Health care under attack
The Abbott government is preparing to attack the health care system in a very big way. This will be disguised as a way of saving money, but in reality is ideologically driven.
It will help achieve the government’s aim of removing the social capital of a universal health care system from the majority and pouring money into the pockets of the wealthy – the private health insurance industry, private hospital operators and large corporate general practice owners. It will leave workers, the poor and those with chronic illnesses less able to access good primary health care.
The Australian Centre for Health Research (ACHR), in a submission to Tony Abbott’s Commission of Audit, has proposed the introduction of an up-front $6 fee (as a co-payment to bulk billing) for GP visits. A quick look at who sits on the ACHR’s board – mostly private health sector executives – reveals where its interests lie.
But it’s not just the ACHR that has Medicare in its sights. Last year, Jeremy Sammut, writing for another right wing think-tank, the Centre for Independent Studies, released a raft of retrograde suggestions, including privatising public hospital facilities to create a “contestable and competitive public hospital sector”.
Also on the list are both a suggestion to allow hospital managers to hire and fire clinical staff on “flexible terms” to circumvent state-wide employment conditions for doctors and nurses, and the defunding of “ineffective ‘nanny state’ public health initiatives targeting ‘lifestyle diseases’”.
The private health industry has Tony Abbott’s performance in the Howard government to assure it that the future is bright. As health minister, Abbott supported the ballooning of the private health industry and oversaw a drop in federal funding to public hospitals from 50 percent to 39 percent of all funding.
In December the current federal health minister, Peter Dutton, approved an average increase of 6.2 percent for private health insurance premiums in 2014. All 34 insurance companies applied. Comments from Dutton last May, as shadow minister for health, supporting privatisation of the management of public hospitals, also add to a concerning picture.
It is currently illegal, under the Private Health Insurance Act, for insurers to cover medical services that are provided out of hospital and covered by Medicare. However, Medibank Private is currently running a Brisbane-based trial guaranteeing its customers bulk-billed consultations within 24 hours at nearby IPN clinics. IPN (Independent Practitioner Network) is a corporate general practice boasting “over 140 modern, multidisciplinary medical centres located around Australia”.
Medibank Private is getting around the law by contributing to IPN’s “administrative costs” for seeing its customers, rather than paying for the consultation directly. Dutton says he sees “no evidence” of illegality in the arrangement.
Insurers are also pushing for a law change so they can start paying GPs incentives if they are able to reduce the “cost” of the insurers’ most expensive patients. As in the US, this will lead to doctors tailoring health care to suit insurers rather than to treat patients.
And of course there is the annual $5.6 billion spent on the private health insurance rebate, feeding money through private insurance companies, which then finance more expensive private hospital care.
Considered in this context, the latest proposal to charge for visits to a GP appears to be another part of the ideological crusade against a universal access health system and for a user pays two tiered system with a second rate “safety net” for those who can’t pay.
