The health debate in this year’s federal election will be conducted on two fronts. One is the precinct of the ‘policy wonks’, the other the preoccupation of aspiring parliamentarians. The former muses about structural reforms to the health system, the latter agonises over measures to reduce health costs and broaden service options. The savvy political performers will blend the two and appeal to a vision that alleviates hip-pocket pressures.
Since the last federal poll health has been very much on the back burner at the national level. It has not drawn the same degree of public debate that was the case prior to the 2004 election. Bulk billing by doctors has improved, health insurance membership has stabilised, private hospital revenues have grown and public hospital woes have almost become ‘par for the course’. Sadly, there is a mood of complacency, even resignation, that some issues are becoming too big to solve in a single hit.
Where once shocking front page newspaper stories of public hospital crises would have spun the political class into overdrive, today these same stories draw a considered, almost ‘managerial’, response from political leaders. Both John Howard and Kevin Rudd have deliberately adopted more reflective stances to the recent emergency department horrors besetting major metropolitan hospitals. This is more a product of the sensitivity of the political ownership of the problem than it is an indication of a ‘new politics’ in the health debate. Where hospital crises can be contained to administrative bungles rather than a lack of political oversight or investment, the more political leaders can adopt a statesmen-like persona and keep at bay the rising pent up public frustration.
But despite this political management, the health debate is squarely about the system’s capacity to meet demand.
The ageing of the population has exacerbated the inadequate size and range of the health workforce. There literally are not enough doctors and nurses, let alone dentists, psychologists and attendant carers. Thus the funding squeeze has only got worse. Now the orthodox health management mantra is to ‘do more with less’! As some senior policy makers claim, ‘the health system is now too complex to manage, at best it can only be steered in general directions.’
Into this environment come the major political parties seeking to lure votes without sending alarmist signals on how they will handle this complex issue.
To date the Coalition’s strong suit has been in