The Guardian • Issue #2086


Fighting at 40

  • The Guardian
  • Issue #2086

On the first of February this year, Medicare, also known as ‘the universal health insurance scheme’ turned 40. Happy birthday! Should we shrug, celebrate, or fight? It’s a natural reaction to shrug, because Medicare can easily feel like just one of those things we always have, like running water or roads. It isn’t. Medicare is only 40. We haven’t always had it, and we might not have it in future.

We should definitely celebrate Medicare’s birthday because universal healthcare, however imperfect, is a good thing. Nobody’s health should depend on their income or postcode. As the Guardian said not long ago, “quality healthcare should be universal with no fee.” Medicare is a lot closer to that than what we had before 1984, and it’s infinitely better than the USA’s kleptocratic insurance-company-run health system.

So we’ve got Medicare. Great! Consider it celebrated. Why fight for it? We don’t fight for roads, or traffic signals. Isn’t it just one of those things?

Medicare is a good deal more fragile than other services we take for granted. It is always under attack from the neoliberal ideology that pervades Australia. In 1987, the leader of the Liberal Party, John Howard, declared Medicare “a failure” because it added $4 billion to the Federal Budget. In power, Howard shovelled money to the private health insurance industry without counting the cost.  His successors in the Abbott government tried to introduce a compulsory charge for every GP visit.

Labor doesn’t attack Medicare directly. They’re proud that they’re the party that introduced it under Whitlam and and reintroduced it under Hawke. Labor is in government now, but don’t relax – they’re into the same neoliberal mindset which dictates that any money not spent in some kind of market is wasted. This thinking has led both parties to waste millions on letting the private sector profiteer off public services. Labor doesn’t have the visceral hostility to Medicare that the Liberals do, but they share the same belief that making people pay for things makes the world more efficient.

The government is very proud of increasing bulk billing visits, but many clinics still charge a gap fee – the difference between the Medicare rebate and what the clinic thinks will cover their costs. Emergency departments are still filled to bursting with people who can’t afford to visit doctors otherwise.

Labor also puts Medicare under pressure indirectly with its other spending priorities. This country has gone from wanting to spend $6 billion on French submarines to a plan to spend $368 billion on submarines from the US and the UK. That sort of spending doesn’t feel real to a lot of people. The Australian Financial Review just said that “the bulk of the cost will be largely borne by future governments.” That’s not correct. The cost will entirely be borne by Australian workers, and it will come out of social services including Medicare. That’s why the Communist Party of Australia has campaigned to give peace a budget!

Like many 40-year-olds, Medicare could be in much better shape and do much more. This country can afford universal health care with no fees. We can afford to have dental on Medicare. We can afford all this, but we’re going to have to fight for it.

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