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Issue #1682      April 29, 2015


Capitalism and health – a conflict of interest

From day one of the Abbott government, senior ministers have warned of swingeing cuts to health spending in order to fix the Commonwealth’s “debt crisis”. Last year’s federal budget contained several stunning “reforms” that would have had a serious, negative impact on the health of Australians, especially the less well off, including the proposal for a $7 “co-payment” for GP visits. People weren’t fooled. They recognised that Medicare and the principles that underpin it were under threat. The protests were so strong that the talk in the corporate media was of a one-term Coalition government.

Abbott and Co started climbing down from their policy positions. The co-payment to be levied was reduced to $5. Then the whole concept was thrown out in favour of freezing or cutting the rebate paid to the GP for short visits. A $20 reduction was pulled just before it was due to go into force. Incoming Health Minister Sussan Ley has tried to project a “softer” image in line with the political needs of the day. But the privatising, neo-liberal agenda in health remains.

A less ambitious $5 rebate reduction for shorter GP visits is due to go into effect in July. Doctors will have the option to bill their patients. The minister has announced a number of reviews she says are intended to find efficiencies and eliminate “waste” in the health budget. The problem is, as she sees it, that Medicare costs have gone from $8 billion per annum to $20 billion over the past decade and the Medicare Levy only pulls back $10 billion of that amount. And, as the now widely-questioned Intergenerational Report points out, Australians are going to live longer and their expectations of treatment are going to go up.

Ley has established a Medicare Benefits Schedule (MBS) Review Taskforce to “consider how services can be aligned with contemporary clinical evidence and improve health outcomes for patients,” as the minister puts it. She is also establishing a Primary Health Care Advisory Group to “investigate options to provide: better care for people with complex and chronic illness; innovative care and funding models; better recognition and treatment of mental health conditions; and greater connection between primary health care and hospital care.” She wants to “work with clinical leaders, medical organisations and patient representatives to develop clearer Medicare compliance rules and benchmarks.” It almost sounds philanthropic.

The minister denies the various reviews are cost-cutting exercises but the preamble to the relevant announcements is all about costs. The corporate media has been helping with tales of over-servicing, over-screening and even “over-detection” in the case of some cancers such as prostate cancer. The ridiculous image of a pampered, unduly health-conscious public is being built up. No doubt over-servicing by professionals keen to recover the cost of expensive machinery does take place. The fees charged by surgeons for some procedures is hard to justify in some instances. But the government’s “reforming” zeal isn’t directed at those targets.

Neither is it keen to make the most obvious saving in the health area – the Private Health Insurance Rebate with its $6.6 billion a year price tag. Despite expert advice about this massive waste of public funds, the government is deeply committed to this article of neo-liberal faith and its “self-provisioning” message to the Australian people.

The government is in no mood to tackle the pharmaceutical transnationals, their price-gouging and abuse of the Pharmaceutical Benefits Scheme. Australians pay $42 for generic statins versus $3 in NZ or $2 in Great Britain, for example. If this type of rorting were fixed, billions could be saved. And if the minister would stop the attacks on GPs and, instead, expand the role of primary health care, fortunes in taxpayer dollars could be saved in the hospital system.

These sorts of necessary changes won’t happen as long as governments serve the interests of big business, including pharmaceutical and insurance monopolies. Governments like the present Abbott government are not going to put the health of the people ahead of private profit. The demands of globalised capitalism now clearly stand in the way of a healthy future for Australians.

Next article – Protest against Cambodian offshore processing

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