The Guardian May 22, 2002

Budget 2002-03: War on the sick

by Anna Pha

"All Australian doctors will have to deal with frightened patients 
tomorrow, worried about the cost of their medications", said Doctors Reform 
Society NSW President Dr Con Costa, following the delivery of the Federal 

"Most sick and elderly patients are now on multiple drugs for diabetes, 
heart disease, asthma and blood pressure and are continually hounded by 
their doctor about the importance of taking them regularly", said Dr Costa.

The Federal Treasurer announced increases in payments for prescriptions 
under the Pharmaceutical Benefits Scheme (PBS).

Aged pensioners, disability pensioners and other health care card holders 
will pay $4.60 for their PBS medications from August 1  an increase of $1 
dollar (28%) per script.

For those without a health-care card, the script price will rise $6.20 from 
$22.40 to $28.60.

That would cost a family of four $114.40 for just one antibiotic each.

"Some patients will stop taking their drugs. These drugs save lives. Those 
lives will be at risk. Under-treated patients will turn up in already 
under-resourced public hospitals because they are not taking their 
medications", said Dr Tim Woodruff, National President of the DRS.

"This government wants patients to pay more for health. If you can't, you 
suffer. They don't care. "

The Government hopes to slash PBS spending by $1.1 billion by putting the 
cost of medications out of reach of some of the most sick and disadvantaged 
in the community. But it will not reduce costs in the long term.

"Canadian research in the late 1990s on the effects of the increase in co-
payments for medicines for social security recipients showed that increased 
co-payments caused an increase in hospitalisations (194%), doctor visits 
(22%) and emergency department visits (106%)", said Dr Kerryn Phelps, 
President of the Australian Medical Association.

Why pick on the PBS?

"The PBS budget has doubled since 1996. Something must be done", said Dr 
Tim Woodruff. "The government's response is that patients will have to pay 

"But the private health insurance rebate has also doubled in cost since its 
inception only two years ago, from $1.2 billion dollars to $2.35 billion 

"It is uncapped and unsustainable. But the government had no budget 
measures for this", said Dr Woodruff.

The rebate is a 30 percent subsidy for private health insurance.

"Why have they picked on the PBS?" asked Dr Woodruff. The private health 
insurance rebate is likely to overtake the PBS as the fastest growing 
single item of health expenditure.

The war on the sick and the PBS is part of a wider government agenda.

In reality these changes are another step towards the destruction of the 
PBS, in line with the demands of the powerful pharmaceutical corporations.

The pharmaceutical companies want a completely deregulated market where 
they can charge what they like. Like the Howard/Costello Government, they 
don't care what happens to the sick who cannot afford their medications.

They would prefer to make a killing by charging monopoly high prices to 
rake in superprofits.

The Government has already begun the process of destroying the 
Pharmaceutical Benefits Advisory Committee by appointing pharmaceutical 
industry representatives to it.

"Educating" GPs

Doctors are blamed for pushing up PBS costs by prescribing expensive 
pharmaceutical products when there may be cheaper products that would be 
just as suitable.

But nothing will be done to rein in the pharmaceutical corporations that 
bombard the computers of GPs with advertisements for the latest drugs.

GPs will receive "education" about approved PBS drugs, to reduce 
"unapproved" or "inappropriate" prescribing.

And who will educate the GPs? The pharmaceutical industry!

John Kilborn, managing director of one of the largest pharmaceutical 
corporations, Bristol-Myers Squibb, said with a straight face that there 
would not be a conflict of interest.

"Our sales force are highly responsible, scientifically trained people, and 
they are absolutely capable of respecting these requirements", he said.

This outrageous proposal is consistent with the government's aim of 
completely handing over the medical system to the private sector.

The idea is "self-provision", where each individual person takes on 
responsibility for financing their own care and their own needs on an 
individual basis.

The collective is being replaced by the individual. Too bad if you are not 
wealthy and you get sick.

Defend and extend Medicare

The budget also continues the process of undermining Medicare by failing to 
provide adequate funding for this very popular public health scheme. As a 
consequence, more doctors are finding it impossible to continue bulk 

The National Medicare Alliance, which is made up doctor (DRS), nursing 
union, and other organisations concerned about the public health sector, 
put forward an alternative health budget which would not cost a cent more 
than the one being proposed now.

Their proposal centres around the scrapping of the 30 percent private 
health insurance rebate and re-investment of the $2.35 billion saved in the 
provision of services.

"We could spend that money so much better. We could improve public 
hospitals, Aboriginal health services, aged care services, dental health 
and use of medicines  and still have money left over for other 
initiatives", said Professor Peter Sainsbury, President of the Public 
Health Association, a member of the Alliance.

The Alliance suggests an increase of $650 million for public hospitals, 
$300 million for aged care, $750 million for a dental health scheme, $200 
million for a genuine education program for doctors, and $80 million for 
Aboriginal health.

That would still leave $317 million change for other initiatives such as 
rural health, preventative and primary health care, before consuming the 
$2.35 billion paid out of taxpayer's money as a subsidy to the private 
health system.

"It's all a question of priorities  public or private", said Dr Woodruff.

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