Medicare moves state the bleeding obvious
CRISPIN HULL COLUMN
On March 2 this year I wrote on these pages: “Bulk-billing GPs have borne the brunt of the Coalition’s stealth attack on Medicare. They should have a very substantial catch-up, and in a way that makes bulk-billing pretty much universal. It would happen more quickly if the Government did not just give more to bulk-billing GPs but also reduced the payment to those who do not.
“And with specialists, too, there needs to be much bigger incentives to those who bulk-bill and reduced payments to those who do not. Maybe Medicare payments should cut out altogether when specialists’ gap fees rise too much – certainly if they are more than the scheduled fee itself.”
Last week the independent think tank the Grattan Institute came out with a similar proposal.
It suggested that Medicare benefits should not be available to the patients of specialists who charge more than double the Medicare scheduled fee.
I do not mention this to give myself a pat on the back, or, indeed, to give the Grattan Institute a pat on the pack.
To the contrary, it shows that what I had proposed was hardly original. Indeed, it was the bleeding obvious.
A lot of what you might read in this column each week is the bleeding obvious. The dispiriting thing is that government behaviour in Australia is often so bad that the bleeding obvious has to be pointed out again, and again, and again.
Capital gains concessions, cash franking credits, negative gearing, tax-avoided trust incomes, superannuation tax concessions for the uber-wealthy, profit-shifting to tax havens; tax rebates on private-health premiums, GST exemptions for health and education enjoyed mostly by the well-off, over-funding of private hospitals and private schools, gambling advertising, food labelling, the sugar tax, exploitation of workers in the gig economy, massive immigration increases, fossil-fuel subsidies, idiotic and ineffectual housing subsidies that fuel the fire, massive investment in inefficient private transport, and the list goes on and on.
Solid think tanks, like the Grattan Institute and the Australia Institute, and oodles of my journalistic colleagues point out the merit of reform in all these areas and more, again and again and again.
Yet nothing happens. Why?
It bespeaks the slow erosion of the way government is done in Australia. And now should be the time to do something about it.
This is because nearly all of the items in the list above are legacies from the Howard Government and all of them have made access to quality health, education and housing much less equal and more unfair.
Now with the election results declared, the final ironic legacy of the Howard Government lies before us. Howard began the systematic process of removing nearly all the moderate people and moderate policies from the Liberal Party, which has resulted in the party being unelectable and the country without an effective or constructive opposition.
The pews to the left of the nave in Howard’s “broad church” have been emptied.
With that narrowing to the right, membership of the party aged and shrank, so it had to turn elsewhere for the resources (human and monetary) to underwrite election campaigns in the form of large corporate donations and shadowy organisations like the Exclusive Bretheren handing out how-to-vote cards.
The price was social and economic policies moving even further to the unacceptable right.
To a lesser degree it happened to Labor as well.
To that extent Prime Minister Anthony Albanese’s address to the National Press Club was disappointing. Not because he said that he was reformist not revolutionary but because of the suggestion that the winding back any of those Howard agenda items would be “revolutionary” when in fact they would hardly be even reformist – just a return to the centre.
The message Labor should get from the election is that at the very least the electorate wants an end to the unfair policies. And they want the putting into effect very obvious evidence-based policies to protect people against harm – gambling and sugar, are good examples – all under-pinned by more democratic processes.
Labor’s superannuation changes are example of how not to do it – just tinkering at the edges while the rorts are left largely intact.
Of course, the obvious cause for the policy interia is the control of the major parties by sectional interests: big employers, big agriculture, fossil fuels, mining, property, big pharma, and the list goes on.
It is fine for a major political party to have as its aim the gaining and retaining of power. The trouble now is the way that is done and for what purpose. These days it is not by appealing to what the mass of voters want or arguing a case before the voters so they support it.
Rather it is done by getting enough donations to run an election campaign even if that means compromising the public good in favour of sectional interests to as great an extent as they can get away with. In that context it becomes the pursuit of power for its own sake, necessitating the duping of many voters as to what they are doing.
The Trumpists, the Brexiters, and the Coalition used distraction and blame to exploit the resentment of those who had lost out in the free-trade, economic-rationalist revolution by saying it was the fault of the Washington swamp, the Brussels bureaucracy, and the Canberra bubble – elite conspirators against older, white, male, Christian workers.
But people working in government or academia are much more likely to be on the side of the broad public interest than the real swamp and bubble dwellers – industry lobbyists who slink around the corridors of power promoting the selfish, sectional interests of their masters invariably in a way inimical to the public interest and the environment.
Policy should be developed in a more open way, with the public, the parliament and the party rooms, and diverse inputs, not hatched in the Prime Minister’s office and imposed from the top down.
Whether Albanese calls it revolutionary or just reform does not matter. Getting rid of that way of politics would go a long way to making Labor the natural party of government if the Liberal Party continues to go down an unelectable sinkhole with the National Party.
Otherwise, voters – who are slowly realising how they have been dudded and by whom they have been duded – will continue to turn to the independents.
This article first appeared in The Canberra Times and other Australian media on 17 June 2025.
*Crispin Hull is a distinguished journalist and former Editor of the Canberra Times. In semi-retirement, he and his wife live in Port Douglas, and he contributes his weekly column to Newsport pro bono.
The opinions and views in this column are those of the author and author only and do not reflect the Newsport editor or staff.
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