While the world is held ransom by a volcano that looks like its name was invented by a process of fist mashing the keyboard, the future of the country’s health system is being held ransom to a similarly incomprehensible force of nature in Canberra: a meeting between state premiers and the Prime Minister.

In fact, to give volcanos credit they only erupt every 20 years or so, are relatively easy to understand and haven’t inconvenienced anyone on this level for quite a while. There seems to be a COAG meeting every three weeks under Kevin Rudd and this health debate has been the most torturous so far.
To say this is an important issue is an understatement - it is probably the most important policy issue for the Government to get right before the election, because of both the desire for action in the electorate and yet unfulfilled promises for that change.
Fairfax publications were this morning leading with a poll that showed 62 per cent of Australians backed the Rudd Government’s proposed health reforms.
Which is all well and good, but it failed to ask people if they even understood Kevin Rudd’s proposals. As The Age’s Tony Wright pointed out this morning:
Whether the same 60 per cent understand the detail of Mr Rudd’s proposals, so vociferously opposed by Victorian Premier John Brumby, is not tested in this poll. Nor does it test what voters might think if Mr Rudd fails to persuade the premiers to give him the reforms he seeks.
What a poll like this does demonstrate is a desire for action on health led by the Commonwealth, which is a pretty sensible view, especially given that the Backyard Blitz were name the second most competent to fix our hospitals ahead of state governments (that wasn’t actually in the poll, but I do have a theory that more state services should be outsourced to TV renovation teams).
Despite the fact that the Government will claim a mandate for its proposal because this desire it doesn’t really mean that at all.
As Laurie Oaks said in the Sunday Herald Sun, Rudd hasn’t made it clear how his proposal is going to change anything much besides holding bragging rights over John Brumby in a manner similar to defeating your brother at ping-pong:
Not that Rudd’s handling of the issue is without fault, as some people on his own side admit.
A long-time Labor strategist says: “What is Kevin selling? The wholething has been about the fight, not about the policy. If you’re going to run a campaign, you need a slogan. ‘End the blame game’ doesn’t do much to arouse emotions.”
So what does Kevin Rudd want to do? Basically he wants to take a third of the states GST revenue and use that to change the funding balance for health services in the states from a 40-60 Fed-State split to the other way around.
The Commonwealth would also take over funding of primary care completely – that is basically stuff that doesn’t involve going to a hospital and does suffer from bitsy funding models, particularly in mental health.
This morning the Daily Telegraph reported that NSW has been promised an extra $5.3 billion in extra funding from the package, responding to Kristina Keneally’s “demand” that NSW not be worse under the package, a pretty hallow demand given the state of hospitals in NSW.
If I had to make a prediction I’d say that this will drag out for another day with Brumby and Rudd emerging to strike “an eleventh hour deal”, which will guarantee the future of hospitals in Victoria and the rest of the country etc etc.
This is also known as the Miss Universe/Miss World compromise, where both leaders come out looking like winners in separate beauty contests.
So if Rudd can strike a deal what’s his message going into election? That he took it up to the states and risked it all for reform and has therefore made good on his election promise - you’ll just need to give him time to see the outcomes.
Assuming he avoids having to go to a referendum (which would actually be pretty entertaining to watch given neither Rudd and Roxon nor the states want to go near it), the Government have to hope the deal they achieve will placate the electorate, a particularly tricky task if they’re not sure what they were being promised in the first place.
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