Slowly, inexorably, the Abbott government continues with its project to reshape Australia into a meaner, less equal place.
Today, for instance, the government is introducing its radical higher education reforms to the Parliament. As we argued on Tuesday, such changes will almost certainly make Australia’s university system less equal, more unfair, and produce worse outcomes. Leaked modeling, released to Fairfax on Wednesday, appears to back this up. But Education Minister Christopher Pyne is pressing ahead.
The government is also pushing on with its plan to force ordinary Australians to pay a $7 co-payment to visit the doctor or get a blood test. Like so many of the government’s measures, it lacks support from the people it will affect: health consumer groups oppose it, ordinary citizens loathe it, and health experts have been vocal in arguing against it.
The Australian Medical Association, often a friend of conservative governments, opposes the original measure, wanting a modified payment with stronger safety nets instead. Not that we should pay too much attention to what the doctor’s union thinks: in an astonishingly self-serving proposal, the AMA wants a $6.15 co-payment, with the money going not to a medical research fund, but straight to doctors. Even the government thinks that’s a bit rich.
Meanwhile, the government has already passed the majority of its budget measures through appropriations bills, locking in funding cuts to pensions and benefits, health, education, legal aid, the ABC, and the arts.
The thread that runs through these decisions is a philosophy of inequality.
Although the government is trying to dress up its reforms in the rhetoric of the market – the GP co-payments, for instance, have been justified as being necessary to send a “price signal” to patients – the consistent pattern is one of attacking welfare entitlements, especially those that apply universally and equally. The result of these “reforms” will be a less equal Australia.
As we know – indeed, as even the government knows – the budget changes will primarily affect poorer Australians, and those at the lower end of the socio-economic scale.
In education, the university fee deregulation will obviously affect poorer students and families, as university fees sky-rocket. The wealthy will be able to pay off their student loans sooner, or simply get their rich parents to pay them up front, while struggling students – especially women and the unemployed – will actually pay higher fees, as real rates of interest ratchet up their loan repayments.
In health, the GP co-payment will also be unequal. The wealthy are unlikely to worry about a $7 fee to visit the doctor, while for citizens relying on bulk billing, the impost will genuinely hurt.
The co-payment is inherently regressive: poorer households will have to spend a greater share of their income than wealthy households. As the Grattan Institute’s Stephen Duckett argued recently, for the poorest households in Australia, health costs are already a significant burden.
“More than one in ten of the poorest households [spend]more than a fifth of their disposable income on health care,” he wrote last month in The Conversation.
Another recent report, by researchers from the Family Medicine Research Centre at the Sydney School of Public Health, came to similar conclusions.
“The introduction of co-payments will not have an equal impact across the population,” they write. “It is the high users, usually the older, sicker people in our community who will be the most affected.” Fancy that.
The other key point about the co-payment is that it attacks the universal nature of Australia’s public health system. Universality is a founding principle of Medicare, and one of the key reasons Australians enjoy such a high standard of health. As Christopher Del Mar argues in a recent editorial for the Medical Journal of Australia, “universal access to primary care is one of the essential aspects of our Medicare system and is one of the things that keeps the quality of Australian health care high.”
Despite the obvious benefits to the nation in treating sick people before they wind up in an expensive public hospital, the GP co-payments will likely deter many poorer Australians from going to the doctor. This is already happening: a recent Australian Bureau of Statistics survey found that as many as one in 20 Australians delay visiting a doctor because of the cost. And yet, in May, the government actually cut funding to public health.
In the cold hard calculus of political realism, it is hard to see why the government continues to try and push the co-payment cart. The measure appears doomed in the Senate: the Palmer United Party has signalled repeatedly that it won’t support the legislation, and Labor and the Greens remain implacably opposed.
The bizarre thing about the co-payment is that it won’t even help the budget deficit in any meaningful sense. The government still wants to link the income from the co-payments to the creation of a medical research fund. That means most of the revenue won’t improve the bottom line.
As with so many other policy spheres, the government is all over the place when it comes to research policy. While Joe Hockey trumpets the benefits of the proposed medical research fund, Christopher Pyne has been threatening universities with cutting federal funding… for research.
There are ways to fix the budget without smashing lower and middle-income Australia. An obvious place to start would be Tony Abbott’s cherished paid parental leave scheme, which the Parliamentary Budget Office now says will cost upwards of $5 billion a year. The scheme could be much more tightly means-tested, or the government could stick with Labor’s scheme.
Another way to improve the budget would be fixing up the huge tax subsidies to the well-off in superannuation; attacking property and capital gains tax concessions would be another.
But crimping the tax breaks to the top end would mean taking on this government’s favourite interest group: corporate Australia. Hammering the sick and the poor is far easier, it seems.
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