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Issue #1734      June 8, 2016

Cast your vote for Medicare

Medicare, the public hospital system and the Pharmaceutical Benefits Scheme (PBS) have together provided the people of Australia with comprehensive cover and a world-class public health system. Now all of that is under threat.

Photo: Anna Pha

Bulk billing, universal access and quality care are the pillars of Medicare. They are being dismantled and replaced by user pays, with access dependent on ability to pay. Staff in under-funded public hospitals are already struggling to maintain quality care.

The government is in the process of dismantling the public health system and going down the path of the profits-first American health system, the most expensive and the worst in terms of access and needs-based treatments of the industrialised nations.

Prime Minister Malcolm Turnbull and Health Minister Sussan Ley have connived to cloak their agenda with evasive language and weasel words. They are proceeding by stealth, with Ley lying at every step about the government’s Healthier Medicare, Healthier Population and Healthier Nation while taking the knife to funding and preparing to restrict access to public health services.

The Abbott/Hockey 2014 budget cuts of $54 billion to public hospital funding for the states and territories are still on the agenda.

A Medicare co-payment is being introduced by the back door with a six-year freeze on doctors’ rebates. This comes on top of earlier freezes. Doctors are campaigning against this freeze which is hurting their incomes. Some have already been forced to abandon bulk billing for economic reasons.

The government plans to make co-payments obligatory for all patients. Patient contributions for prescription medications are set to rise even higher. Safety net thresholds are also set to increase.

This is an extremely regressive policy which would hit hardest the sickest and those least able to afford it. The data confirms that those who visit the doctor the most often tend to be older and on lower incomes and more likely not to see their GP because of cost.

Medicare cheaper and more efficient

Government and media claims about unsustainable, runaway costs of Medicare and the PBS are pure fiction – an attempt to justify a callous cost-cutting agenda.

The importance of healthcare cannot be overstated. Yet the government, with a total annual budget of around $445 billion, can only find $22.7 billion for Medicare!

Likewise spending on the PBS is not out of control as is implied. Government spending on the PBS is $10.4 billion. (It actually fell in 2015.) That includes some expensive, life-saving medications that would otherwise be out of reach of those requiring them. Surely that is not a big ask out of a budget of $445 billion!

The Abbott/Hockey plan to implement $54 billion in cuts to public hospital funding has not been withdrawn. That money will be used to fund corporate tax cuts and contribute towards a runaway, unsustainable military budget. In the 2016-17 Budget there is a token pre-election increase of $2.9 billion over three years.

It has been demonstrated time and time again, that the public health system can deliver better quality and at a lower price. There are no layers of profit built into the system. There are no vested interests paying higher prices or charging high fees. There are no financial motives for taking short-cuts.

The surgeons and other practitioners do not have a financial interest in a public hospital or day centre where they are carrying out procedures.

No funding crisis

The government can find $6.5 billion per annum to subsidise otherwise unviable private hospitals through the rebate on private health insurance premiums. It can forgo billions of dollars in future taxation revenue by slashing corporate tax from 30 to 25 cents in the dollar; the big four banks alone stand to make a killing of $7.4 billion from that.

At the same time as portraying healthcare funding as unsustainable, the government allocated a whopping $47 billion in subsidies to the fossil fuel sector over the next four years. That’s two years of Medicare funding.

Even more obscene and unjustifiable is the bloated military budget. The Turnbull/Morrison government can find $195 billion for “additional capacity” over the next 10 years over the ongoing military budget. This is around $30 billion per annum and rising. In total it has budgeted for $1 trillion over the next 20 years for killing machines and war preparations.

Just 10 percent or 20 percent of that military spending of that “additional capacity”, if redirected to public health services, would amount to an additional $5 billion to $10 billion a year.

Basic human right

Health care is a basic human right, not a commodity to be bought and sold on markets to those who can afford it. Yet that is what the government plans to do if it is re-elected. If it gains control of the Senate, there will be no stopping it.

In pre-Medicare days visits to the GP, blood tests, medications and hospitalisation were dependent on ability to pay. People lost their homes, went to jail for unpaid debts and even died through lack of access to treatment.

Expand public health system

The public health system needs to be adequately funded and resourced. Staff should be paid in line with their qualifications, experience and responsibilities.

The Communist Party of Australia (CPA) is calling for dental care to be included under Medicare.

It is vital that regional and rural Australia and Indigenous communities receive the funding and access to the services they need.

Disability and aged care are other areas which are neglected, in which patients often receive second class care, if any care at all. Support for mental health patients is badly lacking.

Greater use of salaried doctors, not just in hospitals but in the community and for aged care facilities, could have great benefits in the care and services provided.

Government i.e. taxpayer subsidies to the private sector for health services should be abolished.

The CPA calls for prescriptions to be free to patients and medications funded out of central revenue.

To raise the necessary funding for these and other progressive reforms such as a greater focus on preventative care, a number of measures can be taken.

Funding

These include:

  • phasing out the private health insurance rebate
  • no corporate tax cuts
  • an end to the Australia-US alliance and Australia’s massive arms build up.
  • dental care should be included under Medicare
  • bulk billing should be universal with doctors’ rebate fully indexed or doctors given the choice of being salaried
  • home care, aged care and so much more should be fully funded and universal.

The Communist Party supports medical and other health services being funded centrally through a progressive taxation system.

Universal access, a central pillar of Medicare, can only be achieved by services being free at point of delivery.

Centralised funding turns the private, user-pays model on its head. Instead of access and quality of health care based on ability to pay, access becomes universal and ability to pay determines the contribution to costs.

A compulsory co-payment spells the death of bulk billing. Means testing spells the end of universal access. In other words, these two actions amount to the destruction of our Medicare.

When voting on July 2, put the Coalition and other conservative parties and conservative independents last. Vote for Medicare by supporting the Australian Greens and other left and progressive candidates.

Next article – Editorial – Penalty rates a test of commitment

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