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targetstargetsMedicare cuts prove the Coalition is bad for our health

 

By Michelle Pini | 21 October 2021, 7:00am |  37 comments |  951 | 


(Cartoon by Mark David / @MDavidCartoons)

 

Like most things the Morrison Government implements, recent sweeping changes to Medicare rebates affect our most vulnerable citizens and have been rushed through under cover of night, with scarcely a murmur from the Government or its media cheer squad.

Prior to the last Federal Election (and the one before that), then-Opposition Leader Bill Shorten warned of the Government’s intention to whittle away Medicare benefits – a long-held Coalition policy objective. As with most Labor Opposition criticisms of the Federal Government, however, this was weaponised by the mainstream media, turned against the messenger instead of the perpetrator and promptly labelled “Mediscare 2.0”.

'Cutting Medicare is in the Coalition’s DNA. Scott Morrison has launched the biggest attack on Medicare in decades with one in six rebate items changing.'

~ Bill Shorten

WHAT MEDICARE CUTS? 

However, planned Medicare cuts were indeed on the Morrison Government’s agenda — they just weren’t communicated until they were done and dusted.

And on 1 July, some 900 items were reduced or removed altogether from the Medicare benefits schedule. Items with altered or deleted status affect orthopaedic, general and vascular surgeries and screening tests such as MRIs. The Government's speedy adoption of these changes means details are still being quantified by private health insurers and the AMA. 

Shadow Minister for NDIS and Government Services Bill Shorten told IA:

‘In the election campaign in 2016, the Coalition strenuously denied they would ever make any changes to Medicare and here, under the cover of a pandemic, they are sneaking in 900 changes to the basic safety net that people rely on more than ever.’

The changes are the result of a five-year review by the MBS Review Taskforce, which, according to the Health Department website:

‘…has considered how more than 5,700 Medicare services can be aligned with contemporary clinical evidence and practice and improve health outcomes for patients.’

It is hard to imagine how removing access to items required for surgical procedures and tests, virtually overnight and without allowing time for their proper implementation or planning by health professionals and patients dealing with their consequences, can be considered an improvement, however.

The AMA website published the following statement from President Dr Omar Khorshid, who did not mince words:

...Giving the sector just weeks instead of months to change over its entire system to support almost 1,000 changes leaves the health system and patients at risk.

 

The Government's reminder to doctors to consider patients' circumstances when charging fees misses the point. At the moment there's no way for doctors to know if they are charging a gap due to the chaos caused by the Department's poor implementation.

WHAT PBS CUTS?

Not included in the 900-odd Medicare changes indicated above, wide-ranging changes to Pharmaceutical Benefits Scheme (PBS) listed medications are also coming into effect without warning. They include the alteration and deletion of a range of pharmaceuticals used primarily for cancer treatments and auto-immune diseases.

Many shared their experiences on social media of fronting up to the pharmacy pick up their usual prescription and, without warning, being charged $89 instead of $6.99, for example.

One high-profile deletion scheduled for 1 December, is sertraline, more commonly known as Zoloft — a widely prescribed anti-depressant. It is yet to be determined what this will mean for the cost of this product and IA has sought clarification from the PBS as well as the manufacturer.

Another inexplicable deletion involved the free shingles vaccine (Zostovax) for seniors over 70, which would require them to pay around $200 for the privilege.

However, Independent Australia understands access for over-70s was reinstated following an uproar on social media, after which Health Minister Greg Hunt promptly proclaimed the Government’s intention to extend the free vaccine for another two years. Or, perhaps, at least until its next planned deletion can go unnoticed.

'MEDISCARE' IS REAL

When not intent on dismantling it, the Coalition’s relationship with Medicare has been characterised by constant sabotaging of the free basic health care system since Medicare was introduced by the Hawke Labor Government in 1984.

A brief history of the Coalition’s obsession with Medicare reveals vehement policy opposition at four elections, a series of significant cuts when in government and culminates with this latest quiet achievement of delisting or reducing 900 separate medical benefits and making many commonly prescribed medications unaffordable.

Current Minister for Health Greg Hunt announced his intention to do away with Medicare and opt for a U.S.-style health system in his maiden speech to parliament, back in 2002.

 

The whittling away of our health care system has always been the end game for Coalition governments, but they have faced much opposition and outrage over the years. It is hardly surprising, then, that these latest health service “changes” are delivered by stealth while we are distracted during a pandemic.

WHAT MEDIA?

As Bill Shorten told IA:

'Cutting Medicare is in the Coalition’s DNA. Scott Morrison has launched the biggest attack on Medicare in decades with one in six rebate items changing.

 

This is what we said they were going to do and the Government needs to tell the Australian public what is being cut and why.'

 

 

This is an abridged version of an editorial originally published in the IA's weekly newsletter. Subscribe now to read the full version online in the IA members-only area.

You can follow managing editor Michelle Pini on Twitter @vmp9. Also, follow Independent Australia on Twitter @independentaus and on Facebook HERE, and in the new IA subscriber-only Facebook page HERE.

 

Read more:

https://independentaustralia.net/politics/politics-display/medicare-cuts-prove-the-coalition-is-bad-for-our-health,15657

 

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the national cabinetto of dr scumo...

 

BY Professor Kerryn Phelps

 

The management of the COVID-19 pandemic has displayed the fault lines in the relationship between the levels of government in Australia.

Cost shifting and blame-shifting between different levels of government for underfunding of the health system has been treated like a national spectator sport for decades.

 

Ambulances piled up outside emergency departments? Blame the state governments!

Aged care residents unprotected against COVID? Blame the Federal government!

Elective surgery waiting lists piling up? Blame the state governments!

Nobody seemed to be able to work out who was responsible for the Ruby Princess debacle, so with the Federal and New South Wales State governments, it fizzled out with the two levels of government left lamely pointing fingers at each other and calling it a draw.

 

Vaccine supply and quarantine are without doubt Commonwealth responsibilities, yet the Morrison Government botched the vaccine rollout and outsourced the quarantine part to the states. The states figured they could make do with the temporary solution of unsuitable hotel quarantine until the Federal Government got its act together and established purpose-built quarantine facilities — which it has so far failed to do.

After years of arguing about federal and state lines of responsibility, there was a glimmer of optimism when the so-called National Cabinet – a group of federal, state and territory leaders – was formed to deal with the emergency that is the COVID-19 pandemic.

It turns out the word “cabinet” may have been used in the title so that the Morrison Government could pretend that the deliberations of that group could be kept secret for decades like, you know, the actual Federal Cabinet.

Independent Senator Rex Patrick challenged this assertion in the Administrative Appeals Tribunal, which ruled that the group was not a real cabinet and that the deliberations should not be kept secret.  As Freedom of Information requests start to flow, we may develop a picture of those deliberations. As it should be. If decisions are being made about restricting the liberty and livelihoods of citizens, we have a right to know on what basis those decisions were made.

Of course, in response, the Federal Government rushed into Parliament a Bill designed to prevent the release of any further information from National Cabinet. It failed to gain support with Liberal Senator Gerard Rennick indicating he would cross the floor and Independent Senator Jacquie Lambie saying she would also oppose it.

So the small “c” cabinet which is not a big “C” cabinet came up with a National Plan. This was based on modelling which formed the basis of a political decision about how many hospitalisations and deaths would be politically acceptable as lockdowns were eased.  The plan would come into effect once a percentage of the population over 16 was vaccinated with a vaccine that would reduce hospitalisations and deaths, but not stop transmission to people who were not protected by vaccination. The latter group includes every child under the age of 12 and other vulnerable people in the community who, through no fault of their own, are unable to be fully vaccinated.

Meanwhile, every state has the right to control its own state borders. So the members of the National Cabinet, armed with the National Plan, went off in different directions to impose different restrictions and border closures.

Some states, like Queensland, are required to follow the public health orders imposed by the state’s chief health officer (CHO), while for other states, like NSW, the CHO's advice is FYI only. “Thanks, but NSW State Cabinet (big C) will decide which advice we heed and the circumstances in which we will ignore it.”

So Queensland, South Australia and Western Australia raised the drawbridge and maintained normal life for their residents with zero cases pending high vaccination numbers. New South Wales had the opportunity to nip the latest outbreak of the highly transmissible delta strain in the bud when there were as few as four cases in the community but inexplicably decided not to contain the outbreak, resulting in tens of thousands of cases ripping through a largely unprotected community.

Then NSW Premier Gladys Berejiklian resigned, opening the door for the ascendancy of new Premier Dominic Perrottet. Days into the job, Perrottet announced that New South Wales would open the international borders to Australian residents and international tourists. 

Until PM Scott Morrison chided him later that day, with a reminder that international borders and tourist visas were a Federal matter and that no decision had been made on that timing, thank you very much:

"It is for the Commonwealth and Federal Government to decide when the border opens and shuts at an international level and we will do that."

As vaccination numbers rose to that “magical" 70% in NSW and despite then-Premier Gladys Berejiklian warning not to call it "Freedom Day”, the media called it Freedom Day, and the reporting on the celebrations in the street would fool many into believing that the pandemic was over.

Not so much celebration for health care workers dreading the prospect of the health system being overwhelmed by a surge of cases predicted in modelling by the Kirby Institute’s Raina MacIntyre et al.

Which brings us to late October and the return of children to school in NSW and Victoria after months of lockdown and homeschooling — a state government decision.

Unvaccinated children crammed into close proximity with each other, masks optional up to grade six and an undercooked plan to improve ventilation or supply HEPA filters to improve air quality is a recipe for multiple school outbreaks and that expected surge of cases.

We do know that COVID-19 can cause serious illness and death in some children, but we have no idea of the long-term consequences of a COVID-19 infection on a child in later life, so if this scenario was posed as an experiment, I doubt that it would pass ethics approval.

Once the Federal Government decides they will reopen international borders to vaccinated travellers without quarantine, the states and territories will face another public health challenge.

The clunky division of responsibilities between the Federal and state and territory governments has long been used to shift costs and blame from one level of government to another and the management of the COVID-19 pandemic has highlighted some of those problems. It is long overdue for a comprehensive review.

 

Professor Kerryn Phelps AM is a general practitioner, an advisory board member and conjoint professor at NICM Health Research Institute, an OzSAGE member, a City of Sydney Councillor, former Federal Member for Wentworth and former president of the Australian Medical Association. You can follow her on Twitter @drkerrynphelps.

 

 READ MORE: https://independentaustralia.net/politics/politics-display/kerryn-phelps-passing-the-covid-buck-risks-more-than-government-reputations,15670

 

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