Each Wednesday during the election campaign, Croakey plans to publish a rolling wrap of health and election news. We welcome submissions and suggestions.
In this wrap, Associate Professor Lesley Russell covers the latest health announcements, shares some behind-the-scenes insights into how policies are developed and costed, and includes upcoming events and links to relevant election policies.
This wrap also launches the #AusVotesHealth2022 Election Report Card, which will be updated each week, and don’t miss the “Campaign shockers” section.
ICYMI, here is part one of this health election series, published on 13 April.
Lesley Russell writes:
The first week of the federal election campaign was pretty unedifying: as predicted, the major political parties spent most of their time and energy beating up the other side’s record and the mainstream media was endlessly focused on gotcha moments.
The second week promises that worse is yet to come. The Coalition seems determined to “play the man” on Labor Leader Albanese and there are signs that they are looking to resurrect their favourite divisive topic – asylum seekers and border protection.
Meanwhile, Labor has seized on the announcement that Senator Anne Ruston will assume the Health portfolio after the election as an opportunity to revive their Mediscare campaign.
It is hard to discern voters’ voices, other than in staged media opportunities, and in many cases their views are being overlooked in favour of the loud opinions of key stakeholder groups.
A classic example of this was in The Guardian, which initially headed an article about needed hospital funding “Health Sector is disappointed by election health policies”, when in fact the story only quoted the Australian Medical Association (which doesn’t even represent most doctors). The headline was later changed after readers raised concerns.
This article also serves to highlight another facet of the campaign that has already emerged: with five more weeks of campaigning to go, there are already complaints that “Party X has no policy on issue Y”.
Again the AMA is speaking out, going beyond the comments in The Guardian, and stating on April 18 that “There is a lack of policy on both sides, or not very good policy”.
The Morrison Government has just laid out its future plans for health and healthcare in the federal Budget, so that might be a fair comment on their policies, but it is jumping the gun when it comes to Labor.
The fact is that at the end of the campaign on May 21 there won’t be election commitments on all the issues everyone cares about – even where these are important and mainstream.
That is why past actions are worth scrutinising. It’s also why the media should be much more forensic in their analyses of both new policies and previous statement and policy offerings.
Key election announcements
To help readers keep track of policy announcements from the major parties, Croakey has develolped an #AusVotesHealth2022 Election Scorecard.
This will be updated weekly, and by the next edition I hope to have added in links to the campaign pages for all the Independents who are running.
A recent article in the Sydney Morning Herald outlines why (at least some) Independents, if elected, could play key roles in “keeping the bastards honest” on issues such as climate change and an integrity commission. There will be more on this in future editions of The Election Wrap.
I am presenting the election issues here under three headings: the formal announcements from the Coalition and Labor, and the media comments, statements and slip-ups that also contribute to the debate and indicate the parties’ positions.
• $273.1 million (I think this is over four years) to cut the cost of Continuous Glucose Monitoring devices for an additional 71,000 Australians with Type 1 Diabetes (T1D).
While some Australians with T1D are already eligible for free devices, the newly-eligible people will be required to pay a co-payment of up to $32.50 per month (this is stated as being equivalent to the cost already incurred using blood glucose strips).
Within hours of this making the news, Shadow Health Minister Mark Butler tweeted a commitment to do the same, should Labor win the election.
• Nationals leader Barnaby Joyce has announced $1.5bn to transform Middle Arm peninsula adjacent to both Darwin and Palmerston into an industrial hub and export precinct. This would include a petrochemicals plant for plastic, pesticide and fertiliser production.
But a Northern Territory risk assessment report released the same day says the hub could have “significant adverse impacts” on community health. The report also found air quality in the area may be significantly affected. It flagged potential damage to Indigenous sacred sites, the seabed and marine ecosystems during dredging, infrastructure construction and shipping operations.
The slated development would also likely stop the NT achieving its greenhouse gas emissions targets.
• A number of announcements have been made about new funding for mental health and suicide prevention for the States and Territories (see for example, this media release about Western Australia), but these are merely the delayed agreements to distribute funding that was part of the 2021-22 Federal Budget.
• $14.8 million over four years as a grant to Melanoma Institute Australia to deliver more melanoma nurses to every State and Territory (the number of new nurses is not stated).
• $12 million to deliver better aged care services for the Maronite community. This funding will go to Lebanese Maronite Order of Australia.
• Labor has promised a sweeping review of the National Disability Insurance Scheme in a pledge to ensure the system delivers better services. An integral part of the review will be an examination of the excessive use of consultants. See this Twitter thread from Every Australian Counts reporting the launch.
In the media
The Prime Minister has announced that Senator Anne Ruston, the current Minister for Families and Social Services, will replace Greg Hunt in the health portfolio after the election.
Her naming was anticipated but has generated concerns: she is a strong supporter of the cashless welfare card scheme (something Labor has said it will scrap); has previously said that Medicare is unsustainable without increased co-payments; and claimed that an increase in unemployment benefits would end up in the hands of drug dealers and pub owners.
Shadow Assistant Minister for the Treasury, Andrew Leigh, speaking at an ACOSS event, said that Labor has not committed to an additional increase to the JobSeeker payment and has dropped plans for a review into the rate. Instead the focus will be on rent assistance and providing social housing (Labor’s housing policy commits to 30,000 additional social and affordable homes).
A Labor Party spokesperson has said that constitutional recognition and a referendum to create a Voice to Parliament for First Nations people will be Labor’s constitutional reform priorities. Labor is no longer committed to holding a vote on whether Australia should become a Republic within its first term of government.
Labor leader Anthony Albanese, appearing at Bluesfest in Byron Bay, turned jeers into cheers when he mentioned the issue of constitutional recognition.
It’s reprehensible that to-date the only mention of the needs of the LGBTQI community in the election campaign has been in relation to the bigoted remarks about trans people by the Liberal candidate Katherine Deves who is running against Zali Steggall in the seat of Warringah.
The Prime Minister has defended his captain’s pick, the Minister for Women, Marise Payne has refused to endorse her. Leaked communications between Morrison and NSW Premier Dominic Perrottet indicate that they are aligned with Deves’ views.
Meanwhile, Equality Australia is circulating an open letter, calling on all political parties and candidates to treat LGBTIQ+ people with dignity and respect, and “to campaign in a way that does not undermine our community’s health and wellbeing”.
On 5 May, a public event with journalist Patricia Karvelas and representatives from the Coalition, Labor and the Greens will discuss the issues that matter to LGBTQ people and people with intersex variations this election. The event will be held online and at the Victorian Pride Centre in Melbourne.
It’s dreadful to see the issue of asylum seekers who come by boat turning up yet again. Albanese provided an opening when he stumbled over Labor’s position on Temporary Protection Visas (TPVs), and the Coalition has seized on that and run with it.
Home Affairs Minister Karen Andrews gave a very unedifying interview on this issue on RN Breakfast with a totally illogical argument about the need for TPVs that hit all the usual dog whistle points.
Let’s hope in the weeks ahead we see human rights and social justice emerge as issues in the campaign. To date, only the Greens have policies in this area.
This week’s example of an issue not receiving enough attention in the news is climate change! Perhaps this will change with recent polling highlighting the tough race Liberals such as Trent Zimmerman, Tim Wilson and Treasurer Josh Frydenberg are facing against Independent candidates who have put climate change at the top of their issues lists – because they know it tops voters’ lists.
The Greens have announced plans to overhaul how the oil and gas industries are taxed, potentially raising an extra $90 billion in revenue over the next decade. Meanwhile, Labor has committed to supporting more coal mines.
I’m sure everyone has a long list of issues they would like to see addressed (sensibly) in the campaign, with commitments that will result in real action from the new government.
Here at Croakey Health Media we are compiling our own lists (I’ve just added the increasing cost of healthy foods) and we will tick them off in future editions of The Election Wrap.
How election policies are developed and costed
You may be across the little contretemps in the media over whether Labor’s policy on GP emergency clinics was costed. At the same time, there was grumbling about which stakeholder groups had been consulted (or not).
So I thought I would give you an insiders view of what goes on in the policy rooms of a major party during election time. I’ve done my time through several election campaigns!
A recent article in The Guardian outlines how the parties’ policy and media units are set up, In reality, it’s a bit like being in lockdown in a university college, with senior advisors crammed into shared office spaces working incredible hours, always ready to respond to whatever is in the news, the demands from the team travelling with the party leader, and all the candidates across the nation.
While there is great camaraderie and cooperation, there is plenty of room for displays of temper and frustration. There is also lots of bad food and rampant opportunities for the spread of infections – if one person gets sick, everyone gets sick.
Most of the work for the major policies will have been done weeks ago, in consultation with trusted experts. In health, many of the major groups often complain that they have not been consulted; generally this is because of a concerted effort to avoid leaks, rather than oblivion as to who is affected.
The parties’ policy units have their own economic experts who can do most of the costings involved (this is obviously easier if you are in government when there is access to much more information and many more resources).
The Parliamentary Budget Office exists to be an independent arbiter of costs but is often not used. The Greens seem to be the primary users of the PBO services.
Election policies can also be submitted to the Treasury and the Department of Finance for costing under the Charter of Budget Honesty Act. These costings are then made public. This used to be the common convention for the major parties but in recent years it has been used much less, presumably as a way of avoiding scrutiny. This is especially the case if savings to pay for a new initiative are taken from cuts in other programs.
In 2013 the Coalition went so far as the present a booklet on their costings process, which was mostly done in-house. This enables a much more political spin to be put on both their numbers and those of their opponents.
Already this year the Coalition’s costings unit has tried to argue that Labor’s policies would cost $302 billion over the decade. But it appears the unit was costing the wish list of items in Labor’s national platform rather than the election commitments.
A Twitter thread from journalist Ben Eltham helps put all this in context (with tongue in cheek): “A bit of a thread about costings. Journalists love to write stories about costings, especially in election campaigns. But costings are almost always meaningless. Let me explain. 1/n”.
Should you, a voter, care about costings?
No, there’s very little point.
Costings may or may not be plausible, but they don’t represent much more than a back-of-the-envelope calculation.
They are essentially a piece of campaign theatre. Much like hard-hats and hi-vis.”
Following last edition’s example of a fake beer can that was created to market Liberal policy, we now bring you – fresh from a Croakey householder’s letterbox – this example below of political attack advertising.
You have to turn it over and find the small print to discover it is from the Liberal Party. That was before some Croakey digital mischief.
The Morrison Government says it “Guarantees Medicare” – what does that mean?
As previously noted, Senator Anne Ruston, who will be the next manager of the health portfolio for the Coalition, has been under pressure about her position on the sustainability of Medicare and whether, as Health Minister, she would oversee Medicare cuts. Her response has been: “We absolutely guaranteed Medicare in law, absolutely guaranteed Medicare in law.”
What does this mean?
In 2017, several years after the 2014-15 Budget that looked to slash federal spending on Medicare and the Pharmaceutical Benefits Scheme (PBS), and in the wake of a huge (and ultimately successful) push to get the Turnbull to begin unfreezing Medicare rebates, then Treasurer Scott Morrison introduced legislation described as “guaranteeing” Medicare and the PBS.
In fact this is simply an accounting trick. It merely changes the way the money that pays for these key programs is managed.
The legislation ensures that proceeds from the Medicare levy – minus any portion which has been set aside for issues like the NDIS or gun buyback schemes – are paid into a fund held by the Department of Finance. These funds are topped up, annually as needed, with money collected via personal income tax and then transferred to a Department of Health Special Fund to cover the cost of Medicare and the PBS.
The bill does not guarantee the continuing existence of Medicare or the PBS and it does not really make the funding of these programs more transparent.
It took me quite a while to find this special account in the Budget Papers: it is on page 139 in the 2022-23 Budget Paper #4.
Many comments have been made on media coverage, including omission of key health topics.
Many health professionals and organisations are working hard to put a focus on climate.
Social determinants of health
Other public health issues
See this Twitter thread by ACEM president Dr Clare Skinner on the history of access block.
Living with COVID: 28 April, free public lecture, La Trobe University
Links to election policies
Australian Academy of Health and Medical Sciences
Australasian College for Emergency Medicine
Australian College of Mental Health Nurses election priorities
Change the Record Election Platform
Council on the Ageing (COTA) Australia agenda for the next Government and Parliament
Joint statement by Australia’s suicide prevention sector, representing 40-plus organisations
National Rural Health Alliance election priorities
Obesity Coalition – 2022 election priorities
Refugee Council of Australia scorecard
Royal Australasian College of Physicians
Women with Disabilities Australia
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