Medicare: 'Free' does not mean worthless

December 5, 2014
Medicare services are essential and were won through the struggle for a social wage.

Just because we don't pay for something, it doesn't mean that it has no value. Clean air, safe food and public education are just some of the things that we expect to be provided “free” by governments. Yet ask anyone, and they will tell you how valuable these things are. We expect government to provide these services as a matter of course.

Yet it was not always the case. Legislation that protects clean air, regulates safe food and provides free public education had to be fought for and won. There is nothing innate in a profit-first society that stops it fouling its own nest. It is only the will and determination of people fighting for basic rights that have forced governments to act.

Though we do not pay for the air we breathe, it does not mean that it comes free. Taxes that we pay on every dollar we earn (unless you are a major corporation) and almost everything we buy, from a pair of shoes to a house, pay for the functions of government. We, as working people, pay dearly for the services that government provides.

And it is the same with Medicare. Medicare is not a national health service, where the government employs doctors and provides the service “free” (like public education for instance). It is a universal health insurance system, which we all pay for through taxes and the Medicare levy. It ensures that we are all provided with the minimal level of health care — “free” visits to a GP and “free” ancillary services such as pathology and radiology. It is not much, but for many it takes away any financial concern about taking a sick child to the doctor and getting the recommended tests.

We still pay for essential medicines, for most specialists and almost all dentistry.

As limited as the “free” services Medicare provides are, they are essential and were won through the struggle for a social wage — services provided free to all of us, and paid for by the tax system, part of sharing the wealth that we all create. As soon as we accept that we need to make a payment on what was once provided without a fee, it is a slippery slope to “full cost recovery”, where only the wealthy can afford services that were once provided for all.

In Australia this give-back began with university education. The Whitlam government abolished tuition fees for universities in 1974. In 1985 the Hawke government reintroduced them, first as a visa fee for overseas students, then as a compulsory enrolment fee (of $250) for domestic students.

In 1989, the university fee was converted to HECS, a deferred tuition fee, paid as an extra tax levy when a student's income reached a certain threshold. Twenty-five years later and the federal government is attempting to deregulate university fees, which are tipped to increase to $100,000 for some degrees. Education would again become the province of the rich.

There should be no question in anyone's mind that the same thing would happen to health care. If this government is allowed to introduce its Medicare co-payment, either by legislation or regulation, it is the beginning of the end for Medicare.

What's next? A “co-payment” for public schools? Galling, when governments contribute millions to private schools, including the most wealthy, but an essential step in breaking down working people's expectation that they should receive basic health and education services in return for the taxes we pay.

Co-payments, privatisation, fees and cuts to services are part of the price that capitalism has attempted to extract from working people the world over since the late 1970s with the collapse of the Keynesian long-boom into stagflation. Their system is broken and breaks down again and again (witness the GFC). The only way they can keep their profit-first system going is to increasingly force the cost onto us.

It's time to say enough is enough. No more co-payments, no more fees, no more privatisation. Working people create the wealth in this society. Without us, everything stops. We are entitled to a fair society. This means defending the rights we have left and fighting to restore those that we have lost.

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