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Thursday, 27 November 2014

Abbott Must Clear More Than Barnacles To Stop The Coalition Ship Sinking |

Abbott Must Clear More Than Barnacles To Stop The Coalition Ship Sinking |

Abbott Must Clear More Than Barnacles To Stop The Coalition Ship Sinking

By Ben Eltham

Dutton's medical co-payment on the rocks, the government can only
recover if it navigates away from the rocky seas of its own budget,
writes Ben Eltham.

The Abbott government is in deep trouble.

That’s the take-home message from a turbulent week of federal
politics, in which the possibility of a first-term Coalition defeat
began to be seriously discussed.

Talk is cheap. But the scale of the government’s recent blunders have
started to shake the long-held consensus that the Abbott government
would eventually be able to arrest its unpopularity and campaign
strongly for a second term. 

The government has trailed in the opinion polls for most of the year,
but recent surveys have seen its support sink to new depths. A
short-lived bounce from the government’s pivot towards national security
and foreign affairs petered out after a dismal G20 meeting. New
calamities seem ready to engulf Abbott and his front-bench at any

The government’s handling of the funding cuts to the ABC and SBS is a
case in point. The Coalition has been badly wrong-footed by the
intensity of the public backlash; worse, the controversy bled quickly
from anger at Malcolm Turnbull into a damaging debate over whether the
Prime Minister had broken an election promise.

Abbott is now struggling to right a listing ship, telling the Coalition party room this week that he is prepared to knock some “barnacles off the ship” – in the form of unpopular policies.

This is presumably why the government is reported to be planning to abandon the unpopular $7 fee proposal.

Actually, “abandon” might be too strong a word. The measure,
announced in Joe Hockey’s disastrous May budget, has never even made it
to Parliament. Unlike Christopher Pyne’s equally contentious university
reforms, the $7 co-payment hasn’t had any legislation introduced.

Should a bill be introduced, it’s unlikely it would pass the Senate.
Labor and the Greens remain vehemently opposed, while few of the
cross-bench Senators have signaled their support.

The very fact that the $7 co-payment proposal is still being debated is a sign of the Abbott government’s political challenges.

This is one of the Abbott’s cherished fiscal reforms from the May
budget. But it is deeply unpopular, not just in the health sector and
among doctors and policy experts, but throughout the electorate.

The fee is sometimes describes as a GP tax, but that’s actually
underestimating its impact. The fee will be levied on all basic
pathology and radiology tests, effectively imposing a consumption tax on
health services across the board.

And yet, despite the government’s rhetoric about the fee being
necessary as a “price signal” to make the health system more
sustainable, the money raised by the fee won’t actually go back to the
health system. Instead it will be quarantined in a medical research
fund, to support basic research in health and biomedical science.

As with so many of the government’s neoliberal convictions, there is
precious little evidence to suggest the $7 fee will work. A Senate
Committee took extensive submissions on the issue earlier this year, and
concluded the fee would be counter-productive.

A huge evidence base across the world shows that the best way to
improve health outcomes is to fund and support public, primary health
care. The government’s health policies do precisely the opposite, by
attacking the universality and accessibility of primary care.

Indeed, there is plenty of evidence to suggest that forcing poor
people to pay an extra $7 just to see a doctor or get a scan will only
make the health system more costly and inefficient. Public hospitals in
particular are terrified of the proposal, which they believe will cause a
flood of presentations for minor ailments to emergency departments.

Modelling recently released by the New South Wales Health department shows that the fee could lead to an extra half million people seeking treatment in public hospitals in the state. Grattan Institute health economist Stephen Duckett agrees and told a Senate committee earlier this year
that “if more than one in three of these patients go to an emergency
department [instead of visiting a GP] there will be no saving to the
government.” To top it all off, recent government health statistics show that Commonwealth health spending is actually falling. So much for the unsustainability of the health budget.

The contrast with Pyne’s higher education changes is instructive. The
Education Minister may not be everyone’s idea of an effective political
operator, but he has at least organised a coalition of support for his
changes – including a chorus of highly-paid Vice-Chancellors and the key
universities lobby group, Universities Australia. 

In contrast, Health Minister Peter Dutton has been conspicuously
unable to win the support of doctors or health groups. The AMA, normally
a supporter of a more privatised health system, remains opposed to the
$7 co-payment, as do patients’ groups and many health policy experts.

The ongoing speculation over the co-payment is damaging the government politically. In a recent Essential poll
on government decisions, the GP fee racked up a hefty 66 per cent
disapproval figure. The only decisions more unpopular were the
university changes and the Abbott government’s massive cuts to public
hospital funding.

The morass of health policy is a mark of this government’s poor
political acumen. Not only is the government copping flak for a proposal
that hasn’t even been voted on by the Parliament, it’s also directing
the electorate’s attention back to an area where the Coalition is

And yet the government still can’t seem to bring itself to axe the unpopular policy. While journalists are being backgrounded about the $7 fee being dropped, Dutton is still holding the line that the co-payment will go ahead.

Some kind of circuit breaker is clearly required: a ministerial
reshuffle, perhaps. But a reshuffle won’t remove the real albatross
around the government’s neck: its demonstrably unfair budget, and the
resolute judgment that voters have passed on it.

In similar tight squeezes, John Howard was adept at crafting
political compromises, in ways that wedged his opponents and reinforced
his claim to occupy the middle ground of Australian politics. Tony
Abbott has showed little of that tactical nous, time and again taking
hardline positions far to the right of the cautious conservativism that
Howard made his own.

Polls come and go. But if the government continues to blunder and
drift, Abbott’s own leadership will inevitably come into question.
Coalition backbenchers are far more loyal than their Labor opponents.
But they’re not stupid.

If the political standing of the government continues to deteriorate
in the new year, leadership speculation will begin in earnest.


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