A former health advisor to the federal and Victorian state governments is calling for honesty on the sustainability of Australia’s public health system, warning it was impossible to “grant every wish” around funding.
Healthcare reform has been one of the hot topics in the current federal election cycle, with the centre-left opposition Labor Party promising to expand aged care services, and shake-up the $30 billion (US$22.03 billion) NDIS program—an ambitious scheme introduced under the Labor government in 2013 to pay for disability services.
Meanwhile, the Australian Greens have proposed to offer free dental to all by bringing it under the Medicare program—the country’s universal healthcare scheme.
Terry Barnes, former senior advisor to two Howard-era government health ministers, said the major parties were not looking at long-term solutions to addressing public healthcare, and were simply looking at short-term spending boosts.
“It’s always, ‘We can spend a billion here, a billion there, or we can do this, we can do that,’” he told The Epoch Times. “It doesn’t really look at the totality of our health care. We don’t take a holistic look at it.”
Barnes said part of the problem was that the voting public had become accustomed to seeing healthcare in “terms of quantity, not quality,” and that political parties were reluctant to engage in tough debates on the issue.
“To have a discussion about that implies blame and responsibility and nobody really wants to go down that path,” he said. “They’d rather have voters sip the Kool Aid and keep reassuring them that whatever happens we can afford it.”
One example is the costing of the NDIS, where Prime Minister Scott Morrison admitted during the People’s Forum debate on April 20 that it was “more expensive than Medicare” but maintained that it was “worth investing in.”
“Because every single person who has a disability is different … you need to tailor the programs to each and every single individual,” he said.
The program, which covers the support services for 500,000 Australians, is staring down a budget of $33.3 billion by 2024–25 despite being in operation for less than 10 years (Medicare will cost $31.4 billion in 2022-23)—an NDIS Financial Sustainability Report estimates costs to reach $60 billion by 2030.
This has forced the centre-right Coalition government to introduce reforms to streamline NDIS and make it financially sustainable.
The moves have triggered criticism from Jean Cotchin, campaign manager of Every Australian Counts.
Cotching said the program was facing “death by a thousand cuts.”
“Every single day we hear more and more stories from people who have had their NDIS funding cut—with no reasonable explanation,” she added.
Barnes said dealing with the growing need for healthcare—due to the ageing population—did not mean expanding the public health system.
“You’ve actually got to make it worthwhile for people to put their own money into private healthcare,” he said. “But I think that’s been undermined by successive governments for the best part of 10-15 years.”
“There is this prevailing ideological mentality that every dollar spent in private health care is one dollar not spent in public health,” he said.
Barnes proposed making sure the cost of private health surgery and treatments were capped or driven down, to ensure health funds would be able to cover it.
“There needs to be structural reform of what’s covered,” he said. “That includes looking at the credentials and making sure insurers are in good shape to pay and ensuring that they’re not over provisioning.”
