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#AusVotesHealth Week 3: “What does it really cost? What about the cost of inaction?

We’re now half way through the five-week 2019 election campaign and Labor is still setting the agenda on health and the social determinants of health.

As was clear from Prime Minister Scott Morrison’s performance in the first Leaders Debate – a lacklustre affair on Channel Seven (see tweets below) – the Coalition’s commitment to billions of dollars of tax cuts means it can’t match Labor’s bold promises, even if it wanted to.

That leaves Morrison and his team peppering Opposition Leader Bill Shorten on every policy announcement with ‘what does it really cost?’

“He’s not telling you what the costs of change will be,” Morrison told the debate audience.

It’s an important question but there’s a much bigger one of course, which Shorten has spoken of when pressed about the costs of Labor’s climate change policies.

And that’s the cost of inaction.

As Greens Leader Richard Di Natale said on Wednesday, the UN Intergovernmental Panel on Climate Change (IPCC) has given us only 12 years for global warming to be kept to a maximum of 1.5C, beyond which even half a degree will significantly worsen the risks of drought, floods, extreme heat and poverty for hundreds of millions of people.

That’s just three terms of government.

We are also now seeing some of the costs of political opportunism, with the revelation this week of a Coalition preference deal with Clive Palmer and endorsement by National Leader Michael McCormack of One Nation.

As Guardian Australia’s Katherine Murphy said, the problem with the Liberals and Nationals lining up with “crackpots and cranks” is that it’s not a cost-free exercise.

The preference deal with Clive Palmer is one thing, prompting a warning from former WA Liberal Premier Colin Barnett that it risks damaging relations with China and an electoral backlash given that Australian taxpayers footed the bill when the Coalition Government paid his outstanding $67 million in worker entitlements. 

But more jarring, Murphy said, was having the Nationals Leader Michael McCormack telling the National Press Club on Tuesday that it was fine to pursue preference swaps with Pauline Hanson’s One Nation because the policies of the two parties were more in alignment than with Labor or the Greens.

Watch McCormack’s address here. Oh, and this report on the resignation of One Nation Senate candidate Steve Dickson after footage of him inside a US strip club.

Nationals once were at pains to disassociate themselves from extremists, understanding that some sentiments should not be legitimised, and the way to hold electoral ground against insurgents was not to cuddle up but to distinguish themselves forcefully from political movements intent on capturing their base.

 We feel a very long way from that objective in 2019. Almost in another universe.”

It was a worry taken up by Labor’s foreign affairs spokeswoman Penny Wong, in one of the only foreign policy addresses so far in the election, at the Lowy Institute on Wednesday.

 She said:

 Through his preference deal with Clive Palmer, and his refusal to ensure One Nation is preferenced last by all members of his government, Scott Morrison is supporting political figures who promote fear and division.

 He is supporting figures whose views hark back to the White Australia policy – harming the perception of our nation in the region.”

And we can add, causing deep hurt and harm also at home.

Read Wong’ s speech, or listen to it here: https://www.lowyinstitute.org/news-and-media/multimedia/audio/address-senator-penny-wong

Labor has promised to boost foreign aid every year, following savage cuts by the Coalition in the past six years, but she again in this speech did not commit to a target. 

#AusVotesHealth Twitter festival

To discuss these issues and more, please join us next Wednesday, 8 May for an #AusVotesHealth Twitter festival hosted by @CroakeyNews.

From 8am, a program of guest tweeters will discuss health-related policies. We encourage our readers to join the conversation using the #AusVotesHealth hashtag.

Already, there are more than 700 participants at the hashtag, sending more than 2,400 tweets over the past month, creating more than 19 million Twitter impressions. Read the Twitter transcript here.

This week’s big announcements

Labor this week made a big announcement on oral health – promising access to free dental care for up to three million older Australians with its $2.4 billion Pensioner Dental Plan.

As importantly it signalled the move as the “next step in Labor’s vision for universal access to dental care” in Australia, which experts like the Grattan Institute accept will need to be done in stages, though the Australian Council of Social Service (ACOSS) is urging immediate access for recipients of Newstart and the Disability Support Pension.

See ACOSS’s election tracker here: https://www.acoss.org.au/2019-election-policy-tracker/

Labor’s other big announcement this week was its proposed $4 billion reform to the childcare subsidy – labelled “communism” by the government.

It’s not without concern: academic Jen Jackson said Labor had not specified how the wage increases will be delivered, instead committing to further consultation with the sector and that big questions remain about how government subsidies – to parents or educators – will be absorbed into a sector with for-profit and not-for-profit providers.

The promise also highlighted poor wage rates for other sectors yet to attract the same support (see tweet below).

Beyond those concerns, it’s been broadly welcomed.

But there’s more to it than as a family savings measure that will also increase workforce participation for many families, particularly as it comes on top of Labor’s previous promise of  15 hours of funded preschool for every Australian three-year-old (compared to the Coalition’s commitment to date to four year old preschool).

You can read more here on the mounting evidence including from the World Health Organisation that two years of quality preschool sets up a child for success throughout their education and life.

At the other end of the age spectrum, the Coalition announced initiatives on aged care, including $34 million to establish a new Aged Care Workforce Research Centre, a goal of reaching 475,000 aged care workers by 2025, and $10 million to develop a Seniors Connected Program to “address the silent battle of loneliness” that thousands of older Australians live with every day.

But journalist Laura Tingle also raised an interesting issue in aged care in an article about a $320 million payment announced in February – then re-announced in March – then re-announced in the federal budget, that “has caused disquiet even among those who benefit from it, the owners and shareholders of residential aged care facilities.”

 

In other critical social determinants, Labor on Wednesday also announced a big spend on remote Indigenous housing: $1.5 billion over 10 years to combat housing shortages and chronic overcrowding, and said it would revive the national partnership for remote Indigenous housing (NPARIH), a 10-year, $5.4 billion agreement with the states and territories.

As The Age reported, the announcement comes after a stoush between state and federal governments over the funding of housing projects in remote WA late last year, which left 12,000 vulnerable Western Australians in limbo.

Also on housing, seat by seat analysis by researchers from University of NSW for the Everybody’s Home campaign shows that rental stress is being concentrated in outer suburban and regional seats, which are seen as traditionally affordable areas.

National Everybody’s Home campaign spokesperson, Kate Colvin, said the analysis busts the myth that housing affordability is an issue only in inner Sydney and Melbourne, with electorates in Western Sydney, the NSW North Coast and South Eastern Queensland dominating the 20 electorates with the highest rates of rental stress in Australia.


Stepping up on health

On health issues, we’ll hopefully get down to some nitty gritty on Thursday with the National Press Club debate between Health Minister Greg Hunt and Opposition spokeswoman Catherine King.

And while it has taken them six months to act, the Coalition is to be congratulated for responding finally this week to shocking rates of silicosis diagnoses among stonemasons which health groups say “represents the biggest lung disease crisis since asbestosis”.

The call to action came from the Royal Australasian College of Physicians (RACP), the Thoracic Society of Australia and New Zealand (TSANZ), Australian Institute of Occupational Hygienists, Australian New Zealand Society of Occupational Medicine (ANZSOM), Australasian Faculty of Occupational and Environmental Medicine (AFOEM) and the Lung Foundation.

Labor has yet to respond.


Putting the NDIS on the agenda

Disability service providers from around Australia are expected to join the Every Australian Counts National Day of Action on Friday to call for a better NDIS and to get it onto the election agenda.

The dream of a better life under the NDIS has turned into a “bureaucratic nightmare” for too many people, according to campaign director Kirsten Deane, who details some of the heart-breaking and scandalous issues in this article at Croakey.

Those concerns heightened last month when the Budget revealed an NDIS underspend of $1.6 billion in 2019-20. It’s not the first time, Deane says: the NDIS has been underspent every year since it began, “not because people don’t need help, but because they can’t work their way through the system to get it”.

And the incoming Federal Government now has another opportunity to show its commitment to the NDIS and those who rely on it, with the unexpected resignation this week of National Disability Insurance Agency (NDIA) chief Rob de Luca, a banker who disability advocates say has pushed a economic rationalist agenda, particularly through a cap on NDIS staff numbers.

They say it is high time that a person with disability is put at the helm of the NDIS.

(Raising perennial concerns about ‘gamekeepers turned poachers’, de Luca is moving to head Zenitas Healthcare, a for-profit community health group that is an NDIS provider).


F for fail and future

The release of a new report by the Climate Council sets the scene for Friday’s #ClimateElection National Day of Action, the latest set of rallies across the country by striking school students.

The Climate Council’s report – Climate cuts, cover-ups and censorships – finds the Federal Government has gone to extraordinary lengths to keep the public in the dark on climate change.

Scoring it an ‘F’, it says the Coalition’s tenure “has been characterised by slashing climate science funding, cutting effective climate change programs, rejecting advice from expert domestic and international bodies, misleading claims from Federal Ministers, a lack of any effective climate programs, and consistently covering up poor performance.”

Well timed ahead of the schools strike, Labor announced it will help Australian schools cut their energy bills and access cleaner energy by establishing a Solar Schools program which it says will not only help schools cut their energy costs, but also deliver energy back to the grid – driving down electricity bills for households and businesses.

It had a catchy line: “Scott Morrison cut schools and cut hospitals – the only thing he won’t cut is pollution.”

However Labor continued to resist any suggestion that it could work with the Greens, despite Greens leader Richard Di Natale making overtures and indicating his party is prepared to compromise on contentious international carbon permits.

At the National Press Club on Wednesday, Di Natale also outlined a range of Greens commitments on climate change, health, the environment and on reforms to political donations and lobbying laws, saying “we have no hope of cleaning up our environment until we clean up politics”

You can watch his full NPC address here.


Coal and water not the only rural issues

The National Rural Health Alliance launched its Federal Election Charter in Canberra this week, with the message that “health matters as much as coal and water this election”.

NRHA CEO Mark Diamond, who is tweeting this week at @wepublichealth, said:

“Big issues like water and whether new coal mines should be opened can overwhelm the equally significant health service needs of the 7 million people who live outside Australia’s big cities, but in fact these are all ultimately health issues.

“For example, Labor will spend $2.4billion to give pensioners $1000 worth of free dental care every two years but we need to ensure there are dentists that our rural pensioners can get to and we know there’s a significant maldistribution of them across the nation.”

Diamond welcomed Labor and Greens commitments to creating a much needed new Rural Health Strategy, and the Coalition’s $100 million pledge for clinical trials in rural, regional and remote areas which will mean “for the first time, a targeted approach to addressing health clinical research needs in rural areas is going to be addressed.”

Labor also announced it would invest $245 million to address mobile black spots, improve digital literacy and data collection, and fund local projects to improve connectivity in regional communities.

As part of the plan it will work with industry and consult experts on options to improve the consistency of battery back-up arrangements for new base stations built in bushfire prone areas, and provide funding to improve remote Indigenous telecommunications and broadcasting “and address the digital divide in remote communities”.

The Victorian Aboriginal Community Controlled Health Organisation (VACCHO) also released its federal election platform this week, calling for, among other asks:

  • A reformed comprehensive Primary Health Network model for Aboriginal Health
  • A long term needs-based funding model for ACCOs that addresses the complex health needs of Communities, including capability funding to buffer the costs of establishing and delivering NDIS and aged care supports
  • Five per cent of Medical Research Futures Fund allocations to be quarantined specifically for research into the health and wellbeing of Aboriginal peoples, by Aboriginal peoples
  • The appointment of an independent National Commissioner for Aboriginal Children and Young People, and
  • A Parliamentary Inquiry into Institutional Racism experienced by Aboriginal peoples in mainstream health systems.

Further reading:

Thanks to NACCHO for the alert to this Budget overview on Indigenous health from the Parliamentary Library.

What the experts want us to know about public health (HT @TerrySlevin)

Here’s how to renew Australia’s democracy (HT @MrDenmore)


Verdicts on the Leaders Debate

And more via Twitter

And finally,  now might be a good time to watch the latest episode of the ABC’s You Can’t Ask That: talking to former politicians Amanda Vanstone, Cheryl Kernot, Sam Dastyari, Tony Windsor, Wyatt Roy, Richard Evans and Greg Combet.

• Editor’s note: This article was updated after publication.

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