The Guardian August 1, 2001


Government killing public health system

by Anna Pha

The Government is spending tens of millions of dollars of taxpayers' money 
on its "closing the gap" advertising campaign. It is trying to persuade 
people to take out private health insurance. The campaign is part of the 
Government's strategy to gut the public health system, including Medicare, 
and boost the private health system. Private health is already being 
monopolised by a few major corporations.

The Government is deliberately creating a two-tier health system. One level 
that will provide services for those who can afford private health 
insurance and are able to pay for their care, and a second level, which 
will be a run-down skeleton of a public health system used by those on low 
incomes and the very poor.

The public health system is being eroded and undermined on all fronts. Bulk 
billing is disappearing in many areas as big corporate medical centres sign 
up local doctors. Public hospitals are grossly under-funded and under-
staffed, resulting in long waiting lists and jeopardising quality of 
treatment.

Many essential medicines cost more. The Government has bent the knee to the 
big pharmaceuticals corporations, and has removed from the Pharmaceutical 
Benefits Advisory Committee (PBAC) several of its most experienced members. 

They have been replaced with individuals with vested interests who have 
connections to the drug industry. 

The PBAC plays a crucial role in deciding which medicines are on the 
Pharmaceuticals Benefits Scheme, and so are affordable to all. 

The Government has scrapped the national dental scheme and now, the poor 
and elderly cannot afford basic oral health care. 

Prime Minister Howard promised Medicare would remain, but it would be the 
Medicare that he and Health Minister Michael Wooldridge have in mind: a 
shadow of the current universal, bulk-billing, public system.

Howard and Wooldridge are pushing Australia towards the US system of 
"managed health care", where the health insurance funds  not doctors and 
patients  decide what medical treatment will be given. It is a "for-
profit system" in which people only get the treatment they can afford  
not the treatment they need.

In the US, where there is no Pharmaceutical Benefits Scheme, the cost of 
routine diabetes, cholesterol and blood-pressure medications is around 
$1,000 per month! 

And when Howard talks of closing the gap, he means only the gap between 
doctor/hospital fees and the refund they are entitled to from the private 
health insurance companies. Most patients will find they still have to pay 
for blood tests, pap smears, X-rays, check-ups and all other basic health 
needs.

It is intended that the remnants of the public health system will offer the 
most minimal of services to the most desperate in the community. This drive 
for privatisation is coming from the big private health insurance funds and 
the transnational medical corporations that are taking over family 
practices, radiology and pathology services and are building private 
hospitals.

Their objective is not to care, cure, prevent diseases and save lives, but 
to make but to make big bucks for shareholders.

One of the difficulties facing the Government and its corporate friends is 
the fact that the majority of Australians want Medicare. They have 
repeatedly voted with their feet and at the ballot box for Medicare. The 
Government and the health funds have used every tactic they can think of to 
scare people into private health insurance. 

These latest advertisements, as with previous publicly funded promotions, 
have been used to undermine Medicare by creating fear in people's minds 
over long public hospital waiting lists.

Many who did take out private health insurance have continued to use the 
public hospital system, much to the chagrin of the Government, the private 
hospitals and the insurance funds. 

People turn to the public hospital system and Medicare when they find that, 
despite the huge insurance premiums, they are still heavily out of pocket 
after treatment. "Closing the gap" is an attempt to overcome this 
difficulty by reducing the amount of money people in a private hospital 
have to fork out after their treatment.

The gap between what the health funds pay and the hospital and surgeons 
charge is being closed either by taking out more insurance or by agreements 
between insurance companies and those providing the medical treatment. 
These agreements are moving in the direction of the US-style "managed care" 
system.

The Government continues to cry poor and talks of the need to balance 
budgets, despite there being no shortage of money when it comes to handing 
out $2.8 billion to prop up the private health insurance industry by way of 
the Government's 30 percent rebate on private health insurance premiums.

This money, if redirected to public health care and services, could treat 
every person currently on a public hospital waiting list in Australia and 
re-instate the Commonwealth Dental Health program as well. It could also be 
used to keep up with the costs of newer generation pharmaceuticals, fund 
new teaching hospitals, and implement the much-needed upgrade of existing 
public hospitals.

The money is there, but the political will is not. The Howard Government is 
committed to enriching shareholders and boosting profit margins. It has no 
interest in providing for the health and welfare of ordinary Australians.

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