Ignore health policy at your peril

Health policy must be driven by people who know health intimately, writes AMA's Dr Michael Gannon

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Health policy must be driven by people who know health intimately, people with skin in the game, not bureaucrats, writes AMA President Dr Michael Gannon

The election has been run and won. Prime Minister Malcolm Turnbull and the Coalition are back for a second term, with a wafer-thin majority in the Lower House and a patchwork quilt to deal with in the Senate.

In post-election commentary, everybody agrees that health – either as policy or a campaign tool (“Mediscare”) – was significant in determining how people voted. In short, health changed votes.

The Coalition attacked Labor over its Mediscare campaign, which deliberately painted a picture of a fully privatised Medicare. The Prime Minister subsequently called it an “extreme act of dishonesty”.

The AMA, too, was critical of the Opposition’s Medicare privatisation claims. There is, and was, no move to privatise Medicare. All that was announced, and later withdrawn, was a plan to ask the Productivity Commission to look at outsourcing some backroom administration arrangements in the antiquated payments system, something that the AMA would still welcome and support.

Nevertheless, the political reality is that health played a major part in this election, and it was the Coalition that created and nurtured the fertile ground that allowed the scare campaign to grow and thrive.

The seeds of Medicare uncertainty, and fear, were sown more than two years ago with the Abbott government’s 2014 budget and the birth of the co-payment bogeyman.

For almost the entire term of the last government, the Coalition lacked a cohesive health-policy narrative. The successive co-payment nightmares, followed by the Medicare freeze debacle, were succeeded by a series of reviews which, while worthwhile, were never going to report or translate into policy until well into a second term.

As a result, the Coalition did not have a coherent health message to take to voters at the election. This played into the Opposition’s hands.

The AMA, the RACGP, and other health groups, campaigned on issues that have a direct impact on patients – the freeze on Medicare patient rebates, the need for more public hospital funding, and the impact of cuts to bulk-billing incentives for pathology services and X-rays.

These are all issues that Australian families can relate to from everyday experience. These are all issues that impact negatively on patients, doctors, and other healthcare providers. But they were not issues that appeared from nowhere in the final fortnight of a long election campaign. They have been around since the 2014 budget, and the Coalition did not acknowledge them as electoral threats, vote losers, and game changers.

The AMA warned the Government, under both Malcolm Turnbull and Tony Abbott, and directly to Health Ministers Peter Dutton and Sussan Ley, that the health policies from the 2014 budget were bad and must be changed.

When Mr Turnbull met the AMA Federal Council in Canberra just prior to the election, he was told first-hand by doctors from all states and all specialties that the Coalition had to change course on health policy.

During a meeting with the Prime Minister in Perth just weeks ago, in the middle of the campaign, I issued similar warnings.

There is no doubt that the Coalition will take health policy very seriously ahead of the next election. The Prime Minister has made that clear, saying that “… a material number of Australians were sufficiently concerned about our commitment to Medicare that they changed their vote, and that is something we need to address”.

The first bit of advice we offer the new Government is to approach health policy as a means to improving public health and saving lives, not as a way to save money for the budget bottom line.

Health policy must be driven by people who know health intimately, people with skin in the game, not bureaucrats from Treasury and Finance.

The AMA will advocate that investing in preventative health measures and in primary health care is not only a moral imperative, it is an investment in the economic productivity of our nation – and perhaps even political survival.

The challenge is very clear for the new Government: ignore health at your peril.

Dr Michael Gannon is the President of the AMA