The future of our public health system is at risk. Medicare cares for the rich, the poor and everyone between according to need and not by the ability to pay. To alter this would be a great loss for all Australians and our future generations.
The current federal government’s philosophy of a two-tiered, user-pays health system is undermining Medicare and its principle of universality. This is being done insidiously with attempts to increase our reliance on the private, for-profit health system. We have experienced severe restrictions on public hospital funding while at the same time taxpayers’ money has been poured into an inequitable, expensive, private industry that serves fewer people.
With adequate funding the public system can provide inclusive, quality health care. Excluding the well-off and powerful from the public health system leads to its deterioration into an underclass safety net and not a public asset for the benefit of all. Forcing people into the private system solves nothing. If the wealthy pay their taxes they are not a burden on the public system.
We can achieve this through a fair, progressive tax system. A strong commitment from government to Medicare, public hospitals and the principle of universal access to public health care is required. We have not seen this from the current Coalition government. Their actions have attacked the principles of Medicare as we know it. The anti-Medicare policies of Pauline Hanson’s One Nation Party would give further impetus to Medicare’s demise if they held balance of power.
Medicare would be replaced with a "choice" between a public Medi-poor or a private Medi-profit. Medi-poor would be run-down and over-strained. Medi-profit might suit the wealthy but be inadequate and a financial strain for most. Witness the United States where a large proportion of the population have inadequate health cover and personal health expense is the largest cause of bankruptcies.
As both a general practitioner and health consumer I see ramifications to individuals, their families and the public health field. For the individual and family in a user-pays system, accessing services can be difficult and stressful. At times of illness there is the additional burden of financial worries and up front costs. This extra stress can have direct negative health effects and together with poorer and later access to health care result in worse health outcomes. People with chronic illnesses, the very young or old incur more of the financial cost of health care. This is in contrast to our current Medicare system where people pay not at the time of their illness but through their taxes according to their income.
There are also grave implications for the wider picture of public health in Australia. Preventive health measures including immunization, Pap screening, mammograms, well baby checks and infectious disease prevention strategies would be adversely affected. Early consultation and on-going care would be hampered resulting in later diagnosis, less effective treatment and more costs in the long run. The community suffers.
Speaking as doctors concerned about the future of health care in Australia, the Doctors Reform Society urges the Australian public to consider carefully the erosion of Medicare and our public health system. We are proud of Medicare and what it stands for. The little green and yellow card has come to mean so much to Australians. Let us make the choice, say yes to Medicare and no to the alternative Medi-poor / Medi-profit.
Dr Tracy Schrader
Doctors Reform Society (Qld)
15 Sept 1998
The Doctors Reform Society is a member of the Public Hospital, Health and Medicare Alliance of Queensland (PHHAMAQ)
Published in the DRS column of Medicine Australia MedicineAu the online journal of medicine.