Monday, 30 December 2013


Prime Minister Tony Abbott has been in office less than four months and there are now press reports of a crucial change to the pillar of Australian health delivery, Medicare. As I write, Terry Barnes is speaking on ABC 24. Barnes was a health adviser to Tony Abbott when he was Minister for Health in the government of John Howard.

Interpolation: I am very critical of Abbott and his government but I believe in giving credit where credit is due.  I was very grateful to Abbott as Minister for Health.  Through my life, I had always taken care of my teeth.  I am getting older and had not been able to afford visits to dentists. As well, I was suffering a number of chronic illnesses.  Health not top notch.  Now, dentists - historically - have avoided any form of medicare as if it was the plague.  Under Abbott, a number of Medicare numbers became available to allied health professionals so that areas such as dentistry, psychology, podiatry and so on opened up and people could be bulk billed for a limited number of visits or, in the case of dentistry, a limited amount of money in a particular time period. There were two qualifiers - three chronic diseases and a care plan from your medical practice.  Initially, there were no dentists available anywhere near me making it impossible to take advantage of Abbott's new scheme.  Gradually, however, dentists began to come on board.  I found a dentist and over time received two or three bundles of credit.  For me it was like winning a lottery.  The scheme was closed down under Labor amid accusations of the scheme being rorted by well-off people getting cosmetic surgery.  I can't speak about that but Labor never did mention the boon to aged pensioners like myself in poor health without the ability to get desperately needed dental work.  Surely, if there was rorting by the rich a means test would have rectified the problem.  When the scheme was finally closed in November 2011, Labor put nothing - yes, nothing - in its place. They made a huge fanfare and promised to fund more 'chairs' for public dentistry but that is not due to start in 2014.  I'll be keeping a watching brief on that ... particularly now that there is a new government which does not have to take responsibility for a policy announced but not implemented by Labor.  My betting is that there will be little, probably no, dentistry available.  The major difference between the Abbott program and Labor's proposal is that eligible people could book in with a private dentist like any other patient.  No waiting list as there had been in public facilities.

Now that I have done the niceties with a tip of my forelock to Abbott, back to the matter at hand.  

Barnes's recommendation is part of a commissioned private proposal presented to the National Commission of Audit.  I have not got exact confirmation but I believe that the Barnes report was commissioned by the Australian Centre for Health Research.  [For the Terms of Reference of the NCA, please see the document embedded below. It can be read here on line or down-loaded from this post.]  The term "commissioned private proposal" I interpret as code for saying that this is a Liberal Party generated proposal, more than likely with Abbott's consent, put together by an adviser to the Minister for Health (namely Abbott) in the previous Liberal-National Party Government.  The National Commission of Audit is not a new concept.  The same thing occurred when John Howard Government came to power

The Commissioners for the Abbott Government's National Commission of Audit are:

It seems to me that the personnel of the National Commission of Audit are there for a combination of bureaucratic expertise and political  and business gate-keeping.  The NCA is certainly not informed by either policy or economic vision.  

Back to Terry Barnes and his appearance on ABC 24.

One of the problems that could be brought about by imposition of the $5 co-payment - people opting for an Emergency Department visit instead of a visit to the GP -  is easily dealt with according to Barnes.  No probs, says Barnes.  State Governments could introduce a co-payment on Emergency Department visits in State Hospitals!  In short, there will be gate-keeping either at your General Practice or at the Emergency Department of your local hospital.  

There will be sufficient concessions introduced to induce you not to complain.  Pensioners and concession card holders will be exempt from the co-payment.  Families will be provided with 12 free bulk-billed visits annually.  

Barnes think that the co-payment, even the co-payment at Emergency Departments, is not a big deal.  He compares it, blithely, to no more than the price of a burger and chips. Silly me.  I thought we were trying to encourage a healthy diet away from burger and chips.  Not all poor families frequent Maccas or its competitors.  They care for their budget and they care for their health.  I don't believe that Barnes, those who commissioned his report, and those who will receive it have a clue about ordinary families let alone poor families.  None of those on the Commission of Audit have taken young families to the GP recently ... so how do they have a clue?

Lastly, why has this been spread first all across the Murdoch Press?  Melbourne's Herald Sun is full of praise for the proposal. This then is propaganda.

Why did Abbott not announce this at the election?  Fearful of the polls?
Why did Abbott not have a national conversation about this post-election?  Fearful.

Clearly the Abbott government is determined to implement this policy while maintaining its distance as the conversation goes on somewhere else ... anywhere else but having the conversation take place between the nation, himself and his Ministers, Peter Dutton and Fiona Nash.  No.  This policy is to be introduced by sleight of hand ... or by some amount of apparent coercion by the Commission of Audit.  

We will be told over and again 
>    how this has to happen.
>   how a price signal has to be sent.
  how it is a small and reasonable amount.
>   how it will not prevent people seeing a doctor
ad infinitum, ad nauseam.  

Please continue to follow 
the introduction of a dishonest policy, 
by dishonest people in support of a dishonest government.

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