What next for health?

This weekend marked my second Australian general election and turned out to be a pretty eventful one.  Here’s what I had to say about the implications of the results for health policy, which was published on the University of Melbourne’s Pursuit site.

In the run up to the election, health policy was a key point of debate. A number of commentators have already suggested that Labor’s accusations that Coalition plans to privatise Medicare may have been instrumental in significant gains for Labor, particularly in Tasmania. Meanwhile, the Prime Minister has announced that the Federal Police will investigate text messages sent by Queensland Labor urging voters not to back the Prime Minister and his government in order to “save Medicare”.

Regardless, of what plays out as a government is formed, what is clear is that health will remain a hotly contested issue. With the political move to the centre in recent years it has been difficult to distinguish between traditional party positions. To some degree Labor have attempted to return to days gone by in presenting themselves as the saviours of Medicare.

Yet the outcome of this process is likely that there will be little hope for significant reform of the health system. This outcome will not leave any government with a clear mandate or render them willing to take on a substantial health reform process. Indeed, parties may feel that the greatest reward comes not through a positive vision for the future, but through scare campaigns and negativity. None of which offers much hope for substantive change.

In the run up to the election there was not much to divide the various promises of the parties on the health front. Both argued that they were committed to maintaining universal health services. Labor planning to do this through a cash injection into the system and by making savings on private health insurance. The Coalition committed to more limited investments, but with a desire to use existing resources more effectively (including those in the private health system). But what was missing in these election commitments was a clear sense of how the health system would be reformed in a significant way to ensure that we see the level of change that is needed to ensure that this performs as well in the future as it does now.

This election has demonstrated that people care deeply about their health system, but this will not result in politicians feeling courageous about taking on reform in a significant way. The fractured parliament that we will inevitably be left with will also make it more difficult than ever to pass legislation. No doubt we will see money freed up for various different agendas – and likely many of these will focus on interests of independents holding the balance of power. But none of this bodes well for those of us who wish to see Australia embark on a careful and considered reform of its health system.

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