Some 800 people attended a rally in Sydney last Saturday that had been called in opposition to proposals from the corporate and financial establishment to introduce an up-front fee, or copayment, for doctor’s visits that are currently not charged under the Medicare health scheme. The perspective of those who organised and promoted the event, however, including the Greens, the pseudo-left Socialist Alternative, and a number of unions, was to provide the Labor Party with a platform to falsely posture as a champion of public health.
The current discussion in financial circles about the introduction of a “copayment” began when it was leaked in late December that Terry Barnes, a former Liberal Party advisor on health care, had called for a $6 fee for Medicare-covered visits to doctors in a submission to the federal Coalition government’s Commission of Audit. The Commission is effectively tasked with drawing up proposals for the sweeping austerity measures demanded by the corporate and financial elite. Andrew Podger, a former Health Department secretary, publicly called for a $30 fee and the Abbott government has refused to rule out the introduction of a copayment.
The introduction of a copayment will hit the poorest and most vulnerable in society, forcing them to choose between seeing a doctor and other basic necessities. Abby, a registered nurse, told the WSWS: “These cuts are going to affect the people who can’t do anything about it—the old-age pensioners. They’re not getting any increase in their pay. The government and the rich are trying to save money for themselves. They’re making the rich richer and the poor poorer.”
While broad layers of the population are hostile to further attacks on public healthcare, the claim, repeated by a number of speakers at the rally, that Medicare is the centrepiece of a universal healthcare system established by the Labor Party and the trade unions is a cynical fraud.
Sally McManus, the Australian Services Union secretary in NSW, declared: “Medicare is the principle and the promise of universal health care for all. It’s something that was fought for and won by the union movement, by the Labor movement of Australia. It’s uniquely Australian—it’s the most effective universal healthcare system in the world.”
In reality, Medicare has never been a system of universal free health care. Established by the Hawke Labor government in 1984 as the successor to Medibank, Medicare is a government-operated insurance scheme, partially funded by income tax levies. It covers treatment in public hospitals and 85 percent of “schedule fees” charged by GPs. Many doctors do not accept bulk-billing and the “charge gaps” between what the government pays and the actual cost of the consultation, which is paid by patients, are increasing. Medicare does not cover dental treatment at all.
Richard Di Natale, a federal Greens senator and the party’s spokesman on health, struck a similar note. He claimed that Medicare is based on “the principle of universality” and that under the scheme it “doesn’t matter if you’re rich or poor.” In reality, statistics modelled by Professor John Glover from the University of Adelaide —and quoted in the Sydney Morning Herald just days before the rally—show that those living in working class suburbs are far more likely to delay medical treatment due to costs than those living in wealthy areas.
Di Natale also claimed that the system provides broad access to specialist medical services. In fact, Medicare figures for 2012 showed that an average of just 27 percent of the cost of out-of-hospital specialist visits are covered by bulk billing, resulting in an average charge of $58.20.
Demonstrating that the Greens have no principled opposition to the agenda of cost-cutting to the healthcare system, Di Natale commented: “We have an opportunity. The door is always open, we will talk to minister Dutton and Prime Minister Abbott about where savings can be made, and revenues increased…”
Labor councillor Linda Scott told the rally: “Labor got on and delivered with the Labor legacy that was Bob Hawke starting Medicare. We got on and delivered the Labor legacy for health in the face of silence from the Liberal opposition.”
In fact, it was Bob Hawke who first sought to introduce a Medicare copayment in the 1991 Labor government’s budget. The move was only dropped due to Labor’s fear of the widespread anger in the working class that its announcement generated.
Scott’s claims about the Labor governments of Kevin Rudd and Julia Gillard from 2007 until last September’s election are no less fraudulent. Under Labor, substantial cuts were made to public health-care funding, resulting in the closure of hundreds of hospital beds across the country. The National Disability Insurance Scheme, one of the centrepieces of Labor’s austerity program, is aimed at forcing people off the disability pension and privatising the care of the disabled.
The final speaker was Sarah Garnham, the national education officer of the National Union of Students, and a member of the pseudo-left Socialist Alternative (SAlt). She boasted that SAlt, together with the Young Greens, had played a decisive role in building the rally—a revealing comment given that the entire purpose of the event was to channel opposition to attacks on public health behind the Labor Party.
Garnham described Medicare as a “project of the union movement” and insisted that any struggle to defend health care today “has to be a union fight.” In fact, the support of the unions for Hawke’s introduction of Medicare was part and parcel of their collaboration with his government’s campaign of workplace restructuring, economic deregulation and cuts to social spending, aimed at forcing down the conditions of the working class. For three decades, the unions have collaborated with both Labor and Liberal governments, state and federal, in ongoing cuts to essential services, including public health.
The Socialist Equality Party alone insists on the necessity for workers to make a decisive political break with the Labor Party, the trade unions, and the entire political establishment as the precondition for a genuine struggle against attacks on social spending. The SEP calls for the independent mobilisation of the working class in the fight for a workers’ government to implement socialist policies, including the basic right to free, high-quality health care for all.