Labor makes health central in its election bid

stethoscope-adult-navy-blue-2147-12-214-240-lr_220In revving up his election spiel Shorten said spending on health was an investment, not a cost. He says investment in health is basic to economic growth. It would be an important battleground if Turnbull would engage. The pointy end is that Labor is choosing to invest in Medicare and the Pharmaceutical Benefits Scheme rather than spending money on company tax relief.

Turnbull just says it’s unfunded, which is a lie, and he knows it.

Labor will end the freeze on Medicare payments to GPs, started as a temporary measure in 2012 by Labor and extended by Abbott/Turnbull to 2020. The policy would apply from 1 January 2017, at a cost of $2.4bn over the next four years, and $12.2bn over the decade.

On the box Matthias Corman said the bulk billing rates were over 80% and had continued to rise under the LNP. That surprised me, but may not be far from the truth. An article in the Oz (paywalled, but Google Sean Parnell Bulk-billing rates have continued to rise under the Coalition) says:

    the overall bulk-billing rate was 78.1 per cent, compared with 77.5 per cent for the same period the year before.

    For unreferred GP attendances, excluding nurses, the rate was 84.8 per cent, compared with 84 per cent previously, suggesting the larger corporate clinics have absorbed the added financial pressure.

A 2015 survey found that 71.17% of respondents reported that their most recent GP visit was bulk billed. Seems the tendency to bulk bill is related to the number of GPs in the area, patient characteristics and the nature of the visit.

A Fact Check from 2013 shows that it was high and rising under Labor, about as high as it is now. The fact check was done to test the claim made by Tanya Plibersek before the 2013 election:

    “The bulk-billing rates are at historic highs now. Visits to GPs are 82% bulk-billed. When Tony Abbott was minister it was 67%.”

It seems Plibersek was cherry-picking, as this graph shows:


The blue lines mark the time Abbott was health minister. From the graph it looks as though Abbott may have done something to change the trend, but I don’t know what.

Nevertheless if the rate has only risen a couple of percentage points under the present government, Cormann’s statement was misleading. It looks as though bulk billing rate is pretty much flatlining, and the talk is that the system is under severe strain. The full fee is about double the Medicare rebate. If the freeze continues a co-payment of $15 is being spoken about for a standard GP visit.

Now Shorten has also pledged to axe the 2014 budget cut to the pharmaceutical benefits scheme, which has been booked as saving $1.3bn but is blocked by the Senate. It’s part of the $18 billion worth of ‘savings’ technically in the budget, but in limbo because of a hostile senate.

    Under the government’s plan, general patients would make a $5 co-payment and concession patients would pay an extra 80 cents on each prescription and there are also increases to the scheme’s safety net threshold.

Dumping that plan would cost $3.6 billion over 10 years, which again Labor is offsetting against the company tax cut.

Here’s Shorten spruiking his plans:

    The Liberals keep saying that Australia has to choose between good schools, decent healthcare, and fair pay on one hand or a growing economy.

    It’s is a false choice the Turnbull conservatives love so much: that you can only have a strong economy or you can only have a fair society but you can’t have both.

    We in the mighty Labor Party, we understand that growth and fairness are not mutually exclusive – they are not enemies opposed.

    Each depends upon the other and reinforces the other.

    Labor knows investing in people is the best growth strategy that Australia ever had and ever will have going forward.

Certainly a healthier population will be more productive.

Shorten also says the LNP “allocated $5m for a secret government taskforce to investigate the fastest way to privatize parts of Medicare.”

14 thoughts on “Labor makes health central in its election bid”

  1. Today I paid my GP a visit, mainly for a script of stuff I need regularly. The practice works on 15 minutes per consultation and I saved her a bit of time, so we had a chat about bulk billing.

    She felt that you couldn’t practice good medicine and be reasonably rewarded for the skills GPs possess and what they do under bulk billing.

    Bulk billing provides $37.05 for a standard consultation. That’s $74.10 for half an hour. I’ve recently been charged $80 by a podiatrist for half an hour, and $85 by a physiotherapist. My doctor said that iridologists claim expertise and charge quite a lot.

    About 10 years ago I used to go to a clinic that bulk-billed. The consultations were booked on a 10 minute basis and it was hopeless. After the first three consultations my doctor was always way behind.

    Turnbull thinks doctors should carry the can until we can afford to give them a break.

  2. Freezing the Medicare rebate does nothing for the typical person in the street who ends up paying the doctor one way or another.
    The method Australians demonstrably prefer is to contribute to universal health care through the tax system.
    (We actually prefer Medicare, which is why John Howard had to blackmail us into taking out private health insurance. Isn’t the taxpayer footing 30% of private insurance premiums effectively socialised medicine??)
    Freezing the rebate puts pressure on GPs to charge co-payments since their expenses are rising all the time. The result can only be consultations becoming more out-of-pocket expensive, resulting in people with limited means deciding they can’t afford it and either presenting at hospital emergency departments or forgoing treatment altogether.
    By extending Labor’s unconscionable freeze until 2020 the Abbott/Turnbull Government is effectively engineering a decline in the average health of Australians. Maybe they’re hoping poor people will die out?

  3. Turnbull thinks doctors should carry the can until we can afford to give them a break.

    Brian, I think he should be upfront about how Australia can’t afford a health system. Honestly, we really can’t and as every politician seems to be saying these days, “We’ve got to live within our means!!”
    We should close all medical facilities immediately and make medical practice illegal within Australia. The wealthy will be able to access medical care off shore and the rest of us, if we’re unfortunate enough to get sick or injured will either recover or die – problem solved.
    Think of the money we’ll save.
    We can spend it on really, really important things like submarines and joint strike lemons, and hard hats and hi-vis jackets for politicians to wear while they inspect the submarines and joint strike lemons.
    And our universities will be able to concentrate on really important, life enhancing courses like MBAs when they don’t have the burden of funding medical schools.
    The only downside is that there’ll be a helluva lot of vastly overqualified people making hamburgers.

  4. Well I am not a great fan of Labour’s total obsession with Health, Education , and Work Conditions. These are vitally important issues, but they are not the ONLY ones.

    The economy goes first, and the public instinctively knows this.

    I’ve just done three days of a manufacturing and industry show in Sydney (National Manufacturing Week) which clearly laid out the situation. For starters the show was reduced from three halls to one. Secondly the unanimous expectation is that everything is imported, “you make this product here?, in Australia? nobody does that any more!!!”. The Chinese contingent of stand holders was nearly equal to local stands (most representing imported products).

    We are heading rapidly to becoming consumerserfs in our own country (well actually the aboriginal’s country), enslaved by brands of one kind or another, all from overseas, and the neoliberals are cleaning up as the brokers of our enslavement. To add insult to injury the politicians we elect are unwittingly subservient to the brokers. Think about the passage of change that allowed Murdoch to mop up the biggest share of Australian media, and then the progression of banking industry deregulation.

    Yes, that sounds extreme, but think about it. How much of your life do you spend strolling in the meadows and smelling the flowers? We spend the very largest proportion of our lives working to educate our kids and hang on to the one thing we own, our houses. This is the twenty first century, I kind of recall debates about managing our excess leisure time…..this century.

    So what has happened? It is simple, we have been seduced by the notion of cheap goods, which have been supplied reducing our living cost. The problem is that we have used that free income to inflate the cost of our properties while at the same time converting our economy from a healthy agricultural, high value minerals and manufacturing economy to a far less healthy agricultural, low value bulk minerals and services economy, with the bulk of the population dependent on services and construction.

    It is a very frail economic structure. Think of it as a single silk thread supporting a string of dew drops along its length, as against a complex web supporting dew drops all over the web. This does not make Turnbull right, as his policies are structured to make managers rich and do nothing for throughput (taxation is drawn from throughput), but it does mean that Labour’s approach is deficient as it offers nothing to alter the frail structure that our economy has become.

    What is the solution?? That is the debate we should be having. Innovation, the buzz word at the NMW show, is only part of the answer, the real solution is Entrepreneurship…at every level….Innovation is useless without it.

    Entrepreneurship is what Labour should be promoting in this election. A resurgence of individual initiative and creative effort is the real solution to our fiscal woes, and it is very easy to promote with some carefully thought through creative policies. But that is hard to do when one is obsessed with thinking of people as employees (workers) only.

  5. BilB, Labor always stresses the need for health, education, skills training, research, infrastructure (including NBN) as necessary conditions. Necessary, but not sufficient.

    I went looking and found their policy Powering Innovation, which to my untutored eye seemed to have scoured the world to see what works and seemed to have the main bases covered. Plenty about entrepreneurship there. I’d appreciate your reaction.

    Carriage in the shadow ministry seems to be mainly with comrade Kim Carr and Ed Husic.

    I agree that entrepreneurship is important. Early in my investment career I invested in a quite a few promising startups with world-beating potential. Almost every one came unstuck for various reasons.

    I remember making some money out of an outfit that made lightweight brakes for the auto industry (Pacific BBA). Don’t know how they ended up.

    However, I have encountered the cultural attitude that making things here is not what we do.

  6. Out of that lot, Brian, which looks to me like a the output of a late night committee, I would:

    Smart Investment Fund should be managed by a body called CARPA which would take in the first four items

    The STEM (Science Technology Engineering and Mathematics) item is a good one taking in the next item and this takes in the other two related items to do with promoting teachers in this area.

    The University Startup Year is a good one as long as it does not then on develop into a business startup pre requirement over time.

    The “Learn Code” item is a powerful modern life skill, not only because codes of various kinds are useful but because it teaches structured thinking as well.

    The National Digital Workforce Plan is a good one.

    The attracting international talent with a special visa is a good initiative particularly pulling in European talent.

    Above all though for the long term the absolute best educational tool that should be infused into our education system is ……philosophy. Not University philosophy, but fundamental philosophy.

    The UNSW has an excellent resource kit for this field which starts at the preschool level. It is all about learning to inquire and think constructively. With this in our schools everything else falls into place naturally.

    However, additional to the Labour platform I would add:

    I’ve already put forward the notion of CARPA which is the civil version of the US DARPA. Civil Advanced Research Projects Agency, with a broader focus would be a better structure through which to promote innovation while including a number of strategic national significant themes themes such as renewable energy implementation. Here is an example of how DARPA works. Now think about what the Civilian (CARPA) equivalent organisation would work and how that buttresses all of the Innovation initiatives proposed by both parties.

    Another vital item missing from the innovation platform is that of Sales. Selling products is every bit important as production, perhaps even more so. If you cannot sell it then there is absolutely no point in producing it. Marketing is often confused with sales but selling is where the talent is. We even should have a minister of sales and marketing separate to the minister for commerce. Blending sales in with innovation will improve the performance of innovation efficiency, and the reason is simple…….

    Innovation is a process. Innovation is the process of solving problems in a manner that yields a marketable product. The first requirement of the Innovation process is to have a problem to solve. The best kind of Innovation yields a product that the market needs and can be readily sold. Sales and Marketing are the natural partners of the Innovation process right from the outset. Every Industrial Design office knows this to be the fact as that is their bread and butter, and their business process.

    Australia desperately needs to improve its attitude to Sales people and develop a body of talented sales professionals. We churn out accountants by the thousand forgetting that the essential prerequisite to accounting is turnover ie Sales.

    Another vital need for new product developers and Innovators is……….space. Somewhere to work. In times past this would be the garage, the back shed or the farm barn, but with to drive to increase the density of our cities the need for people to have space to be creative has been forgotten as an essential need. People living in units are especially limited in this way. I believe that there is a new facility out here at Western Sydney University intended to service this need, but that is a high end version structured to promote networking specifically. Even before that there is the need for a space where people can have some tools and some privacy. Perhaps a young version of men’s sheds, the creativity shack maybe.

    For me one of the most important skills I learnt was sewing, which I learnt in first class primary school in Port Moresby New Guinea. I can even remember where I was sitting in that class. It is the little things that make the difference. I have come back to that many times through my life. I was very fortunate to have a father with a love for philosophy and who understood the power of an inquiring mind.

  7. Brian,

    Labour routinely makes the mistake in elections to over boil Health and Education. These are very important things but they are not what occupies people on a daily basis. We take our education for granted, and we do not think about being unhealthy consistently. What we do think about is earning enough to pay the bills and to have a roof over our heads. Labour needs to focus more on our future employment prospects with some real understanding and energy. They traditionally address employment with their focus on wages and work conditions, but right now people are seeing those employment prospects drying up and becoming difficult to find. That should be their larger focus in this election, and Innovation is only a part of that.

    Fairness in the remuneration field is a big vote winner with little cost. People are not as concerned to earn more as they are concerned with the run away remunerations of the executive elite which ultimately make them feel foolish for having done without. This is why Morrison’s determined tax reduction for the wealthy has hurt them so much. Labour needs to drive this advantage hard. Then,… they can talk about Health and Education.

  8. Labour routinely makes the mistake in elections to over boil Health and Education.

    That’s probably right. Labor never takes them on properly on what the public sees as the LNPs strength – economic management. Stephen Koukoulas did that article showing that over the last 42 years Labor’s performance was superior. The ALP should make something of it, and blow them out of the water, rather than just countering “jobs and growth” with “putting people first”.

  9. BilB, upthread you mentioned phlosophy as something that should be taught in schools. The link was o’seas and was under the rubric of “gifted and talented”.

    There’s a bloke called Philip Cam at the UNSW who has been promoting philosophy in schools for all kids for decades. When my youngest was in a composite class of Yr 5-7 in a small Brisbane school in 1998-2000 they did Philosophy. I attended a demonstration lesson led by Philip Cam himself. The Catholic primary schools were big on it too. The kids loved it.

    In addition to the skills mentioned in your link, I would highlight listening skills, respect for the views of others if they can be defended with rational argument, and ethics. At that school behaviour management issues in the school yard would be brought into the classroom and discussed by the kids, with the leadership of the teacher.

    I’ve lost contact, but I imagine all that good stuff has been squeezed out now by the crowded National Curriculum.

  10. You are right, Brian. Phillip Cam’s work is what I was attempting to find., but it wasn’t leaping out at me. It is a huge loss that our public schools have not universally adopted UNSW’s philosophy for schools resource. Worse, I don’t think they understand the nature or extent of the loss.

  11. BilB, my wife says she met the woman who was principal at my son’s school last year at a funeral.

    Said principal is retired, but teaching philosophy at Hillbrook, an innovative private secondary school here. She said it was taught at a number of secondary schools around the traps. I wasn’t aware that it had penetrated secondary at all, so good news, as far as it goes.

  12. Yep, BilB, that’s the one. Her name, which deserves to be known is Lyn Hinton.

    When she took over the enrolment was 48, and if it’s under 50 at the end of the first week you lose your third teacher. So she put an advertisement in the local shopping centre promising exciting, innovative programs. Then, she says, she reflected on what these might be. That got her three new kids, if memory serves.

    It was a school in a disadvantaged inner city area (now no doubt gentrified). A few years later the enrolment had to be capped, at a little over 100, I think. There is no zoning in Qld schools and we drove across the city twice a day for three years to get our son there.

    She did it on a literacy grant she applied for from the federal coffers for disadvantaged kids. Along the way she won Australian Teacher of the Year.

    A great lady, a Kiwi, who apparently wasn’t much good at school. Or so she says.

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