PUBLIC HEALTH FUND THE SYSTEM The following article was published in "The Guardian", newspaper of the Communist Party of Australia in its issue of Wednesday, July 28th, 1999. Contact address: 65 Campbell Street, Surry Hills. Sydney. 2010 Australia. Phone: (612) 9212 6855 Fax: (612) 9281 5795. Email: <[EMAIL PROTECTED]> Webpage: http://www.peg.apc.org/~guardian Subscription rates on request. ****************************** A conference of State and Territory leaders meeting in Sydney last weekend agreed that the delivery of health services in Australia is under unsustainable stress. Amazingly, this conference of national and state leaders did not mention the two key factors behind the stress on the public health system: lack of government funding for public hospitals, and the billions of dollars being diverted from the public system to prop up the inefficient and costly private health insurance system. Funding for public health has for a long time been a political football kicked about between state and federal government. Neither level of government wants responsibility for funding public hospitals and both have constantly sought the ways and means to cut the level of funding. This is reflected in the conference finding all sorts of reasons to explain why the system is under stress: the ageing population, technological and scientific advances, inefficient practices, rising costs, shortages of skills etc. The reality is that the hospital systems are under-funded, which is why health workers and, in NSW at least, doctors and specialists, are up in arms. Funding for the public hospital system in NSW has been cut to the point of near-collapse of parts of the public hospital system. In Victoria health workers have been left with no option but to carry out a concerted industrial campaign (see story page 4). All the states and territories are experiencing similar problems. A prime example is Sydney's Westmead Hospital in the western suburbs, where funding cuts have resulted in a reduction in the number of beds from 1,000 in 1979 to 750 today. A proposed further cut of $9.5 million dollars will see the number of beds reduced to 660. At Westmead, cancer patients have been forced to wait up to six weeks for urgent surgery. In the week preceding the conference, 12 heart attack patients had to wait hours for treatment in the accident and emergency unit because no beds could be made available. The unit itself has recently been forced to close at least once a week for other than life threatening cases. The Premiers resolved that there should be an inquiry into the efficiency, effectiveness and future profitability of the delivery of health services in Australia, with a draft report submitted within one year and the final report within 18 months. A number of organisations have called for an increase in the Medicare levy to help cover the costs of running state public hospitals. The Public Health Association of Australia this week said that a one percent increase in the levy would largely solve the funding problem, without resort to means testing of patients. The Queensland and Tasmanian Labor Governments have expressed opposition to any downgrading of the current level of service or change to the funding arrangements and the introduction of "co- payments" for treatment at public hospitals has been proposed by the governments of Western and South Australia. Under this scheme a patient would be forced to pay part of the cost of treatment at public hospitals, which is currently free of charge. The Carr Labor Government in NSW is giving the co-payment proposal a sympathetic hearing. Victorian Premier Jeff Kennett wants to go much further. He wants to see the Medicare levy scrapped and all but the most destitute of patients forced to take out private health insurance, or pay the full cost of treatment. Kennett is supported in this by the Australian Medical Association which has campaigned for many years for the user-pays system for public hospital treatment and the scrapping of Medicare. The Australian Council for Social Services, the Public Health Association of Australia, the Brotherhood of St Laurence, the Australian Consumers' Association and the Catholic Healthcare Association all called for the State and Territory leaders to reject calls for "user pays" policies in any form for public hospitals. The ACTU has also indicated its vigorous opposition to the proposals, pointing out such a move would create a two-tiered health system. ACTU Assistant Secretary Greg Combet said that Medicare had enabled Australians to have equitable access to the highest standards of health care at a relatively low cost. "Medicare is one of the cornerstones of the social wage, and universal, free access to health care is of critical importance to workers and their families. To propose that public hospitals charge patients would inevitably lead to a US-style, two-tiered system", he said. The real aim of the proposed inquiry is to prepare public opinion for the undermining of Medicare with the possible introduction of means testing, co-payments and other measures that would eventually lead to the destruction of Medicare as we know it and the establishment of two systems -- where the quality of service depends on your ability to pay. Australians have voted with their feet for Medicare as a system of universal health insurance, with bulk billing and "free" hospital treatment as central features. One public health system is the best and most efficient way of providing health services for all Australians, rich and poor. The public health system, including Medicare, must be defended in its entirety. The Guardian 65 Campbell Street, Surry Hills. 2010 Australia. Email: <[EMAIL PROTECTED]> Website: http://www.peg.apc.org/~guardian
