It’s half way through the election campaign and both major parties have made some significant health policy announcements with Labor outspending the Coalition on health by over $2 billion (over four years).
However, despite the fact that health consistently rates as the number one issue for voters, neither major party has satisfactorily addressed the key issues essential to ensuring that our health system is fair, efficient and equipped to meet future challenges.
One problem for the Coalition is that after the 2013 election it had a slow start in the health portfolio, doing virtually nothing but debate GP co-payments for twelve months.
Then after the appointment of Sussan Ley to replace Peter Dutton as Minister for Health, the Government appeared to go into overdrive, instigating reviews, consultation processes and inquiries in virtually every part of the health system.
The early election this year has meant that many of these processes have been stopped mid-stream. This leaves the Coalition in the tricky position of either pre-empting their findings or remaining non-committal on these issues, with the expectation of winning Government and resuming business as usual.
So far the Government has chosen the latter and as a result has had little to say on key policy areas, such as primary health care, mental health and private health insurance. The Coalition’s most notable policy decision came in the Federal Budget when it surprised and disappointed the nation’s 26 000 GPs (and apparently also its own Health Minister) by deciding to maintain the Medicare rebate freeze for another two years, saving almost $1 billion.
Compared with its substantial savings measures, the Coalition’s election commitments have been very modest.
It has focused on ‘boutique’ health issues with relatively low levels of spending but high voter appeal. Its commitments so far include $7 million of new funding to increase access to clinical trials for people with cancer, with a particular focus on children and adolescents and $20 million to increase medical research capabilities.
The most promising reform measure from the Coalition thus far was the announcement of the Health Care Homes trial in the Budget. This measure, although it has been criticised for being under-resourced and having too short a time-frame, at least addresses some of the structural barriers to accessing care for people with complex conditions.
The Opposition has so far significantly outspent the Coalition, mainly due to its commitments to unfreeze Medicare rebates and to reverse the planned price increases for PBS medicines. Together these measures will cost almost $2 billion and reflect Labor’s strategy to send a clear message to voters that Labor is the party to safeguard Medicare and universal health care.
Labor has also made commitments in the areas of breast and prostate cancers, mental health and tobacco use. In relation to health reform, Labor has announced that it would establish a permanent Australian Healthcare Reform Commission, along the lines of the Rudd-era National Healthcare and Hospitals Reform Commission.
The Commission will be created through the consolidation of the Australian Commission on Safety and Quality in Health Care, the National Health Funding Body, and functions formerly associated with the Australian National Preventive Health Agency, Independent Hospital Pricing Authority, National Health Performance Authority and Health Workforce Australia which have been transferred to other agencies.
Its overarching aim would be to investigate, develop and evaluate proposed changes to Australia’s health system, and advise governments (including State and Territory Governments) on these changes.
It would also have a strong implementation capacity and be responsible for rolling out agreed structural reforms to Australia’s healthcare system, including funding agreements and payment systems.
This new body would also include a Centre for Medicare and Healthcare System Innovation, to develop, trial, evaluate and implement new payment and service delivery models that aim to reduce health expenditure while improving the quality and safety of care. The Centre would also take over the responsibilities of the MBS Review.
The Greens have taken a more direct approach to reform in their election platform and proposed some major changes to the funding of primary health care to improve chronic disease prevention and management. This includes $1.5 billion in additional payments to GPs to support them for the additional demands of managing chronic and complex problems and $2.8 billion to increase access to allied health services for people with chronic conditions.
The Greens have also made a strong statement of commitment to Medicare, universal health care and bulkbilling. Other areas they have addressed in their election platform include palliative care, mental health, HIV treatment and Indigenous health. (For more details on policies relating to Indigenous health, see this recent Croakey article).
The Greens proposal for an Active Transport Fund, worth $250 million annually for cycling and walking infrastructure, is pitched as a boost for the environment, as well as population health.
As the election campaign continues, Croakey will keep readers updated with policy announcements and funding commitments, along with the responses to these from key stakeholder groups. We will also ensure a continuing focus on the critical public health concern of climate change.
Jennifer Doggett is a Fellow of the Centre for Policy Development and a Consultant working in the health sector. This article first appeared in Croakey on 6 June 2016. See link below.