Physical wellbeing and health care represent among the biggest tests facing Australia yet you would not know it from the opening shots to the 2013 federal election campaign this week.
The profound challenges facing Australia arising from ageing, rising chronic illness and galloping health costs failed to provoke any
significant response from either Julia Gillard or Tony Abbott this week when they opened their campaigns at the National Press Club .
There was no mention of the vaulting cost of hospitals and emerging disputes between states and Commonwealth on funding. Remember blame-shifting was a problem for Tony Abbott as Health Minister which former Prime Minister Kevin Rudd pledged to end?
Neither leader took up that issue this week despite the current federal-state fights over hospital costs.
It might be hoped that the fixed September 14 polling date might inspire both sides to propose system reforms that promote more effective primary care and prevention. That seems unlikely.
This week, what little mention either leader made of health tended toward well-worn ideological differences that have marred health policy in Australia for many decades.
Prime Minister Gillard yesterday referred to the Medicare dentistry arrangements that then Health Minister Abbott installed in late 2007
as “the millionaires’ dental scheme”.
While that scheme’s failing was that it was open-ended, Labor has not produced evidence that high-earners exploited the scheme. Defenders of the scheme have argued that millionaires as a rule can afford dentists and are unlikely to wait until their tooth ache
compromises their health.
Tony Abbott meanwhile today repeated his vague promise to unwind the means test on the health insurance rebate, asserting that “private health insurance is absolutely in our DNA”.
That’s a statement which does have some weight: ever since the introduction of the 30 per cent tax rebate on health insurance premiums, the Coalition has appeared incapable of acknowledging that the rebate essentially improves access to health care of the well-off at the expense of the uninsured majority who struggle to access elective surgery.
He said he would like to dispose of the means test — which adds hundreds of dollars to the premium costs of high-earners this year. But citing the current financial woes facing government, he would not set a time frame for its removal.
Given Tony Abbott’s quest to claim the voter’s trust, he was inevitably asked about his failure to keep his “rolled-gold” promise to
maintain the Medicare safety net threshold — a pledge broken after the 2004 election.
His explanation was that he was over-ruled by his senior cabinet colleagues. Then he had to bow to authority… “Now, if I can put it more crudely, I am the authority.”
MEDIA RELEASE: Public Health Association of Australia
Raise over $2 billion and improve health: Pre-budget submission
There are opportunities to raise over $2 billion dollars in revenue at the same time as improving public health according to the Public Health Association of Australia (PHAA).
President of the PHAA, Associate Professor Heather Yeatman has called on Treasurer Wayne Swan to keep public health in mind when framing the budget. “Public health requires long term thinking and an understanding that a modest increase in spending on prevention now will bring substantial benefits in terms of both health and costs in years ahead. The PHAA has identified a series of areas of public health where it is appropriate to focus additional expenditure in this budget,” said Associate Professor Yeatman.
The Chief Executive Officer (CEO) of the PHAA, Michael Moore, reminded the government that:
“There are opportunities for raising revenue of over $2 billion while playing a key role in improving long term health outcomes of individuals and the community. However, raising revenue should be just one part of a comprehensive program focused on specific public health priorities.”
Tobacco, alcohol and carbon taxation and a levy on junk food are the main areas of a comprehensive public health approach where revenue can be raised.
“However, public health also requires a proportion of the revenue to be returned through additional expenditure,” said Associate Professor Yeatman. “There is a long history of poor expenditure on population health with only 2.2% of the health budget currently spent on prevention. The PHAA calls for an increase of around half a billion dollars, raising the proportion of the health budget spent on prevention to 4%.”
“A long term vision is what is needed,” said Mr Moore, pointing to examples identified by the PHAA’s pre-budget submission:
• Funding the development of a National Public Health Policy
• Investigating the establishment of a new Australian Centre for Disease Control (ACDC), along the lines of those in Canada and the USA, or a body with a broader remit that includes health promotion and prevention, either alongside or as part of the Australian National Preventive Health Agency (ANPHA)
• Investing in the national preventative health workforce, through ensuring their competence and capacity, embedding understanding of inequity and the social and economic determinants of health, and ensuring they are skilled to effectively deliver preventive and public health services at the local level
• Maintaining the funding of Medicare Locals and Women’s Health at levels that will allow comprehensive primary healthcare based on an understanding of the social determinants of health
• Retaining and extending funding for the “Close the Gap” measures, including additional support for Aboriginal Medical Services and Aboriginal Health Services
“A healthier population is the goal of good government,” concluded Associate Professor Yeatman. “We urge the Treasurer to take our suggestions seriously.”
For further information:
Associate Professor Heather Yeatman, President, PHAA:
0409849679
Michael Moore, Chief Executive Officer,PHAA: 0417249731