Last year’s budget was an easy target for those concerned about our health system. Now the Government is smarter. Instead of attempting to drive a truck through the very concept of a universal access health system, it has attempted to avoid confrontation by much more stealthy policies.
First, there is no mention of the policies of last year which didn’t require Senate approval and are now implemented. The Medicare rebate freeze remains and will lead to decreased bulk billing and increased copayments for GPs and specialists as few doctors will accept a $15,000 yearly income cut which is a conservative estimate of the effect of the freeze.
The abandonment of the National Partnership Agreement on hospital funding which will lead to longer waiting times for elective care in public hospitals and will drive more people to consider private health insurance (PHI) cover. This is part of the plan.
The support for private health insurance in primary health care remains and is set to expand as the Government continues to give this industry the support needed to ensure that those without PHI receive less access to primary health care than those rich enough to afford it.
Secondly, even within the budget, the process of destruction of our world class health system continues. Gone is any attempt to implement the national dental programme. The dental scheme for children is a rebatable fee for service program and Mr Hockey has frozen that rebate too. Dentists will bulk bill less and increase their copayments to maintain their incomes. The dental scheme for adults has been slashed by 25% from $200m in last year’s budget projections to $155m this year.
Increased copayments for pharmaceuticals and increased safety net threshold are still there, having failed to be passed from last year’s budget. Apart from the projected savings from this parsimonious policy, the single biggest savings for the health budget is called (in Orwellian double speak) Rationalising and streamlining Health programmes. This would appear to be mostly about cutting small front line programs aimed at both treatment and prevention for the most disadvantaged who can’t lobby in a powerful and unified way, although the detail about these cuts has yet to be released.
Thirdly, in true `Yes Minister’ style, much controversial policy has been sent to committees for further consideration. The Government considered the report of the National Mental Health Commission for 6 months and has now kept it off the agenda by sending it to yet another committee. Savings to the MBS are now in the hands of another committee. Reform of primary health care is similarly treated.
The opportunity to save $1 billion per year by reducing the price of generic drugs on the PBS has been ignored. Both patients and taxpayers will continue to pay ten times and more the world market price for many prescription drugs because the Government is not prepared to or interested in taking on the power of the multinational pharmaceutical industry.
The intention is clear. The ship of state must head resolutely towards its goal. The barnacle of health care controversy must be removed or hidden. The goal is a two or multi tiered health system and the slow destruction of Medicare as a system of publicly funded health care for all Australians irrespective of their income, geography, or culture.
Tim Woodruff
Vice president
Doctors Reform Society