Dr Stephen Duckett is Director, Health Program at the Grattan Institute
Health policy typically rates as one of the top election issues and one where Labor has a historic advantage.
Yet in this election, apart from a stoush about what will happen to Medicare Locals, both government and opposition have been surprisingly quiet, neither articulating a clear vision about what they stand for, and how that differs from their opponents.
Sure the budget had the usual sprinkling of goodies, dressed up as a coherent program about cancer, or whatever, but publicity about that has evaporated and it is hard to see the opposition coming out against these media-friendly initiatives.
Previous elections have seen some big ideas on the table; 2007 for example, saw then opposition leader Kevin Rudd promising to fix the Commonwealth-State blame game and Labor’s lead over the Liberals on health surged.
The reality of failed delivery in government saw that advantage dissipate, despite prime minister Rudd’s extensive consultation with people around Australia on the topic. Australian Medical Association president Steve Hambleton has described Mr Rudd’s “big picture” reforms turning into “passport photo-sized” delivery.
So what should be on the agenda for 2013?
Elections typically see parties focus on popular policies which will help them garner votes, appeal to sectional interests and/or their base, and get them across the line. These are typically the short-term, one electoral cycle fixes.
Once in government, they also need to focus on important strategic issues that are probably not election winners that can be explained in a 10-second sound bite. But the quality of a government can be measured by whether it is prepared to think beyond the current cycle and start addressing these longer-term needs.
My choices for the key short-term issues for the election are about access to care. Waiting times for public hospital care, both inpatient and outpatient, are too long. There are also problems with access to general practitioners both in terms of waiting times and out-of-pocket costs that make visits unaffordable.
Voters expect parties to be fiscally responsible and in the health sector that means standing up to vested interest and cutting waste. There are big dollars to be saved here, reducing Australia’s sky-high pharmaceutical prices being a $1.3 billion dollar example.
Important as these issues are, the election should also be about assessing who can better handle the long-term strategic issues. These are typically issues which are complex and for which there are no simple solutions. My candidates here include: repositioning the health system to care better for people with chronic illnesses (and to prepare for the increased prevalence of these conditions in the future); improving access to the right sorts of mental health care; and improving the health status of the most disadvantaged in our society (including indigenous people). All of these issues need to be considered in the context of real questions about the financial sustainability of states and an understanding that levers for change are sometimes held by the wrong level of government.
The long-term issues are the critical ones for our future, too often buried in the short-term, sound-bite-friendly, fixes. I’m not suggesting that parties should articulate a clear vision to fix these problems in the campaign. But they do need to recognise that not everything in the health system is going to be perfect after a three-year go at the levers of power. Voters should be confident that they are willing to set the foundations for long-term change, not just the address the short-term priorities.
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