| Privatisation approach an outrage
Dr Wooldridge is right. Surely something in most of us recoils at the idea that income, not illness, determines who gets what sort of medical treatment (and when). So it is depressing to contemplate certain recent events relating to hospital funding showing the barbaric trend of today: · The "Westmead problem" referred to by the Minister which would unashamedly admit patients out of queue as private if they would meet a proportion of the bill. · The proposed changes designed to save money from the food bill of major hospitals ("‘Prison diet’ for hospital patients", Sydney Morning Herald, 11/11/99) · A recent demand from the President of the AMA, Dr David Brand, for so-called pragmatic and sensible reform of Medicare. He said "We can’t let ideology side-track the debate." Presumably he meant that the defence of the public system was "ideological". It seems almost as if policy reforms on the agenda are restricted to denying services. Who is defending the rights of all citizens to civilised treatment when they need it? Tax payers have indicated they would be prepared to pay the extra, but our governments find Health too difficult. They are worried that Australia’s investment rating will be downgraded if they spend money for any other purposes than those which benefit business. The AMA regards the defence of Medicare as an ideology. Fair enough but the Doctors Reform Society would argue that the AMA’s recommendations also constitute an ideology. We would predict for example, that this ideology will lead to the following: · Privatisation of services. · Second-tiering of a neglected Public System (an inevitable consequence of privatisation). · Impoverishment of the education of medical and other health students which has always taken place in public institutions. · The emphasis on profitable technologies and interventions at the expense of valuable aspects of health care such as thoughtful interest, patient education and preventive advice. The DRS viewpoint on health is ideological and we would not deny that. But those who are advocating a more privatised system should be aware that their beliefs are based on theory as well. As we see it, their theory is that: · Health care is just another industry. · Users of health care should individually pay for every service. · The market will know and determine what is best for people. · The rewards should go to those who can most skilfully exploit the market. · Those who can’t pay cannot be left to die in the streets, of course. The Public System will have to cope with them as best it can. · The education of the health professions is not a high priority. · Prevention of illness and education of the pubic can be left to the popular press and TV. · The task of the medical profession is to sell its skills (at the best price) to the highest bidders. · Since it has no shareholder value, a caring attitude is relatively insignificant. Outrageous, Dr Wooldridge? You bet, but it would be reassuring if members of your old profession were to share your outrage.
Dr Alf Liebhold Dr Liebhold is a GP and member of the Doctors Reform Society executive. An edited version of this article was published in Australian Doctor 3 December 1999. |
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