"The Coalition government's plan is not only to privatise Medicare, but to destroy it as a universal, national healthcare system," Peter Boyle, the Socialist Alliance candidate for the seat of Sydney, said on July 1. "The plan is based on a form of 'creeping privatisation,' together with undermining its coverage of the majority of community health services around the country."
He was commenting on the accusation by Prime Minister Malcolm Turnbull that Labor opposition leader Bill Shorten was engaging in a "Medi-scare" campaign by declaring the election to be a "referendum on Medicare" during his official campaign launch on June 19.
Shorten quoted Turnbull from when he was Liberal opposition leader in 2009: "In an ideal world, every Australian would have private health insurance. That would be the best outcome."
In response, Turnbull tried to head off Labor's attack by declaring that same day: "Medicare will never, ever be privatised ... Every element of Medicare services that is being delivered by government today will be delivered by government in the future. Full stop."
This would seem to be refuted by a Productivity Commission inquiry into competition for a range of government services recently commissioned by Treasurer Scott Morrison. The inquiry was looking into digitising the Medicare payment system and outsourcing back-office tasks currently performed by public servants, as a cost cutting measure. A departmental taskforce has been set up to consider the options.
Turnbull refused to confirm whether a $5 million contract to consultants PriceWaterhouseCoopers about outsourcing the payment system upgrade had been scrapped, saying: "The administration of the research into this is a matter for the department."
Boyle said: "Why set up a Productivity Commission-recommended taskforce into outsourcing the Medicare payment system, which would result in the loss of thousands of jobs in the Department of Human Services, if the government is not seriously considering this plan?
"The truth is, after abolishing the Labor government's original Medibank national health scheme in 1976, the Coalition has been trying to undermine Medicare ever since it was introduced by the Hawke Labor government in 1984. Under former Prime Minister Tony Abbott and now Turnbull, the Coalition government is continuing its attempts to cut away at Medicare by any means it can.
"So far, a number of these proposed measures, such as the introduction of a GP co-payment, have been blocked by the Senate, under the pressure of mass opposition in the streets and through public opinion."
From another angle, Alan Mitchell, writing in the June 21 Australian Financial Review, said: "So, Labor is taking a stand against the privatisation of Medicare. But Medicare already has been heavily privatised, and Labor governments have been happy enough to accept the fiscal benefits.
"The privatisation occurred as governments have forced middle income households to take out private health insurance. Of course no one calls this privatisation, but that's what it is. Medicare essentially is a national health insurance scheme. Everyone has health insurance, but the insurance of middle and high income earners effectively has been outsourced to the private sector.
"This has been achieved by using penalty taxes —- called Medicare levy surcharges — and tax rebates to push middle and high income earners into private insurance."
The Greens propose to abolish the private health insurance rebate and reinvest billions of dollars of savings into the public health system. The rebate of up to 30 per cent of the cost of private health insurance is a $5 billion annual hit to the federal budget.
Greens leader Richard Di Natale said on March 30: "The private health insurance rebate is a public policy disaster that has completely failed to achieve its stated objective of easing pressure on public hospitals. If the $5 billion-a-year subsidy [were] reinvested back into the public health system it would take the pressure off hospital waiting lists, reduce waiting times in the emergency department and help fund public dental care."
Ben Eltham wrote in the June 21 New Matilda: "The Coalition has consistently attacked public and universal health care in office. It has encouraged the privatisation of Australia's health system in several different ways.
"One of the first things the Abbott government did on gaining office was to privatise the big government-owned health insurer, Medibank Private. This was no small undertaking: the share float was a multi-billion dollar undertaking, and resulted in a government insurer being sold off and turned into a listed corporation on the ASX. In its latest half-yearly results, Medibank Private made a profit of $228 million on revenue of $3.4 billion.”
The Abbott government's first budget in 2014 included funding cuts to health and the notorious $57 billion in cuts to hospital funding for the states and territories. That budget also planned for the $7 GP co-payment, which would have seen patients paying $7 every time they visited the doctor or had pathology tests.
While not strictly privatisation measures, they would have shifted some of the cost of health care onto consumers. It was an attack on the principle of universal health care and would have led to a two-tiered system, in which richer patients had as much health care as they wanted, while poorer citizens missed out. These funding cuts represented privatisation by stealth, by which the government gradually removed itself from delivering health care, and expected private citizens to take on more of the risks and the costs.
Under a re-elected Turnbull government, bulk-billing will soon be a thing of the past for most patients. The Coalition has already announced that it will continue the freeze on Medicare rebates, which have not increased since 2012, until July 2018. Medical practitioners who do not bulk bill will undoubtedly raise their fees for those without a health care card.
"The truth is that the Coalition is ideologically opposed to Medicare, as a universal, national, public health system," Boyle said. "A re-elected Turnbull government will continue that assault on Medicare, by whatever means it can.
"The community will need to mobilise to defend Medicare, as one of the most important social gains of the past 30 years. We must remain vigilant against the cuts to public health services in all areas and fight against this neoliberal offensive to privatise and cut back Medicare, our public hospitals and all the health services that are so vital to our community life."