The Guardian August 29, 2001

Healing the sick private funds

by Peter Mac 

The Howard Government has further muddied the debate about Australia's 
public health care. Prime Minister Howard's recent claim that his 
government had increased public health care funding but that much of the 
improvement had been thrown away by an increase in NSW public hospital 
patients, is phoney, for two reasons.

Firstly, although the amount of money allocated under the public health 
care category has increased, a large component of this comprises funding 
for the private health insurance rebate.

This rebate has reduced the cost of private health cover for the now 45 
percent of Australians who have it, and has saved the private funds from 
financial collapse, but it will do nothing to lighten the load for public 
patients, nor will it increase the number of public hospital beds. 

In short, rather than being a contribution to public health, it represents 
a drain of funding from public health to the private sector  more than $2 
billion per annum.. 

Secondly, although the number of public hospital patients has officially 
fallen, it has in fact continued to rise. The figures hide the many 
patients requiring continuing hospital treatment (for example those 
undergoing chemotherapy) who have this year been classified as outpatients 
and are no longer included in the statistics for normal admissions.

Moreover, public health treatment is still a preferred option for many 
patients with private insurance. This is not just because of the "gap" 
where the amount charged exceeds the combined Medicare rebate and private 
insurance reimbursement for the service-but because they have no more 
confidence in the public system.

Rather than reducing the pressure on public hospitals by providing adequate 
funding, the government has attempted to divert patients away from public 
hospitals to treatment in private hospitals, as part of a long-term 
strategy to minimise or eliminate the public health system altogether.

They have certainly been successful in terms of supporting the private 
health sector at public expense. The health insurance rebate, together with 
the penalties under the so-called "Lifetime Health Cover" plan for those 
who wait till they are over 30 before joining a private fund, resulted in 
many people stampeding into private health Care.This in turn led to many of 
them having minor operations that would not have been possible in the 
overworked and underfunded public hospital system, which has had to resort 
to discouraging or deferring patients with minor or non-urgent ailments, 
and those with private cover. 

However, in terms of reducing the role of the public health system, the 
government's tactics to date have backfired, and the current demand for 
public hospital beds is now virtually the same as before the introduction 
of the rebate.

The private hospitals, meanwhile, are laughing all the way to the bank 
because of the increase in their patient numbers.

The losers in all of this are those who rely on public health facilities 
and treatment. The funds provided by the government for the private health 
insurance rebate could have simply been allocated to upgrading public 
health facilities.

In this case, the overall result would have been a genuine improvement in 
the level of public health care, including an increase in public hospital 
beds and a reduction in waiting time.

The government has also fallen flat on its face in regard to specific 
responsibilities in the area of public health. A report by a team of 
leading oncologists has found that last year some 10,000 patients had to 
wait up to 12 weeks for, or missed out altogether, on radiation treatment 
for cancer. 

The report stated that some 43,000 of the 85,000 patients diagnosed with 
cancer each year require hospital treatment, but that only approximately 
33,000 had received this treatment.

ALP health spokeswoman Jenny Macklin stated that an ALP government would 
provide funding for all those who needed treatment.

The Federal Minister for Health, Dr Woolridge, responded with a hysterical 
outburst about diversion of funds from genuinely worthy areas of public 
health to Labor's plan for "two and sixpence for everyone with cancer".

All in all, it's not been a good week for the government as far as public 
health is concerned. But then, it hasn't been a good five years for the 
Australian public.

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