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Health policies: the art of the possible

Martin B Van Der Weyden
Med J Aust 2004; 181 (10): 521.
Published online: 15 November 2004

In the recent federal election, politicians criss-crossed the nation promoting their policies, and health was foremost in their bidding war. Labor’s Medicare Gold made a grab for the grey vote: free medical care and no waiting lists for citizens aged over 75! Labor also promoted itself as the true guardian of Medicare, promising higher rebates and other incentives for general practitioners to shore up bulk-billing and also offering incentives for after-hours GP clinics.

Prior to the campaign, the Liberals championed Medicare, pushing their safety-net to cover 80% of out-of-pocket medical expenses above $500 per year. They increased GP rebates, whether doctors bulk-billed or not, and also pushed for after-hours GP services.

Interestingly, both parties pledged to retain the private health insurance rebate.

Despite the constant cries by state premiers that their hospitals were on the verge of collapse, campaigning politicians invaded the wards for photo opportunities and policy-bites destined for prime-time television. All the while, the Greek chorus of political commentators, professional associations and self-interest groups chanted with delight, dismay or discontent at each policy release.

What are we to make of all this?

In promoting a health and welfare system free from cost constraints, both parties effectively ignored the twin pressures of surging demand for health services and spiralling costs. Furthermore, the waste inherent in the federal/state health divide was conveniently cast aside.

Playwright and first President of the Czech Republic, Václav Havel, once observed that politics is not only the art of the possible but also of the impossible. The former is the easy road. The latter is more challenging — it requires creative reform and fearless advocates.

Will we now have three years of the possible or the impossible?

  • Martin B Van Der Weyden

  • The Medical Journal of Australia

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