In the runup to the election of 2019, the Labor Party asserted that Medicare was under threat from the federal government. Numerous people in the media termed this the ‘mediscare’ campaign and insinuated that it was a lie. I had a go at two of the people who did so. The first was Amanda Vanstone1, a former Howard minister of dubious character2, who called it, in reference to its use in the 2016 election: “deliberate deception perpetrated on the Australian public for the purposes of gaining power” (irony font). Another of the Liberal cheer squad was Peter van Onselen who, while calling the Morrison government’s campaign against the Medevac Bill “sickening” said that it was hard to feel sorry for the Labor Party because of the disingenuousness of Labor’s ‘Mediscare’ campaign. At that time, I pointed to Greg Hunt’s maiden speech where he said that private health coverage should be delivered by the inclusion of health care in workplace arrangements3. This is how the system is delivered in the US, where every year, over half a million people go bankrupt every year from medical bills they cannot afford to pay4.
The precursor to Medicare was Medibank, introduced by the Whitlam government in 1975, and it was one of the first systems of universal health coverage anywhere in the world. Of course it was the target of much hostility from conservatives. As a consequence, the Fraser Coalition government abolished it in 1981. It was re-established by the Hawke Labor government as Medicare in 1984. In 1987, then opposition leader John Howard promised he would return to a user-pays system based on private health insurance, taking a”scalpel” to Medicare. That, in part, delivered him a string of electoral losses. In 1996, Howard stated that “Medicare will remain totally in place under a Coalition government”5 and promptly won government.
Recently announced changes to the Medicare Benefits Schedule, starting from July 1st will mean that some 900 rebates will change. These will affect orthopaedic surgery, general surgery and heart surgery. The Australian Medical Association (AMA) said they were concerned that the healthcare sector was not given enough time to implement the changes and also have not been given enough information. As a result, the payment processes have not had time to be updated and could leave patients with higher out-of-pocket costs. This happened previously in 2018 when schedules for private health insurers could not be updated in time. This left patients out of pocket, and “spinal surgeries were delayed and doctors could not provide patients with informed financial consent about potential gap fees”6.
While it is tempting to assume this is just another government stuff-up, to go with all the others over the last eight years, the fact that they have not learnt anything from three years ago, makes one wonder if it is not deliberate. The report into these suggested changes was delivered 6 months ago7, yet it has presumably sat on someone’s desk since then. One could be forgiven for believing that this delay was on purpose, simply to make the Medicare system appear hopeless and confusing, thereby causing patients to become frustrated with it, so when the government wants to get rid of it there is less opposition. This is what neoliberal governments do when they want to privatise something, as explained by Noam Chomsky: “That’s the standard technique of privatisation: defund, make sure things don’t work, people get angry, you hand it over to private capital”8. Many people seem to have forgotten that during the 2016 election campaign, the Coalition government said that they were going to ‘outsource’ the IT part of Medicare to a commercial company, but the ‘Mediscare’ campaign during that election forced them to cancel that outsourcing5. That is another standard technique of privatisation; doing it bit by bit, function by function. So, it will be interesting to see if people like Vanstone and van Onselen are as outraged this time around.