A proposal to introduce an upfront $6 fee to visit a general practitioner has been criticised by the Australian Medical Association (AMA).
A Commission of Audit, set up by Prime Minister Tony Abbott, has received a submission recommending the co-payment system for GP visits.
Under the proposal, pensioners and concession card holders would be exempt from the fee, while families would be granted up to 12 bulk-billed visits annually.
The Federal Government says the new fee is one of several recommendations currently on the table but no decisions have been made.
- via the ABC website, 29th Dec 2013.
And so it begins...
Immediately I think of Richard Nixon's conversation with John D. Ehrlichman on February 17, 1971. This conversation is a signpost along the road of privatisation in the United States which led to the Health Maintenance Organization Act of 1973 which effectively ended the Public Health Service Act of 1941 and set American health care costs from 4.9% of GDP in 1960 to the situation today where it is more than 17.2% today.
Today we see what the Commission of Audit really has up its sleeve and a shadow of what is to come. Whilst Australians were bust enjoying Christmas dinner, the Commission of Audit was welcoming the ghost of Christmas Future; and if these shadows remain unaltered by the Future, then children will die.
In some respects, what we're witnessing isn't an attack on medical services but rather an attack of upon how the benefits of the economy should be shared and to whom.
"The discoveries of healing science must be the inheritance of all. That is clear. Disease must be attacked, whether it occurs in the poorest or the richest man or woman simply on the ground that it is the enemy; and it must be attacked just in the same way as the fire brigade will give its full assistance to the humblest cottage as readily as to the most important mansion.
Our policy is to create a national health service in order to ensure that everybody in the country, irrespective of means, age, sex, or occupation, shall have equal opportunities to benefit from the best and most up-to-date medical and allied services available."
- Winston Churchill, to the Royal College of Physicians in London in March 1944.
The thing is that that made sense in 1944. It also made sense across the western world until the late 1970s when things were still being produced in western nations. However, it should be pointed out that the world of 2013 is vastly different to one of seventy years ago.
The history of labour relations since at least 1600BC has been basically about the same question:
How do you cheat and scam people over and make them work for you, for as little as possible?
Slavery has often been a popular option, from the Egyptian enslavement of Jews, to slavery throughout the classical Egyptian, Assyrian, Greek, Roman, Chinese, etc etc etc Belgian, French and British empires. Slavery was a brilliant method of making people work for as close to nothing as possible until enough people developed a conscience and overthrew that as an idea.
Upon deciding that you couldn't merely enslave people any more, the next best thing to do was to get machines to do it instead. Machine production advanced through ages of wind, steam and electric power and more and more goods were produced more cheaply and all went well.
The thing is though that during the 1960s and 1970s, it was found that there were people living in not much more than subsistence conditions who would work on machines for even more cheaply than people in western countries. People in countries like Japan, then Korea, China, Thailand, Vietnam etc etc etc. all would compete with people in western countries in terms of labor costs and companies simply uprooted factories and built news ones in places of even cheaper labour (only recently, Ford and General Motors have further proven this so singularly). The fact that people die in textile factories in Bangladesh is simply a repeat of what happened in the United States 100 years earlier. Factory owners don't care, it's not them who have to pay the price.
All of this leads nicely to the place we find ourselves today.
In 1944 Winston Churchill's reasoning that the population would be more productive and produce a greater degree of profits if they had adequate health care was entirely sound. The truth is though, if factory owners, company owners and executives decide to set up manufacturing in countries that aren't our own, the economic reason for providing a state health care system, disappears very quickly indeed.
If you have a population who is mainly employed in retail and service industries, then productivity doesn't really increase with a greater degree of health care. If the whole point of the Commission of Audit is to reduce the size and scope of what government provides (ask not what your country can do for you - it intends to do nothing if it can get away with it), then it stands to reason that it can not and should not fund the health care requirements of that part of the population whose "jobs" can be done by someone in another country at a cheaper costs.
From an economic perspective, why bother investing in the maintenance of labour if there isn't a good reason for doing so.
PM - PM Tony Abbott
AB - Andrew Bolt
PM: I'm just not going to pre-empt the work that it does, Andrew, but I would be amazed if, for argument's sake, we need as many public servants in the areas of health and education, for instance, that we have at the moment, given that we don't run schools, we don't run universities, we don't run hospitals, we don't run medical practices or pharmacies…
AB: Would that breach your commitment not to cut health funding?
PM: No, no. We're not going to cut health funding, but that doesn't mean that we're going to have the same back office systems that currently exist. We did say that we would reduce the Commonwealth public sector by 12,000, and that's going to be over and above the modest reductions the former government started to put in place.
- IPA, quoting the Herald-Sun, 25th Oct 2013
Mr Abbott wasn't "going to pre-empt the work" the work that the Commission of Audit was going to do but the fact remains that he more than likely already knew what the outcomes were going to be. All governmental commissions are directed like railway trains and are impartial; just like railway trains, once you lay down the lines for them that's the way they go.
Now, that doesn't necessarily mean that we have two classes of Australian citizens, and any proposed amendment that did in effect create two classes of citizens wouldn't be put forward by me.
- Tony Abbott as quoted in the Herald-Sun, 25th Oct 2013.
Truth is sometimes said where people didn't intend to. You may wish to accuse me of taking this out of context but ultimately society is more divided by class than race and changes to Medicare which this proposal is, stabs the lower classes in the face far harder than it does anyone from the upper classes.
The National Disability Insurance Scheme, Gonski school reforms, wages being "too high": all of these were addressed by Maurice Newman, another of Mr Abbott's appointees, in this case in the Business Advisory Council*; I'm sure the Commission of Audit would be listening oh so intently.
So, keep on stabbing poor people in the face, better yet why not just exterminate them, or place them into slavery? It's how labour problems were solved in ages past.
Better yet, defund the establishments which cost money and to which those who are badly off must go for treatment. If they would rather die, they had better do it, and decrease the surplus population.
A very 'merry' Christmas and a 'happy' New Year. Let's hope it's a good one without any fear... probably won't be.
- Australian Financial Review, 12th Nov 2013.
Addenda: It's really sneaky and slimey how this was announced on 29th Dec; the week when everyone is on holidays. It meant that this story was well and truly buried.