How the health overhaul became a big stink over tax

Richard Ure says:

04:50pm | 06/03/10

Knowing clever commentators will jump on her, Nicola Roxon should be praised for raising the possibility of higher taxes at this stage of the debate instead of pilloried or sniggered at by commentators desperate for a glib headline.

Australians would be well advised to follow the lunacy of the health care debate in the US. If anyone suggests raising taxes there (to pay for benefits they have already received), the full guns come out as opponents call on the views of the founding fathers to make their case for less federal government involvement much less a universal health system.

Meanwhile those same commentators and the readers, whose view of the world they inform, pay much more in private insurance premiums for an inferior service they can lose at the drop of a hat, and feel vindicated in living the capitalist dream.

Dingo says:

02:50pm | 07/03/10

The only reason Health has become a Federal issue is because the some of the State Govts have completely lost the plot.

Anyone who works in a Public hospital in NSW knows the system really started to fall over when the Area Health Services were established and began sucking money out of front line services to pay bureaucrats.  Qld has the same problem. Nothing will improve in these states until these boards are demolished and decision making returned to local hospital boards.

If you want to fix the system you need to start with the actual problem, of too many leeches sitting behind desks and not enough doctors, nurses and cleaners.

Evan Findlay says:

06:35pm | 06/03/10

Thanks Max for your intellectual insight into a problem that has spanned twenty years. Also it’s wonderful to find someone from the conservative side of politics with such detailed and costed alternatives to Rudd’s health policy. The opposition health minister, whoever he or she is, has certainly led from the front on this issue. it’s refreshing to see the policy initiative of the opposition.I for one cannot hide my absolute joy that the coaliton have set the bar on health reform so high. I take my hat off to you!

persephone says:

07:07pm | 06/03/10

Well, I haven’t seen one policy from the Liberals which hasn’t involved higher spending. The only difference is that they won’t say where the money is going to come from to pay for their promises - and given how few they are, you wouldn’t think it was much of a challenge.

But no.

Let’s look at them;

Direct Inaction on Climate change - lots of extra government spending; the creation of a new bureaucracy, the Green Army, subsidies for solar power, incentives for business to become greener, tree planting, research into various carbon emission reducing technologies, pilot projects to create ‘solar cities’ - all with a hefty price tag.

To be paid for by ???  No comment.

Education. We’re apparently going to fund the full cost of any student, no matter how wealthy they are, as long as they do a bit of token work in the meantime, whilst also adopting Labor’s reforms, which means an extra billion to be spent in this area.

To be paid for by? No comment.

Private health. We’re not going to cut the private health rebate, because that would break an election promise, and the Liberals couldn’t let Labor do that (despite voting to break election promises they themselves made).

And the Liberals will add another level of bureaucracy by appointing local boards to each hospital. That’ll also cost money.

To be paid for by—- ? No comment.

The Liberals have opposed every cost saving measure that has been put before the Senate, yet keep whining about reducing debt.

There is a word to describe this kind of behaviour, but I’ll let you work it out for yourselves.

susie says:

08:50pm | 06/03/10

‘the walking bagpipe’ - good one Max, I like that !  Can I use it too, or have you patented it ?   

Max Power says:

05:59pm | 07/03/10

I couldn’t care less about what the liberals are offering at the moment. If I was them I would keep quiet otherwise Labor will steal their policies again. That is why the wheels have fallen off the Labor party wagon, they can’t copy the Liberal policies, all though they are giving it a good shot with their latest promise to fix the health system. Just like all other Labor promises this will be broken to and conveniently blamed on the states. The Liberals win because they opposed the Enormous Tax Scam, the scam Ruddy needs to pay off his record debt in record time. What an economic conservative he is, yet another lie, he is spending like a drunken sailor. Sorry Mr Rudd, you are out of touch. The problem with Rudd is, you just don’t know which of his multi personalities you are voting for.

Max Power says:

06:07pm | 07/03/10

Evan: Thank you for jumping to the conclusion that I am from the conservative side politics and that I, a non-politician is some how responsible for the Liberals policies and costings.  You my friend have gone in half cocked and made a full cock of yourself. I am not a conservative, but someone who dislikes all the personalities of Kevin Rudd and can see through all the BS that spews from his mouth. He has failed to deliver on all of his election promise bar two, the two feel good promises that amount to very little. Clearly the labor party has not costed all their promises and policies because if they did, we wouldn’t be in record debt in record time. Sorry Mr Rudd’s, you are spending like drunken sailors, you’re just out of touch!

Francis Forbes says:

01:46pm | 08/03/10

Rubbish, Rudd has a good plan, we just need Keneally, Bligh, Brumby,
Barnett, Bartlett to tow the line. After all he did an excellent job with Qld health. Why not let him lose on a national front…what can go wrong?

persephone says:

06:31am | 07/03/10

Haven’t read the speech or any of the media reports, have you, Scot? The information is all out there.

I’m not sure what you’re referring to specifically by ‘how this will be done and what it will cost’ - we know how the health plan will be implemented and the costs have been put on the table, so I’m assuming you’re talking about the takeover from the States.

If so, then the costs of running the system will be exactly the same as those proposed under the scheme at present. The Feds will take back even more of the GST from the States to cover some of this.

Rudd has made it very clear that more administrators will not be required, and those working in the system at present may be required to relocate to where the work is (at the network level). As a bureaucrat himself, he will have a good understanding of what’s required.

Most people, when surveyed, make it perfectly clear they’re willing to pay more taxes for better services. However, this may not be necessary as there are a lot of savings which can be made within the health system if it is run on a more rational basis than it is at present.

So, for example, the government is taking over primary care. At the moment, a lot of patients by pass the primary care system and to straight to hospital - either because they can’t get into their doctor’s and go straight to ER, or because they haven’t been able to afford primary care and have let their condition deteriorate until they are sick enough to need hospitalisation.

If better primary care services result in fewer patients entering hospital, you’ve saved a heap right there.

Also, the present system encourages duplication of services (one set provided by State, the one by Fed). In quite small towns, you can find that there are a number of organisations delivering exactly the same service and all demanding money from the taxpayer to do so.

Finally, this duplication encourages cost shifting between the State and Feds (even though the cost is not shifted for the taxpayer, who pays regardless).  Again, if the same service is being delivered by a number of providers, and one is being paid to do so by the State and the other by the Feds, one tier of government is going to try and persuade you to use the other’s services.

Getting rid of this multiple service delivery will save a lot of money.

Having health providers working together on a regional basis will provide them with economies of scale when ordering supplies, hiring staff and so on. They’ll also be able to direct resources to where they are needed, rather than having these lie idle.

A set fee for service, as proposed, will also encourage efficiencies. At the moment, in some health systems, there is little or no incentive to consider costs when delivering services. Under this, there is an incentive to deliver services more cheaply, as hospitals will get to save the difference between the cost of the service to them and the government payment for that service.

So - to sum up - there are a lot of potential savings in the system.

BTW, if the proposed system is going to cost more in tax, then so will any method of delivering health. Health costs are rising and will continue to do so. Governments will only be able to continue to meet these costs by raising taxes or by cutting services.

At least this proposal looks at how these rising costs can be reined in.

Bella says:

09:22pm | 07/03/10

You’re a crack up persephone,

Why is it when Rudd suggests a whole new layer of boards with no funding attached, you say it’s okay… Rudd’s speech guarenteed there won’t be more bureaucrats. Easy. (Presumably Health Depts will form existing staff into boards and forcibly relocate/train them, somehow, at no cost.).
Yet when Abbott suggests exactly the same thing, you blow the whistle:
“And the Liberals will add another level of bureaucracy by appointing local boards to each hospital. That’ll also cost money.

To be paid for by—- ?”

Both Rudd and Abbott are telling porkies…

David B says:

09:35am | 08/03/10

Correct, Rudd knows full well that it wont get up.  This is a strategic move by Labor to shift the focus off the insulation debacle.  The ALP have also recognised that ETS was quickly losing public support so they dropped it and turned to health as their springboard.  When the health proposal fails Rudd will then be able to distance himself from the states.