Green Left Weekly asked the Democrats, the Greens and the Democratic Socialist Party for their views on the threat to the public health system.
The three questions asked were:
- The government has tried to sell its changes to the health budget as "fair" and "efficient", especially the move to shift higher income earners to the private health system. Is this a good move? How much of a threat to Medicare is this?
- What are the likely impacts of the transfer of responsibility from the Commonwealth to the states?
- What, in your party's view, would constitute a fairer health system?
Democrats' health spokesperson Senator Meg Lees:
- The Australian Democrats object to linking the high income surcharge to a failure to take out private health cover. This is a dangerous step which could ultimately threaten the universality of Medicare.
The Democrats do not believe providing a private health insurance rebate and making major cuts to public health care — for instance, the Commonwealth Dental Health Program or funding to public hospitals — is equitable. The government must ask itself if the money being spent on tax breaks could not be used more appropriately in improving the public system.
While the Democrats are supportive of the idea of an increase in the Medicare levy for higher income earners, we believe the increase should be more progressive and imposed irrespective of whether or not individuals have private health insurance. It should not be tied to a failure to take out private health cover.
- The Democrats have a long record of opposing Commonwealth handing over key health and community services to the states. At the moment the federal government seems to be handing over responsibility but not accompanying the shift with extra funding, which could bring instability to the system. This may be a step away from universal standards of health care around the country.
- The Democrats' health policies reflect our commitment to ensuring every Australian, irrespective of wealth, has access to a high standard of health care.
We believe a health system funded through taxation, with a strong emphasis on preventative health measures and education, would open the door to a fairer universal health system.
Democratic Socialists' health spokesperson Jane Beckmann:
- The government is pushing ahead with a two-tier health system with its bid to force higher income earners into the private health system. While the rich are obviously able to (though they may not want to) pay the higher private insurance fee, the DSP's main objection to this is the undermining of the universality of Medicare.
What's to stop the government, further down the track, from introducing more "special" levies and a co-payment scheme once it has won its ideological battle to institutionalise user-pays in the health sector?
The Democratic Socialists also oppose the government acting as a broker for the private health insurance companies while cutting funding to the public system. Health care should be based on the principle that health is a right and not a commodity to be bought.
These moves are a threat to Medicare (and another broken promise) because they are designed to encourage the private health system at the expense of the public one. The disastrous consequences of the two-tiered health system can be seen in the United States where, according to Hillary Clinton, 10 million children are not covered by any health insurance.
- Forcing the states to shoulder the health care burden is simply passing the buck. Combined with hospital funding cuts, it will worsen the queues in the public system. The Commonwealth's hands-off approach will not only reduce its accountability, but it is certain to result in the replication of Kennett-style health "reforms" — longer waiting lists, less spending on hospitals, staff cuts, shorter patient stays and, inevitably, worse health outcomes.
- A quality health system would involve a transition from today's "fee-for-service" medicine to one based on salaried health professionals working with elected community health boards.
A fairer health system would eliminate the Medicare levy, generalise bulk-billing and expand Medicare to cover the services of dentists, opticians, psychologists, physiotherapists, chiropractors and paramedical professionals involved in preventive health care.
Funding to public hospitals as well as the community health sector should be massively increased. Funding to Aboriginal communities to boost the provision of health services must be made a priority, as should funding to community support networks for the developmentally disabled, the aged and their carers.
Public pathology services should be increased to undercut the high cost of private operators. A public pharmaceutical manufacturer should be established and strict limits be set on the prices of pharmaceuticals provided by multinational drug companies.
Greens senators Dee Margetts and Bob Brown:
The Howard budget is "Sneakback" — the 1993 Fightback! package sneaking back under a string of broken election promises to gut public services and compound poverty and environmental degradation in Australia. While the stock and money markets sing the praises of the new budget, monitoring of talkback programs proves that two to one Australians condemn the budget for its vicious and harsh measures.
Cuts to the aged in the 1996/97 health budget provide an indication of the unfair way in which the Howard government has sought to achieve its deficit reduction strategy. The introduction of up-front fees for nursing homes will strike at older Australians who will be frightened of losing their family homes. The abolition of the Commonwealth Dental Program means that the elderly will be forced to wait in lengthy queues to access dental care. While services to the aged are cut by more than $460 million over two years, the $800 million diesel fuel rebate to the mining industry remains intact.
The Greens support an increased Medicare levy for high income earners across the board regardless of whether private health insurance is taken out. The Greens do not support the government's plans for a Medicare rebate for those who take out private health insurance.
The decision by the health insurance companies to raise their premiums adds weight to the argument that the government should not be tampering with the universality of Medicare.
Budget measures the Greens will oppose:
Introduction of up-front fees in nursing homes. The cut of $5 million in 96/97 ($130 million in 97/98) shifts responsibility for improving the poor quality of nursing homes from the government to the residents of the homes. The system requires an injection of $600 million to bring it up to standard but charging fees is only expected to raise $130 million per year. Given the urgency of the crisis the abolition of capital funding by the Commonwealth is to be deplored. 65% of residents are pensioners.
Home and Community Care — increased charges levied on clients of services. Cut of $5.5 million in 96/97 ($17.6 million in 97/98). The government claims to have kept its pre-election promise to maintain the forward estimates for the HACC program of 6% growth in real terms. However, this claim is deceptive. There is only a 4.8% real growth in government funds. The remaining 1.2% growth is to come from increased charges being levied on the clients of the services. The Commonwealth has a responsibility to maintain the 6% growth contribution (HACC only meets half the demand for its services and demand is growing at a rate of 2.7% per annum). 93% of HACC clients are pensioners.
Commonwealth Dental Health Program — abolished.
Cut of $55.6 million in 96/97 ($112.8 million in 97/98). An evaluation of the program carried out by the Department of Health and Human Services in 94/95 showed it has a marked improvement in dental health outcomes for low income people. It had assisted 500,000 people per year and significantly cut waiting lists in each state. The program also provides assistance to Health Care and Commonwealth Seniors Card holders.