By David Elliott
The government is proposing cuts to Medicare, along with the privatisation of Medicare payment processing. Cuts to rebates for pathology tests, including blood tests, pap smears, and diagnostic imaging, have been put forward. These cuts will result in fees for medical screening tests that are currently free. The additional privatisation of online Medicare payment processing is a way to further carve private profits out of a public system.
The government has previously tried to move various government transactions online with the widely reviled ‘MyGov’ website and ‘Express Plus’ phone apps. These have produced second-rate online services, but the underlying problems with government services are caused by systematic underfunding, understaffing, and poor management by neoliberal bureaucrats. It is this more than anything that results in endless frustration for those relying on government services.
The Turnbull government claims that private contractors will improve digital payment technology for Medicare, but many Medicare payments actually went electronic in 2012, and expanding bulk billing would make basic medical care free at the point of service. The actual motive behind the plan to privatise back-of-house processing is to create a new way to make profits out of public funding.
Forcing people to pay for diagnostic screening tests such as pap smears will result in numbers of people not seeking the tests. These tests have saved lives. They make it possible to detect life-threatening conditions early. Discouraging use of medical services early on will mean more people will enter the healthcare system with more serious conditions later, having a devastating impact on peoples lives and placing extra strain on the hospital system.
The Australian Council of Trade Unions (ACTU) has come out against the changes, but we cannot rely solely on meek objections from the ACTU, who are tied to the Labor Party. While the Labor Party finds Medicare difficult to attack publicly, they support public funding cuts in general. Labor put in place a freeze on Medicare rebates in 2012, so that rebates for doctors visits do not grow along with inflation, meaning that patients of non-bulk-billed clinics pay for the effect inflation has on doctors fees. While Labor opposed Abbott’s plan for co-payment fees to see a doctor, they are themselves guilty of implementing these ‘co-payments by stealth’. The Liberals have continued this policy of rebate freezes.
Labor have also slowed the growth of necessary funding to the public hospital system, and only four years ago pushed for the privatisation of disability services and the introduction of a voucher system through the NDIS. Labor’s general lack of credibility is highlighted by the fact that Bill Shorten was heckled over his abhorrent refugee policies at a recent Medicare rally in Sydney.
We need fighting trade unions and community groups to come forward and build a new movement against government cutbacks. Such a movement should not be tied to any party that supports cutbacks or privatisation. We have to move toward the creation of a new workers party by and for ordinary people. Instead of just verbal opposition to the constant attacks on healthcare, this movement would fight to gain ground.
When the Abbott government attempted to bring in co-payment fees to see a doctor, tens of thousands of people came out to rally against it. These actions forced the government to back down on co-payments. It was not the statements of opposition from Labor that the Abbott government feared, but the mass outrage within society as a whole, represented by large demonstrations.
We need to show that we can repeat these demonstrations and escalate beyond them, to build a campaign to fight for an expansion of public healthcare. This could include protests, strikes, and even standing anti-cuts activists in elections.
We must campaign not just to keep medical testing free, but to make all medical care free at the point of service, including specialist services. Medicare can be further expanded to include dental care. Instead of privatising bits and pieces of government services, we must fight to remove private profit from the health sector. This would involve nationalising the pharmaceutical industry and expanding the public hospital system. Only the fight for a socialist society can stop private interests from constantly degrading the quality of public services, and ensure full access to healthcare for everyone.