7
Jul
2016

Election 2016: An open letter to Malcolm Turnbull on Medicare

by Stephen Duckett


Published by the Australian Financial Review, Thursday 7 July

Dear Malcolm,

You have rightly attributed the Coalition’s loss of votes to Labor’s Mediscare. You then labelled it as lies. The truth is that the campaign would not have got traction if the public had not thought it was credible, based on recent experience.

You’ve also said that the Coalition needs to establish its credibility as a defender of Medicare. This will be hard but not impossible. Your predecessor, Tony Abbott, famously declared that private health insurance is in the Liberal party’s DNA. This is true, but you need to elevate Medicare to the same status.

Here are my suggestions about how to do that:

1. A Prime Minister’s statement

You need to reposition the Coalition as Medicare supporters. Not just you, not just your Health Minister, but the whole party. Your rhetoric will help, but you must lock in the party. I suggest you take a draft statement to the Party Room for debate, listen to everyone. You have to get your whole party behind you.

The statement should make a commitment that you will keep. A commitment to Medicare’s universality. A commitment to the Medicare that the public deeply support.

You have to throw out language about Medicare being a safety net. It’s not just for the poor, it’s for everyone. You have to throw out language about people making a personal contribution – we already do, through tax. You have to throw away the idea that “savings” can be made by cost shifting onto states and consumers. Your statement has to do away with the idea that, in health policy, public equals bad and private equals good. And you need to accept that the public sees bulk billing as a core part of Medicare.

2. Revise your policies

You went into this election with lead in your saddle bags. You’ve got zombie PBS co-payments. You’ve got removal of bulk-billing incentives, cuts to public hospitals, a rebate freeze. Probably all of these have to come off the table.

There is money to be saved in pathology, but not the way you did it. There is money to be saved in public hospitals, but not the way the 2014 budget did it. There is money to be saved in the PBS but not by simply shifting costs onto consumers.

You need to demand more from the public service – not just the health department but finance and prime minister’s department, too. And your ministers have to be clever about savings, not just cost shift and slash and burn.

3. Trust the public

The people know that Medicare costs money. They want the best. I suspect they are willing to pay for it, too.

Take them into your confidence. Tell them what the future holds. Tell them that if you are taking these savings off the table it will cost them. Tell them every one is in this together and there is no magic pudding. If these costs are to be met equitably, it means increasing the Medicare levy. That is equitable, and I think the public will buy that.

But most of all, this is not a one-month wonder. John Howard learned the lesson that he couldn’t play with Medicare and he didn’t. It appears this lesson needs to be learned by the Coalition every generation. Maybe you can shape a new, bi-partisan commitment to Medicare. You’ll get a lot of kudos in the health sector, and among consumers, if you do.

Good luck, Stephen