‘Smoke and mirrors’ health policy

Smoke signals suggest the Turnbull Government’s chief means of digging us out of the looming fiscal black hole will be ‘tax reform’ — hiking the GST and justifying the impost in order to fund the ever-growing cost of health to government budgets.

No surprise, then, that health reform has slipped off the government’s agenda, particularly in the wake of the political problems created by the GP copayment debacle. Little wonder the strategy seems to be to let sleeping dogs lie and don’t risk inflicting further electoral damage by even suggesting Medicare entitlements might be tampered with.

To fill the health policy void, the government has commissioned a number of reviews – an evaluation of the Medicare Benefits Schedule, an analysis of primary care reform, and an examination of private health insurance regulations. Add the White Paper on the future of the Federation, and this is the ‘mirrors’ approach to policy formation (“we’re looking into it”) that rivals ex-Prime Minister Kevin Rudd’s appetite for ‘process’.

The Productivity Commission has even put up its hand to undertake a national review of the health system, even though this was the task performed by the National Health and Hospitals Reform Commission under the Rudd Government in 2009.

The Commission might well do go good work to help build the intellectual case for systemic reforms. Particularly as it seems (reading between the lines of its recent Efficiency In Health report) to be up for the fight on contentious issues, such as the links between over-use of health services and reliance on fee-for-service payments in Australia.

Yet process is no substitute for policy substance, especially given the situation in the Senate and the apparent need for governments to run on a declared platform and win an explicit popular mandate to get reform measures through parliament.

All indications, however, are that the government wants ‘tax reform’ to carry the can for inaction on health at the next election. It’s almost like the doctor’s union — the Australian Medical Association — with its insatiable appetite for taxpayer funding, is writing the government’s lines.

If this is so, then the higher-taxing future driven by health costs foretold by the Intergenerational Reports may come to pass — and will seriously damage the Coalition’s reputation for fiscal responsibility.