Howard Government killing Medicare
Since coming to office the Howard Government has undermined the Medicare system, not by openly cutting its funding, but by failing to increase funding to keep up with increases in prices and population. The Government now plans to means test bulk-billing and apply a co-payment for a consultation with a GP to everyone else. Such a move would sound the death knell of Medicare. Already more and more doctors have been dropping out of bulk-billing because they simply cannot operate their practices economically, and more and more patients are being forced to defer seeking medical treatment until their condition becomes unbearable. Country areas are particularly hard hit. Many country towns now have no bulk-billing practices, and those who seek such a service must face hours of driving to another town. Last Friday federal Health Minister Senator Kay Patterson took another step towards finishing off the Medicare system by boycotting planned federal/state public health discussions, announcing that she would not attend the state/federal health meeting to negotiate agreements on funding. This is part the Howard Government's strategy to withdraw from its funding responsibilities. The talks are held every five years. This month's meeting was due to discuss the crisis facing Medicare as a fee-free and universal health care system, and the Howard Government's proposed new Australian Health Care Agreement between the Commonwealth and the States. The current five-year agreement ends in June. Last November angry State Health Ministers let it be known they would be demanding increased funding for Medicare. The effect of Senator Patterson's boycott, and postponement of the meeting until after March, is that the States will have virtually no time to negotiate, and will be faced with a fait accompli from the Howard Government. Under the Government's proposed means tested co-payment fee system, the consultation rebate provided to doctors would increase — but only for those on the lowest incomes. Consultations with patients on higher incomes would only incur the same paltry rebate as at present. As a result, a means tested/co-payment Medicare would continue to be starved of adequate funds. Bulk-billing would become a "safety net" provision, striking a decisive blow to the key principles of Medicare: universal access and fee-free services. As well as spelling the end of Medicare it would result in a two- tier system of health care based on ability to pay. An increase in funding is essential. The rebate paid to doctors when they bulk-bill needs to be increased immediately so that doctors can afford to bulk bill. This, and the additional funding required by the public hospital system, could be provided by scrapping the $2.3 billion government subsidy (through tax rebates) of the private system, and redirecting the money to the public system. Last week more than 100 doctors, chairpersons of Medical Staff Councils at public hospitals around Australia, and representing thousands of doctors who work in Australia's public hospitals, published a joint statement in The Australian newspaper. Denouncing the current crisis in Medicare and public health, they demanded that action be taken immediately to rectify the situation. "Currently the Commonwealth is resisting the most important elements of a broad-ranging reform agenda produced by clinicians and endorsed by State Governments. Given that it is the Commonwealth that controls the purse strings, and much of the structure related to health care delivery, reform without Commonwealth co-operation is impossible", said the statement. The doctors have organised a National Public Hospital Clinicians' Taskforce to communicate with the public and politicians in order to address "the many serious problems" facing the public health system. "We see patients and their needs on a daily basis. We cope with the sadness and the frustration of the many Australians whom the system fails. We are fed up." The Taskforce is calling on the public to add their voice by contacting their Federal Member of Parliament. If a broad strong campaign is not mounted quickly to defend Medicare, it will be destroyed — by the failure of governments to adequately increase funding and through privatisation and government subsidies to the private sector. Trade union involvement in particular would strengthen the campaign to defend Medicare. After all it is their members and families who will be hit by the loss of Medicare — as both workers in the sector and as patients. The 2000 ACTU Congress adopted policy supporting universal access to bulk billing and the need to lobby for increased funding for public health services. The Howard Government was elected in 1996 with the promise to preserve Medicare, but since that time it has set about dismantling the system, while retaining the name. As Dr Con Costa of the Doctors' Reform Society warns: "If the co-payment system comes in, it will change Medicare to a two-class system. The government will lose control over health costs, which will go through the roof, and we will eventually end up with a private health system." "The government wants to cut Medicare, in order to fund its war ambitions", said Dr Costa.