The staged walkout by the state and territory leaders at the recent heads of government meeting was calculated to keep unrest simmering in the health services until the next federal poll. Dissatisfaction with health care changes votes. Blaming a seemingly ‘mean-spirited’ Commonwealth shifts the political risk and provides cover to reduce health budgets, while directing community ire towards Canberra.
Labor leaders like to champion their commitment to health care. More often than not the voters seem to agree. The Prime Minister knows this and has raised the stakes for Labor. By forcing the states to carry more of the funding for hospital services John Howard is challenging Labor to match their political rhetoric with money. Little wonder the Labor leaders are attempting to turn the tactic on its head. For them this is a massive Commonwealth cut to public hospitals and reveals a hidden Coalition agenda to erode the benefits of Medicare. It started with the Commonwealth’s push to raise fees for drugs and medications, followed quickly by a GP package where more patient charges are envisaged. It is now compounded with a deliberate attempt by the Commonwealth to ‘turn the tap off’ in paying for a free public hospital system. Access to essential care is increasingly determined by ability to pay rather than need.
Political ideologies aside, the funding dispute reveals a deeper divide. The shared government responsibilities for health are not evenly matched. Although the states are correct to cite the almost $1 billion reduction from the Commonwealth, their protest is somewhat limp. They have gained nearly $7 billion from stamp duties last year alone. Their capacity to make up the health shortfall seems obvious. Yet they insist that their economies cannot keep pace with the demand for services, the costs of medical technology and the ageing of the population.
The risk management of the health system is increasingly out of balance. The Commonwealth has responsibility for the viability of Medicare. This includes subsidies for medical services and listed pharmaceuticals. The states and territories are responsible for delivering the part of the insurance benefit that gives free access to public hospitals. Although the promise of insurance exists for all, the capacity of the public hospital system to meet demand and evenly distribute benefits is stretched.
Last year up to 60 per cent of people with a diagnosed mental disorder did not receive an appropriate service. Nearly 2000 public hospital patients should have