of dead money". Hockey used both. Then yesterday Abbott produced yet another figure, saying "a family of four would face a $100,000 share in Labor's debt bill". This was a favourite trick of the Howard government -- invent a number (say, about the cost of taking action on climate change) and divvy it up by population to warn that "every man, woman and child" would be up for some hideous debt. Except, the Howard government realised you need to stick to one number when using this tactic, not seven. The other argument, on the co-payment specifically, was that it was a Labor idea, because Bob Hawke had introduced it. They skipped the bit where Paul Keating capitalised on the febrile reaction to the co-payment (which, in Hawke's version, didn't apply to pensioners and was accompanied by compensation) and used it as one of his weapons for blasting Hawke out of the Lodge. Perhaps Malcolm Turnbull remembers that particular bit. But Bob Hawke was "the father of the co-payment", the government kept repeating, and yesterday it insisted Jenny Macklin -- who back then was an adviser to then-Health Minister Brian Howe -- was the "mother of the co-payment". Well, thank goodness the co-payment wasn't reared by a single parent or same-sex couple. That the Coalition brains trust seriously thinks this will be a compelling case for voters deeply hostile to the co-payment illustrates either their desperation or the profound loss of the sure populist touch they had in opposition. It's reminiscent of a desperate John Hewson defending his GST in 1993 by arguing Paul Keating had wanted one in 1985. "And we decided it was such a bad idea we never introduced it," Keating would shoot back. News Corp has been doing its best to help out: today The Australian splashes with an "exclusive" (naturally) that "senior Labor leaders" supported a co-payment. Gamechanger! Who were these senior Labor leaders? Bill Shorten himself? Chris Bowen? Or maybe Kevin Rudd or Julia Gillard or Wayne Swan in the former government? Well, as it turned out, the "senior Labor leaders" (sic) was Peter Beattie, in 2005, who considered charging payments for hospital admissions. We've all seen some desperate efforts to support the Coalition over the years from The Oz, but for sheer WTFness, this was a new high, even before you thought through the logic of the story, which was that Tony Abbott as federal health minister had, erm, blocked the proposal. Still, at least it was only nine years ago, not 23. The government might want to try the tactic of just shutting up. Its efforts to sell the budget, far from helping, are making things worse. Time to stop digging.

Free Trial

You've hit members-only content.

Sign up for a FREE 21-day trial to keep reading and get the best of Crikey straight to your inbox

By starting a free trial, you agree to accept Crikey’s terms and conditions


Leave a comment

52 thoughts on “Co-payments and inept budget messaging put Coalition in a hole

  1. Dez Paul

    Be careful, BK. This gumint might offer you a job as a comms consultant.

    Love the reference to Poodles as the loaded dog….

  2. Jimmy

    Bernard you forgot a reason for the co-payment – pre budget when it was being mooted the reason was that medicare was becoming unsustainable and health costs were growing at something like 7 times the rate of inflation.

    As for News Ltd – articles in the Herald Sun this week have included the amount of money ALP ministers spent on travel, a front page artivle on Sunday about Tim Mathieson’s “bizarre attack” on the amount of charity work our first lady is doing and that 46 people have been on Newstart since it was brought in – no bias though.

  3. leon knight

    Agreed Dez, but I recall the loaded dog was a rather attractive black retriever with a winsome red grin….but Pyne would look a heck of a lot more attractive with a stick of well-wrapped dynamite in his mouth, and it would shut him up while we all excitedly awaited the explosion.

  4. wayne robinson


    You owe me a new iPad. I read your item drinking a cup of coffee and the screen is now ruined. Loved the loaded dog reference. Actually, loved it all.

  5. MsCharli

    You made my day with the use of the term “WTFness”. A term that could be applied to the LNP government in general lately.

  6. klewso

    What’s that old saying “Better to remain silent and be seen a fool, than to gob-off and remove all doubt”?

  7. Steve777

    The Co payment has nothing to do with paying back debt. It does’t go towards the Government’s bottom line but goes into this bizarre ‘Medical Research Future Fund’. It’s real purpose is to make bulk billing less attractive or even unviable for doctors. Those who bulk bill now would have to accept a big pay cut to continue. It is a first step in the process to dismantle Medicare. Malcolm Fraser took 6 years to get rid of Medibank. Abbott, given a second term, probably won’t take as long.

  8. klewso

    It’s black-mail – to crucify Labor with, if they refuse to pass their dog?

  9. Emoticom

    Well it can’t be all of these.  If it’s to fix the budget bottom line it has no effect if the copayment and more is effectively taken from the bulk billing GP to fund the research. At best such research will find expensive remedies for chronic illnesses, many of which are lifestyle driven.

    If it is to reduce overuse of Medicare, the 1% saving in numbers of consultations may well cost more in terms of a reduction in the best management of these same chronic illnesses at the primary level leading to even greater costs, including expensive hospital costs, down the road.

    The sleeper in these proposals is the cost to the patient for necessary pathology tests.  The $7 copayment would apply to each billable test, not each pathology visit.  For many people with chronic conditions, five or mor tests that need to be done regularly, amounting to a copayment of $35 or more each time.  Pathology ordering needs to be reigned in but punishing the patient is not the way to do it.

    The government will be forced to allow unrestricted bulk billing as now for pensioners and Health card holders.  For others, the could allow the GP to charge up to $6 and still bulk bill for the rebate.  This would be optional for the doctor, but the squeeze on general practice due to a freezing of the rebate for three years will push mor doctors to charging some copayment for most patients in this cohort.  The government would get what it wants, a price signal, and the GP would wear the opprobrium.

  10. Barrie O'Shea

    The figures used publicly by the Liberal Party in justifying their cuts are completely at odds with their own Budget figures. According to Statement 10, Table 3 of the Budget papers, our net debt is $145 billion, not $670 billion, and our interest bill is $560 million per month, not $1 billion. We paid substantially more than this for 5 years under Howard, without any “emergency” being mentioned. We should never have let a lawyer handle the accounts!

Leave a comment

Share this article with a friend

Just fill out the fields below and we'll send your friend a link to this article along with a message from you.

Your details

Your friend's details