It’s a common political tactic: frame the question in such a way so that the answer you want appears inevitable. That way, political rhetoric sounds less like the dogma that it so often is (from both sides of the political spectrum) and more like an invitation to the audience to engage with the debate.
So when Peter Dutton questions ‘whether someone on an income of $200,000 can have an expectation of going to the doctor for free’, we can find ourselves wandering down a path of moral outrage at the thought of all those millionaires elbowing out the poor and destitute in their quest for a ‘free’ doctor visit.
It may only take a minute before we recall that, in fact, the more affluent are contributing their fair share to the health system via their taxes (to the tune of $2000 per visit, according to Dr Con Costa of the Doctors Reform Society) and that this is actually a very efficient way of funding health care. Not to mention that we all – rich or poor- have an interest in a cost-effective health system which keeps people healthy and productive for as long as possible and that there is a wealth of international evidence showing that a universally accessible and high quality primary health care system is the best way to achieve this.
It is in this minute – or even a few seconds – of pause, when the politician’s carefully crafted and focus-group-tested words can evoke a response that can make a difference between a positive or negative response at the polling booth and ultimately lead to an election win or loss.
That is why politicians so often ‘answer the question they wish they were asked’ when faced with a tricky inquiry from a journalist. They know that regardless of the content of their answer, the ‘wrong’ question can only lead them down a path they would rather avoid.
With that in mind, it’s worth considering how different the Federal Budget could look tomorrow night by re-framing the questions being asked by the Government, as follows:
Alternative questions: Are we spending more or less than the OECD average on health care?
Are we receiving good value for our health care spending?
What share of our resources does the community want allocated to health care?
Joe Hockey: “Why is it okay for higher income women or higher income men to receive free health care when they can clearly afford to make a contribution and don’t?”
Alternative questions: What is the most efficient and the most equitable funding mechanism for our health system?
Will shifting more health care costs directly to consumers improve health outcomes?
Peter Dutton: “I question whether someone on an income of $200,000 can have an expectation of going to the doctor for free…”
Alternative questions: How will the introduction of co-payments impact on the quality and equity of primary health care?
Will higher co-payments result in a more or less cost-effective health system overall?
Peter Dutton: “If a (private health) insurer can provide additional support to a doctor why would we resist that?”
Alternative questions: What value can private health insurance add to primary health care that cannot be provided by the public health system?
Would a health system with an increased role for private health insurance be more or less expensive and more or less equitable than our current one?
What questions do you wish the Federal Budget would answer tomorrow night?
