The Abbott government is in deep trouble.
That’s the take-home message from a turbulent week of federal politics, in which the possibility of a first-term Coalition defeat began to be seriously discussed.
Talk is cheap. But the scale of the government’s recent blunders have started to shake the long-held consensus that the Abbott government would eventually be able to arrest its unpopularity and campaign strongly for a second term.
The government has trailed in the opinion polls for most of the year, but recent surveys have seen its support sink to new depths. A short-lived bounce from the government’s pivot towards national security and foreign affairs petered out after a dismal G20 meeting. New calamities seem ready to engulf Abbott and his front-bench at any moment.
The government’s handling of the funding cuts to the ABC and SBS is a case in point. The Coalition has been badly wrong-footed by the intensity of the public backlash; worse, the controversy bled quickly from anger at Malcolm Turnbull into a damaging debate over whether the Prime Minister had broken an election promise.
Abbott is now struggling to right a listing ship, telling the Coalition party room this week that he is prepared to knock some “barnacles off the ship” – in the form of unpopular policies.
This is presumably why the government is reported to be planning to abandon the unpopular $7 fee proposal.
Actually, “abandon” might be too strong a word. The measure, announced in Joe Hockey’s disastrous May budget, has never even made it to Parliament. Unlike Christopher Pyne’s equally contentious university reforms, the $7 co-payment hasn’t had any legislation introduced.
Should a bill be introduced, it’s unlikely it would pass the Senate. Labor and the Greens remain vehemently opposed, while few of the cross-bench Senators have signaled their support.
The very fact that the $7 co-payment proposal is still being debated is a sign of the Abbott government’s political challenges.
This is one of the Abbott’s cherished fiscal reforms from the May budget. But it is deeply unpopular, not just in the health sector and among doctors and policy experts, but throughout the electorate.
The fee is sometimes describes as a GP tax, but that’s actually underestimating its impact. The fee will be levied on all basic pathology and radiology tests, effectively imposing a consumption tax on health services across the board.
And yet, despite the government’s rhetoric about the fee being necessary as a “price signal” to make the health system more sustainable, the money raised by the fee won’t actually go back to the health system. Instead it will be quarantined in a medical research fund, to support basic research in health and biomedical science.
As with so many of the government’s neoliberal convictions, there is precious little evidence to suggest the $7 fee will work. A Senate Committee took extensive submissions on the issue earlier this year, and concluded the fee would be counter-productive.
A huge evidence base across the world shows that the best way to improve health outcomes is to fund and support public, primary health care. The government’s health policies do precisely the opposite, by attacking the universality and accessibility of primary care.
Indeed, there is plenty of evidence to suggest that forcing poor people to pay an extra $7 just to see a doctor or get a scan will only make the health system more costly and inefficient. Public hospitals in particular are terrified of the proposal, which they believe will cause a flood of presentations for minor ailments to emergency departments.
Modelling recently released by the New South Wales Health department shows that the fee could lead to an extra half million people seeking treatment in public hospitals in the state. Grattan Institute health economist Stephen Duckett agrees and told a Senate committee earlier this year that “if more than one in three of these patients go to an emergency department [instead of visiting a GP]there will be no saving to the government.” To top it all off, recent government health statistics show that Commonwealth health spending is actually falling. So much for the unsustainability of the health budget.
The contrast with Pyne’s higher education changes is instructive. The Education Minister may not be everyone’s idea of an effective political operator, but he has at least organised a coalition of support for his changes – including a chorus of highly-paid Vice-Chancellors and the key universities lobby group, Universities Australia.
In contrast, Health Minister Peter Dutton has been conspicuously unable to win the support of doctors or health groups. The AMA, normally a supporter of a more privatised health system, remains opposed to the $7 co-payment, as do patients’ groups and many health policy experts.
The ongoing speculation over the co-payment is damaging the government politically. In a recent Essential poll on government decisions, the GP fee racked up a hefty 66 per cent disapproval figure. The only decisions more unpopular were the university changes and the Abbott government’s massive cuts to public hospital funding.
The morass of health policy is a mark of this government’s poor political acumen. Not only is the government copping flak for a proposal that hasn’t even been voted on by the Parliament, it’s also directing the electorate’s attention back to an area where the Coalition is mistrusted.
And yet the government still can’t seem to bring itself to axe the unpopular policy. While journalists are being backgrounded about the $7 fee being dropped, Dutton is still holding the line that the co-payment will go ahead.
Some kind of circuit breaker is clearly required: a ministerial reshuffle, perhaps. But a reshuffle won’t remove the real albatross around the government’s neck: its demonstrably unfair budget, and the resolute judgment that voters have passed on it.
In similar tight squeezes, John Howard was adept at crafting political compromises, in ways that wedged his opponents and reinforced his claim to occupy the middle ground of Australian politics. Tony Abbott has showed little of that tactical nous, time and again taking hardline positions far to the right of the cautious conservativism that Howard made his own.
Polls come and go. But if the government continues to blunder and drift, Abbott’s own leadership will inevitably come into question. Coalition backbenchers are far more loyal than their Labor opponents. But they’re not stupid.
If the political standing of the government continues to deteriorate in the new year, leadership speculation will begin in earnest.
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