Articles

One of my patients has epilepsy. She sees a neurologist for that and he charges $200 out of pocket per visit. He has controlled her epilepsy very well. She is on a disability support pension. She believes she will get better care seeing him privately despite the fact that he also works in the public system.

Out of pocket (OOP) costs have been in the news particularly since the ABC’s 4 Corners program exposed huge costs impacting significant financial hardship on many sick Australians. As a result of a Ministerial Committee report the Health Minister has proposed tackling the issue with a website of specialist charges and an education campaign for patients. The Committee consisted of ten health care provider representatives and one consumer representative. My suggestion to the Minister that more consumer representatives might be appropriate resulted in an intensely angry response. Read more

ALP health spokesperson Catherine King addressed the National Press Club this week to expound Labor’s vision of health care changes if it wins office. Perhaps the highlight of the address was a restatement of Labor’s vision

‘of a truly universal health care system in which every Australian has affordable access to the high-quality health care they need whenever they need it.’

But will such a vision be wholeheartedly pursued under a Labor Government? Read more

In 2017 I referred a patient for relatively simple orthopaedic surgery on her wrist to enable her to get back to working in a café.  She had been advised that she was a category 3 patient and should be operated on within 365 days. During this period she couldn’t do her usual part-time work which she could juggle around child care commitments. Furthermore, Centrelink required her to apply for jobs she couldn’t do. It took 6 months to even get on the waiting list. She finally had the surgery 15 months after I referred her. Read more

As a financially comfortable part time medical specialist, I will be in the group receiving the highest tax cut immediately, whilst my daughters working full time at much lower income will receive about one third of that. It’s of even more concern, that in seven years’ time, the major beneficiaries of the Government plan will be those on incomes like that of politicians, receiving eight times more in reduced tax compared to low income earners. Read more

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The inequities in the status of oral health in Australia are appalling because of a lack of political will and a resistance to recognising that all Australians deserve to receive adequate dental care. This resistance is rooted in the elitism of those in power, the belief that if one can’t earn an adequate income, then second rate access to dental care is one’s lot.

The money to improve access is available, whether from the inequitable inefficient $12 billion private health insurance (PHI) subsidy and associated tax losses, the putative savings of $100 billion over 10 years which the Treasurer says would be the cost of Labor tax initiatives, or general revenue used to invest in the future as we are doing with our $50 billion submarine contract. Read more

On an almost weekly basis now I’m asked as a medical specialist to write a letter to help a patient be accepted by Centrelink as unable to work. My letter and that of the patient’s general practitioner are then assessed by staff with limited or no medical training.

Many have their request declined and are therefore required to attend Centrelink fortnightly, and to apply for jobs they can’t do – even if such jobs exist.

One man had his request accepted only after he was admitted to hospital, despite hobbling on a walking stick, and taking narcotic analgesics.

Something is wrong with how we try to help our struggling and most vulnerable fellow Australians. Read more

The intellectual stimulus for this article was the book ‘Utopia for Realists’   by Rutger Bregman. The emotional stimulus (tears and anger) was the movie ‘I, Daniel Blake’ directed by Ken Loach.

In 1970, conservative republican US President Richard Nixon introduced a health bill into the American Congress. It passed but was defeated in the Senate. He didn’t realise it was a health bill, nor did many of his fellow politicians. It was called the Family Assistance Plan, a guaranteed income for families with children, not adequate to bring the income up to the poverty line, but substantially more than was previously on offer.

It required the breadwinner to accept work if available. Thus it was targeted, conditional, and inadequate by itself to eliminate poverty, but it was a huge change in thinking from a conservative leader in the United States. It came with this impressive rhetoric

 “Initially this new system will cost more than welfare, but unlike welfare this is designed to correct the condition it deals with and thus lessen the long range burden and cost.”

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