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Labor's $2.3 billion cancer care package and promise to roll out more mental health facilities away from the major cities are positive policies. However it could go further with its health platform of funding specialist care by finally sinking its teeth into putting dental for all on Medicare.
Medicare-for-all is best seen as aspirational: it is shorthand for policy ideals and papers over political realities. With Republicans in control of Congress, there is obviously no immediate chance of Sanders's bill becoming law any time soon. But with Republicans and the President viewed as ineffectual in implementing their healthcare commitments and uncaring about voters' concerns, it is advantageous for Democrats to be seen to have solutions to the problems that confront their constituents.
Obamacare, although imperfect, was soundly constructed and thoughtfully implemented. It has withstood constitutional challenges and survived endless Congressional votes to repeal and amend it. Republicans talk only about its problems and the Trump Administration has worked hard to sabotage it further, but the fact is that Obamacare is not in a 'death spiral'. It is working surprisingly well.
Next year marks four decades since promulgation of the seminal Declaration of Alma Ata, which declared health to be a fundamental human right and laid the foundations for what are now widely championed as the social determinants of health. Without action on the social determinants, health policy can be a little like that joke about the cyclopean orthopod who, when confronted with a patient suffering fatal internal bleeding, is interested only in fixing their broken leg. So it is with last week's Budget.
My patients who earn $36,000 a year pay $36 for most prescriptions. My patients who earn $360,000 pay the same, and those on $3 billion pay the same. Usually, these prescriptions are for conditions which can't be avoided - it's just bad luck. This government imposed co-payment is a tax on illness. It is not noticed by those on $360,000 but for those struggling on $36,000, it does affect their small disposable incomes. It is a regressive tax, and its effect on patient behaviour is well documented.
The Coalition Government falsely claims that Medicare co-payments and cuts to welfare and publicly funded institutions such as the CSIRO and the ABC are necessary to 'fix Labor's mess'. There are indeed structural problems with the economy, but essentially the plan is to strip the public sector by cutting universal access to a range of services that also includes tertiary education, to create a dominant free market that marginalises Australians on low incomes.
French economist Thomas Piketty argues that current conditions have set us on track for a return to 19th century-levels of inequality. The Commission of Audit proposals suggest that the auditors and the Government are keen to expedite this neo-Dickensian era. It's all done in the name of 'incentives' toward 'personal responsibility', but this cannot remain coherent in the face of those who will be hit hard by the proposed suite of cuts and co-payments.
Health minister Peter Dutton has refused to dismiss the possibility that a $6 ‘co-payment’ for GP visits could be announced in the May Federal Budget. This would be no more than a quick and easy temporary fix that would penalise ordinary Australians. It would simply defer the government's need to tackle the vested interests that are arguably the major cause of the inefficiencies that have made our health care system prohibitively expensive.
Any excuse, Privatise or perish, Clear and present danger, Keep left unless undertaking