LNP REALLY TRYING TO DISMANTLE THE HEALTH SYSTEM, NOW Having failed to get their $7 GP charge through the senate, Abbott & Co now have a plan B including changing regulations, which requires no parliamentary approval. Other parts of the their plan B changes will still require such approval. One change is an across-the-board rebate cut of $5, moving the policy change on to doctors to implement; theyll have to decide whether or not to pass on the $5 cut. That one was nicely introduced just before Christmas, while they hoped no-one was paying attention. Other changes apparently include a cut in the rebate for GP visits lasting less than 10 minutes. This will be cut to $17; apparently this is currently $37. Thats *at*least* 14 *times* the minimum wage, by the way. Some of these changes require senate approval, and apparently « The government says the change will help improve the quality of care and both Labor and the Greens are considering that argument. » I can make no sense out of this statement unless I take it as one about the over-medicalisation of the community. Maybe Abbott & Co are have been reading material from the Cochrane Library about how pharmaceuticals are now the third biggest killer in the West and so on. If thats whats driving their Medicare changes, though, why dont they just come out and say it? Its as if theyre trying to cutback on iatrogenic (ie medically induced illness) waste, but without openly addressing narratives about the social order. That is, theyre not saying anything that might threaten the social standing of the doctors whose influence theyre trying to reduce. The modern epidemic of iatrogenic disease is a result of what one might call supply-side medicine. Similar to supply-side economics in the broad economy, this is when activity in the medical industry is driven, not by patient need (demand), but by the medical-industrial complex ability to produce products it can pass off as remedies (supply). This is a pretty good way of motivating the production of snake oils. The article (link below) also suggests that a stand-off might be coming: « Labor, the Greens and crossbench senators have vowed to disallow a third measure – to cut GP rebates for general patients by another $5, which will be introduced in July. But fears are growing that the government could try to “play chicken” with the Senate – forcing it to take the untenable step of abolishing ALL Medicare rebates if senators try to oppose the $5 rebate cut.» [My emphasis.] Nothing less than the possibility of the total abolition of Australian universal health care is looming. As crazy as that sounds, its increasingly clear that Abbott has a kind of all-or-nothing death wish, like Al Pacino facing off against the Bolivian Army from his mansion in Scarface. Its clear that Abbott sees himself as being to the minority of elites what Scarface was to plucky Cuban immigrants. I must admit, Im a bit torn with these changes to Medicare. My placards in the past have taken a different approach to pretty much everyone elses: mine have been about finding rational savings in the health system, such as not stockpiling $100/dose Tamiflu when 1c paracetamol works just as well for a flu, or not irrigating the over-50s with statins for which, despite the evidence for their action, theres no evidence that they actually increase longevity. (Cutting cholesterol per se has been understood as a good outcome of statins, even though they cut the production of a whole tree of molecules, some of which might be quite vital and outweigh the benefits of lowered cholesterol, among other issues.) Other peoples placards have been simply about the government keeping its Hands off Medicare! I can at least say my placards have caught the interest of Deputy Greens leader, Richard Di Natale, a former GP whos expressed some support for my position. Also, Im simply against such outrageous pay disparities across society. But on the other hand, what is government for? Without even having the *image* of protecting health across society, and with this (& many other) governments total disdain for all forms of welfare at the bottom of society, what does the social contract between government and the individual boil down to? Protection of property rights and.... thats about it. The poorer you are, though, the less property you have to protect, so a government that implements a social contract solely in terms of property rights becomes increasingly irrelevant the poorer you are. At the bottom of society, such a government becomes completely irrelevant. For all its faults, a universally accessible health system makes government relevant to even societys poorest. Its a bit easier to protect against citizens waste in the health sector, too, as opposed to things like the dole which governments like to paint is being a rorted by an endless stream of lazy people. In the case of the health system, most people really dont like being sick, being stuck with needles, going to hospital and so on. They only participate in these things because they *need* to. Its an inherently not-exploited form of welfare. So as an action that the state can undertake in the name of increasing equality and demonstrating that it believes in a social contract, health care is extremely worthwhile. (On the other hand, while citizens arent so prone to waste in the system, doctors are.) Thus, the risk is that, with the dismantling of the public health system, whole swathes of societys poorest will realise that theres no social contract left for them. They then, in return, might stop maintaining what Civil Society insists is their end of the bargain. The dismantling of the public health system radically increases the risk of social breakdown. Maybe its time to bring out the pitch forks. And given doctors propensity to vote Liberal, along with elderly people who are frequent consumers of health care, its also interesting to see Abbott & Co attacking more of their core constituencies. Interesting times, indeed! On the plus-side, the more interesting (read: crisis ridden) these times become, the longer the Liberal Party will be completely unelectable. theguardian/australia-news/2015/jan/07/doctors-to-demonstrate-in-protest-at-plan-b-proposed-medicare-changes
Posted on: Thu, 08 Jan 2015 09:54:21 +0000
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