(en) Australia, The Platform #1 - Attacks on Medicare and Health Care Inequality by Kieran Bennett

The Abbott government is busy laying the groundwork for a massive attack on the conditions 
of the working class in April?s federal budget. In charge of preparing the ground is 
Abbott?s hand-picked Commission of Audit. In the line of fire: Medicare and your right to 
access a GP. The plan: Rob $750 million from Australia?s poorest whilst giving $5.9 
billion dollars to private health insurers. ---- The Commission of Audit ---- The 
Commission of Audit is an assortment of business lobbyists and Liberal party mates. The 
Commission is headed by Tony Sheppard, president of the Business Council of Australia 
(BCA) and (until October) chairman of Transfield services. As head of the BCA he argues 
for lower taxes, abolition of the fair work act, and various attacks on the social wage. 
As chairman of Transfield Services, he profited from mining, coal, and up to $180 million 
in government contracts for the operation of refugee prisons in Nauru.

Commission member Peter Boxall is a former Chief of Staff to Peter Costello, who spent 
time working for the IMF during the ?structural adjustments? of the 1980s, and played a 
key role in implementing John Howard?s ?Work Choices?.

Amanda Vanstone joins this disreputable bunch bringing her experience as a Howard 
government minister responsible for attacks on the unemployed, students, and pensioners, 
the abolition of the Aboriginal and Torres Strait Islander Commission (ending any 
semblance of self-determination, as flawed as that body was) and of course, the 
imprisonment of many thousands of refugees.

What?s in a co-payment?

The first shot across the bow aimed in the new attack on Medicare was fired by former 
Abbott advisor Terry Barnes of the Australian Council of Health Research (ACHR). The ACHR 
is a ?think tank? funded by Australian Unity, a health insurer with a lot to gain from any 
attack on Medicare. Barnes published a paper to coincide with the election of the Abbott 
government which called for the private health insurers dream ? compulsory upfront fees 
for Australians utilising Medicare.

Barnes wants a six dollar Medicare ?co-payment?. His argument is that poor Australians go 
to the GP too often, and that an additional six dollar upfront fee would send a ?price 
signal? that would harmlessly discourage over use of GPs. Barnes claims that his proposal 
would save the Medicare budget $750 million over four years.

But a six dollar GP tax is not the only health co-payment that Australians are already 
slugged with. Australians already pay ?out of pocket? for a raft of health care services. 
There is no dental care coverage under Medicare leaving most Australians unable to see a 
dentist unless they can pay upfront. There a significant ?gaps? between the cost of 
services and what is covered by Medicare, and access to medical specialists routinely 
involves significant upfront expense for Australians on Medicare.

The effect of all of this is frightening. Co-payments fund 17% of health care in 
Australia. One in six dollars of health care expenditure in Australia is not covered by 
any insurance, public or private, and is instead forked out directly by those who can 
afford it least. In the United States, so often denounced for its backward and regressive 
healthcare system, co-payments only account for 13% of health expenditure.

And the Liberal government is gearing up to whack another six dollar charge on top of 
this. Far from sending a harmless ?price signal?, a six dollar co-payment is a brutal 
measure that would reduce access to GPs by those who need them most, and already use them 
least.

Under Utilisation

The idea that Australia?s poorest over use GP services is both obnoxious and untrue. Terry 
Barnes is on the record as saying that a six dollar upfront payment would not stop anyone 
who is truly sick from attending a GP, as this only represents the price of ?two cups of 
coffee?. Anyone who thinks six dollars is nothing has never attempted to live on the 
minimum wage, let alone the dole, family payments or a pension, in Australia.

Australian workers already make choices between rent, food and health care on a weekly 
basis. Cost already dissuades Australia?s poorest from accessing medical services when 
they need it.

Current research on working class Australian?s use of health care already shows that 
?poorer people are already under-utilising healthcare, and their rate of under-utilisation 
corresponds to their level of illness?. Mapping health care use against average income in 
Australia already shows that people living in Australia?s poorest neighbourhoods are 
?three times more likely to delay medical consultations than those living in the 
wealthiest suburbs?.

The highest use of GP services in Australia, and the highest concentrations of GPs, are 
not where people are poorest, or where people are sickest (which coincidentally is where 
people are poorest), but rather where people are wealthiest. The richest use GP services 
the most, there are more GPs in wealthier suburbs, and Australia?s wealthiest are less 
likely to fall ill and die young.

Being poor and working class, attempting to live on a shitty wage or poverty level 
pension, is a major health hazard in Australia. The wealthiest 20% of Australians live an 
average six years longer than those of us surviving in the ranks of the poorest 20%.

Health Cash for big business

We?re told that Medicare costs too much. A six dollar copayment, effectively a tax levied 
disproportionately on Australia?s poorest and sickest, might save the health budget $750 
million over four years. But there is one area of health spending bloat that the Abbott 
government will never touch. This year alone the government will spend $5.4 billion 
subsidising private health insurance.

The private health insurance rebate is an enormous transfer of wealth from tax payers to 
private, profit oriented health insurers, such as the one funding Terry Barnes? sick 
attack on what remains of universal healthcare in Australia.

The private health insurance rebate was meant to make private health insurance more 
affordable by keeping premiums low. Introduced in 1999, this massive payment to health 
insurers has occurred at the same time that average health insurance premiums have risen 
130%. Average prices (inflation) in the same period have only risen 50%.

The justification for this massive rort was that subsidising private health insurance 
would save money in the long run by reducing costs to Medicare. The most recent analysis 
shows that this $5.4 billion subsidy does little to shift costs from Medicare, and its 
abolition would save the government at least $3 billion a year.

Conclusions

The class self-interest of the government?s health policy is blatant: Tax the poor, throw 
money at the rich. The so-called Commission of Audit is stacked with the same big business 
cronies and Liberal mates who have always attacked the conditions of working class 
Australians, and now they are coming for what remains of Australia?s public health system. 
If the health budget is unsustainable, and the poorest really do have to be slugged with 
an additional six dollar GP tax, it is only because the government continues to throw 
bucket loads of money at private health insurers. The truth is that private health 
insurers want Medicare dismantled, so that more Australians are forced into their health 
insurance rackets, paying ever greater premiums for a diminishing health service.

links at: http://www.anarchistaffinity.org/2014/03/attacks-medicare-health-care-inequality/