If I were Tony Abbott, I would be carefully listening to doctors’ whinges about medical insurance—noting every claim about the costs imposed on their income by the risks of medical misadventure, whether caused by negligence or not. Because the key to any solution is that government assume this burden, but there’s no reason why doctors should benefit much as a consequence. For example, if an obstetrician is paying in insurance half of what she or he receives for the birth of a baby, then it would be a fair bargain if government paid the practitioner half as much as before. It might be wise for government to subcontract the actual management of a claims system to a number of competing private funds, rather than running a national medical insurance agency directly. Private health insurance companies should also be required to contribute their share for every procedure performed. They might be keen to do so since now they have as much interest in keeping medical costs down, and doctors under some leash, as government itself.
Two years into the medical insurance crisis, it is still assertion rather than evidence which governs the debate. A major doctors’ insurer collapsed, but whether that was because it had set its premiums too low or because medical negligence payouts had skyrocketed is far from clear. The evidence of court-ordered payouts does not support the idea of a massive escalation in claims or in amounts awarded. The courts were widening their definitions of negligence, embracing concepts of informed consent and the duty of a doctor to canvas with a patient what could go wrong with a medical procedure. This caused widespread panic in the profession, but it does not of itself seem to have produced a major increase in payouts. However, governments have been spooked by doctors’ panic and have severely wound back the law to reduce the ambit of claims.
But it’s perception as much as fact which governs the politics, and which has accentuated the uncertainties of doctors, made them withdraw services or types of services, or export their risk to the public hospital system, or threaten to leave their profession altogether. Or to practise, in the name of conservative medicine, the very antithesis of it: doing everything, just in case. Even those who think doctors are overreacting will concede a good deal of uncertainty.
But there’s another reason why government should get involved. Most people who