Today everyone is dissecting the election results and it seems appropriate to do likewise. The Sydney Morning Herald analysis (Antony Green October 5), sums up as follows: ........ "the political truth is that the Howard Government was elected on the vote of young families in the outer suburbs of Sydney and Brisbane.....Howard delivered to this group with interest rate cuts to help with mortgage repayments, with tax cuts to young families with only one bread winner, and with private medical insurance rebates, and changes to Medicare payments to close the gap on the cost of childbirth. And that group has repaid the favour."
If he is correct, (and Antony Green is universally respected as an analyst), it might be useful to examine the implications of his statement. It means that there is a perception in Middle Australia that good health can be "paid for" with personal assistance from a sympathetic government. The thinking involved here is one of individualistic (not to say selfish) concerns. The voters have said to themselves: "We’re OK, we’ve got private health cover, we can get the best treatment from the best doctor at a time to suit ourselves".
Now it would be wrong to deny that there is some truth in this train of thought. Especially in these days, where money is so very important and powerful a weapon in the struggle for survival. But let us pursue this logic a little further. People with these convictions will lose interest in the Public Hospitals and the fate of their less fortunate fellow-citizens. A situation where the majority becomes indifferent, averting their eyes, has led to the contradictions of the US style health care system. In such a system the complacent majority can avail themselves of luxury treatment (sometimes indeed over-treatment) while forty million people have poor protection, even in an emergency.
The people drinking coffee in Strathfield may have had full private health insurance cover. It did not save them from being gunned down by a disturbed taxi driver who had been unable to afford mental health treatment. The affluent Californians who were exposed to the risk of TB when they hired poor Mexican servants, realised, all of a sudden, the importance of public health interventions.
No amount of personal insurance can protect us from the end-results of public squalor. Our modern knowledge that the principal killers are " lack of social support, poor education and stagnant economies"(1) has not yet been widely disseminated.
As doctors, we are in a position to make this knowledge and experience available to both the electors and the politicians. Dare we keep silent?
Dr Alf Liebhold
1. Lomas J Contandriopoulos, AP: Regulating Limits to Medicine in : Evans RG, Barer ML, Marmor TR, eds. Why are some people healthy and others not? New York; Aldine de Gruyter, 1994: pp 253-283
Edited version published in Australian Doctor 23 October 1998 as "The perils of privatising health care".
Doctors Reform Society