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 Budget. "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 more". "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 dollars. "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 billing. 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.