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Seeking the Post-COVID Consensus – A New Emphasis on Preventative Healthcare

By Denis Bright  

The drift to corporate healthcare should be challenged at all levels of government across Australia. It is a treatment model with unintentional costs all in the name of that imperative value of freedom of choice. Interested readers should take in the glowing coverage of the rhetorical commitment to elderly people from the web sites of some LNP federal members and senators.

Commitment to the federal LNP’s competitive model of society will of course generate its own health stresses associated with lifelong mortgage payments and the stresses of working in largely non-unionised workplaces. The corporate healthcare model is embedded a wider social perspective. It places profits before the needs of people.

Permit me to promote some discussion on the hollowness of this rhetoric with a few examples from a recent trip to South West Queensland.

As I passed through Toowoomba, I noticed that the scare campaign against federal Labor from the last federal election was still a feature of the local federal LNP member’s site. The so-called retirees’ tax of course referred to Labor’s plans to remove tax credits for dividend imputation (John McVeigh MP in Groom):

Labor’s plans to tax retirees would have the most impact on those on a low and middle income and could force many people onto the Age Pension.

Federal Member for Groom John McVeigh said Labor’s retiree tax would negatively impact around one million Australians including pensioners.

“This is a disgraceful attack on people who have saved throughout their lives to be independent in retirement including more than 6 300 people who live in my electorate of Groom ” Dr McVeigh said.

“On average individuals adversely impacted by the policy stand to lose $2 300 a year and self-managed super funds will lose on average $12 000 a year. For many the losses will be much higher ” he said.

“Like all Australians the people of the Groom electorate deserve a Government that encourages personal responsibility rewards hard work and allows them to keep more of what they earn.

“Labor’s retiree tax undermines these values ripping over $57 billion out of retirement savings. This is part of Labor’s plan for more than $387 billion in additional taxes to people’s homes incomes business and savings.”

Dr McVeigh said suggestions from Labor that this policy would only hit the wealthy have proven to be completely untrue.

“Many retirees in the Groom electorate rely on tax refunds from share dividends to help pay basic household bills,” he said.

The urban sprawl along the Warrego Highway to Toowoomba and beyond reminded me of what I had seen in the USA, some thirty years ago. This is not a healthy model for personal and community development.

The appeal of the countryside in Virginia south of Washington D.C. was shattered by the construction of the Potomac Mills Shopping Centre in 1985. It defied all principles of sustainable urban planning beside Interstate 95. Interested readers might like to check out the details of this development which is currently operated by the Simon Property Group.

Elements of this style of urban sprawl are evident here as the federal government pushes Australia towards a corporate model of urban subdivision and private motorised transport in the name of our own national competition policies.

Near the exists to the motorways serving the second range crossings north of Toowoomba, I noticed the extent of urban sprawl around natural landmarks like Gowrie Mountain where new housing was allowed on its middle and lower slopes by local urban planning guidelines. There are numerous pictures of this style of outer-suburban development on Google Image. So much for those Dreamtime perspectives about natural landmarks which had sustained Indigenous cultures for millennia.

These days the younger residents and retirees from the bush can be sustained by their own commitments to private healthcare. After payment of five or six thousand dollars a year for premium health care cover, these families must expect these hypothetical conversations when they front to pay for routine health procedures like X-rays and other diagnostic tests:

Reception Staff:

Well your procedure will cost $250 today. Would you like to take advantage of the Medicare rebate when you are making your payments for our procedures? We have your Medicare details on file from last time, so it is just a matter of paying the gap fee which reduces your payment by $130.

Patient:

Oh, I thought all these fees might be covered by Medicare as I have not been able to receive a rebate from my own health insurance in the past.

Staff:

Well, our current apt will enable you to gain the fullest possible Medicare rebates even without the need for private health insurance which covers you for a large proportion of in-hospital care.

Patient:

Yes, I appreciate that. Here is my credit card. It’s a charge of only $120. I always support Medicare and voted LNP this time because our government is fully committed to Medicare. Paying $120 is a small sacrifice to make if it is helping to preserve Medicare.

In the spirit of this self-sacrifice, constituents of the new suburbs on the outskirts of Toowoomba supported the LNP at every booth at both state and federal levels.

For the elderly in adjacent countries towns, the corporate style of healthcare is extended to Commonwealth Home Support Programmes (CHSPs) provided by charities and authorised for profit-making agencies.

Basic accounting strategies to minimise perceived assets through the formation of family trusts, enabled more affluent elderly residents to collect the optimum levels of nursing home bond subsidies and in some cases the full pension although their assets were actually in the millions.

The South Western Hospital and Health Service of the State Health Department has skewed the CHSP guidelines to the needs of local communities. I was pleasantly surprised by some initiatives being taken in Charleville, 750 kilometres west of Brisbane.

Image: South West Hospital and Health Service (2018) Showing Healthy Ageing Client May Williams on that New Public Sector Bike

The South Western Hospital and Health Service offers this best practice in community outreach which extends beyond the dependency model of some aged care practices:

Older residents of Charleville now have a fun way of getting around town after a luxurious new multi-passenger pedal cycle hit town.

Healthy Ageing Charleville Project Officer Deb Alick said the organisation had purchased a Surrey Bike for use locally.

“The Surrey Bike is a 4-6-seat, pedal-powered, covered vehicle which allows everyone to participate in pedalling the vehicle along, while one person steers,’’ Ms Alick said.

“It’s like a bicycle, only bigger and better.’’

Ms Alick said Healthy Ageing had several stationary bicycles in place at its Alfred St premises in
Charleville for use by program participants.

“They will be able to use the skills and muscle power developed on the stationary bicycles to take the
Surrey Bike around town for a spin,’’ she said.

“It will help promote physical activity, cooperation, fun and social interaction in our community.

“We already have a waiting list of very excited participants and some very bright helmets, so keep a look out on the road for us in Charleville!’’

The absence of commercial and charitable providers of age-care packages in remote areas has enabled the state Department of Health to fill some of the void and to skew the services offered towards healthy living over nursing care with the assistance of some other voluntary agencies.

This might be a blessing in disguise to the recipients of these healthy living models which can be delivered at a fraction of the costs of the commercial alternatives offered in larger urban centres.

Local TAFE courses are also being offered to train local people in effective caring strategies.

Latest OECD health data shows that the federal LNP is hell-bent on promoting a model of healthcare with a focus on treatment over preventative health. In whole sectors like mental health, diabetes, drug dependence, care of disabled people and the elderly, the model is drifting Australia towards the US corporate model of healthcare with its unproductive levels of expenditure and out-of-pocket expenditures.

Constituents are still largely in love with the sweet rhetoric in favour of corporate healthcare even though its excesses are a burden on the levels of economic growth and community development to which the LNP aspires.

Medical practices cannot run efficiently on current Medicare bulk-billing rates which represent less than half the over the counter fees charged in most clinics for both medical care and essential ancillary care services.

South West Hospitals and Health Care Services offer a more balanced healthcare model with an emphasis on preventative care that tunes into the local stresses imposed by financial and social disadvantage.

Similar applications could be extended state-wide in Queensland through systematic applications by agencies of the state health department for similar CHSP packages.

Let’s hope that blind-spots created by the use of soothing LNP rhetoric do not bring the state back to the Joh era through the strategic allocation of preferences by far-right political parties at a time when constituents are under siege during the current national recession.

Denis Bright (pictured) is a financial member of the Media, Entertainment and Arts Alliance (MEAA). Denis is committed to consensus-building in these difficult times. Your feedback from readers advances the cause of citizens’ journalism. Full names are not required when making comments. However, a valid email must be submitted if you decide to hit the Replies Button.

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13 comments

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  1. Annabelle

    It’s great to know that even in remote areas of our vast state, initiatives are being taken to help older people to keep healthy and therefore not a burden on the often stretched medical facilities In these areas.

  2. Matters Not

    Re McVeigh’s sign:

    On average individuals adversely impacted by the policy stand to lose $2 300 a year and self-managed super funds will lose on average $12 000 a year. For many the losses will be much higher

    True! Or at least that was the stated and claimed well thought through policy originally announced with great fan-fare including much boasting by the economic brains trust of Bowen, Chalmers and Leigh with vigorous nodding agreement from Shorten. In fact, it was the beginning of the end as far as the winning of the election was concerned and signaled the eventual demotion of Shorten and Bowen. Even the intervention of Jenny Macklin to have the policy revisited and then followed by various revisions was not enough to rescue what looked like a certain victory for ever and a day.

    Shorten and Bowen are still in mourning licking major wounds. Only time will tell if any (political) lessons were learned nevertheless. One would hope so.

    Good article as always Denis.

  3. totaram

    Matters Not: There is no evidence that McVeigh’s sign is factual. You are aware of course that there is no requirement for truth in electoral advertising. The AEC is on record about this.

    We had many discussions on this issue and I pointed out that any retiree (like me) who loses out because of this policy, must have millions in assets, or has been very poorly advised. I gave detailed calculations and the public statements of the CFO of my super fund.

    But that does not prevent you from repeating the lies of the coalition as if they were true. Furthermore, you claim this was the reason for the loss of Labor, another fact-free assertion. Notwithstanding a $60 million advertising campaign by Clive Palmer, which managed to get 3% of the voter’s first preferences. I am not claiming wonderful credits for the Labor party, but I like to see some semblance of truth and evidence in all discussion. Fact-free, evidence-free prejudiced opinions do not help anyone, least of all those of us who would like to see the coalition gone.

  4. Leila

    Are those new suburbs really health places when they submerge younger people in a lifetime of debt?

  5. Matters Not

    totaram good to see you put your head above the parapet one more time. So here’s a few things to consider.

    For any (ideological) claim to be sustained there must be a kernel of accepted ‘truth’ within (note the absence of a capital ‘T’) and politics is about taking that kernel of truth and then giving particular and peculiar meaning(s) to same. And that includes the facts. In short it’s about constructing a reality that resonates or will over time. So much so, that a majority adopt it as their own. (Yes people do construct their own reality regardless of what you may think. Just look at the United States politics for recent examples. Of course it may not be your idea (or mine) of true but it is for them and it affects (even effects) their behavior.) Also look at your own construction of reality above.

    The AEC (and virtually all other like agencies) stays well away from demanding truth in advertising because truth is such a slippery concept, particularly in terms of necessary and sufficient conditions. Bit surprised you haven’t noticed that. Further, even scientists involved in the hard variety of science make no claims re truth. Instead they settle for the best information available at a particular moment in time – ever conscious that in the world of science ‘truth’ is so bound and limted by time. Here today – gone to-morrow as it were. Those who cling to notions of Truth (with a Capital T) often have a mathematical background. Yes sometimes mathematics is a handicap because it creates notions of certainty and the belief that certainty is transferable to all areas of life. As for ‘facts’, they are a dime a dozen – almost infinite in number. So take your pick. There’s plenty for everyone.

    Can I draw your attention to your statement re must have millions in assets and then return to the statement of McVeigh which said For many the losses will be much higher. So where is the ‘untruth’ in his claim? Where is the ‘lie’? Surely you must concede that ‘fact’ that for many the loses will be much higher? So where is my ‘lie’? Your statements are there for all to see?

    As for reasons for Labor’s loss. It will always be a matter for conjecture AND at any number of levels. Macro and micro – at the societal and individual level. As a guiding principle, I always take note of those who have real skin in the game and see how they react. Those closest to the action. Craig Emerson’s post-election review identified the franking credit issue as crucial and Shorten himself admitted that error of judgement in the last week or so. Finally, (for now) see what Albo, who is desperate to win the next election, has already abandoned from his future policy platform. Further, from my own connections to Labor circles they know what mistakes were made and won’t be repeating that vote loser.

    Should also point out that it’s always advisable to take a long hard look at what happened and not what one would hope to happen. But am sure this won’t be end of issue.

  6. James Robo

    Cheers to preventative health. Well spoken Denis.

  7. Tessa_M

    Agreed – Better a modest house than a permanent and stressful mortgage burden!

  8. Paul

    Thanks for the article Denis!!! Lots of challenges out there in the west beyond the great dividing range!!!

  9. rubio@coast

    Nursing homes were always a health hazard to the psychological welfare of some cherished residents.I am pleased that COVID has tarnished the use of nursing homes for profit and exposed the moral ethics of welfare agencies who reply on the current nursing home models to justify opportunistic strategies to manage elderly and disabled Australians. Many could live at home with support from Home Care Packages but there is a vast waiting list in country areas for such packages. A small number of elderly people need institutional care.

  10. Chris

    A good expose on the stresses of our current health models.

  11. Stella

    Denis, thanks for your article. Preventative health promotion is so important and their should be more focus on it.

  12. Denis Bright in Brisbane

    Thanks for the comments on this preventative health story line.

    This is a very important issue in Australia as the Morrison Government continues to erode the remnants of a national health scheme in favour of the corporate model in use in the USA. Health costs there are amongst the highest anywhere with a wasteful expenditure of nearly 17 per cent of the US GDP on an ineffective health model.

    The Federal LNP tells everyone with such sincerity of its commitment to Medicare. Here is an extract from a press release from the Hon Greg Hunt dated 28 February 2020:

    “Australians continue to visit their GPs without having to pay a cent, with the latest Medicare data showing 86 out of 100 visits to the GP were bulk-billed for the 2019 calendar year.

    The 86.0 per cent bulk billing rate achieved in 2019, is a 4.3 percentage point increase on the 81.7 per cent Labor were able to achieve when they were last in Government in 2012. Figures for 2019 show an increase of more than 4.3 million free GP visits compared to that of 2018.”

    Most of us try to keep in good health by our own preventative health strategies. I have accessed medical services from an occasional bicycle skids, medial meniscus problems from too much running and even a granuloma from the negative effects of enjoying calorie-free cups of powdered soup at morning tea brakes when I was working. Avoid too much of that yummy Dutch currey flavour from a leading multinational brand.

    Regular swimming in cold water in the surf and at swimming pools can result in exostoses in the ear canal. I go to a specialist for the removal of exostoses every three months or so.

    An eminent ENT Special in Brisbane handled both my granuloma and this ongoing exostoses’ problems. As the specialist is a progressive professional, I avoided an operation for the granuloma with speech therapy which was totally successful but the fees were only partly refunded by private health insurance.

    This specialist bulk-bills me for removal of the exostoses. Most specialist do not bulk-bill as the refunds offered from Medicare are appallingly low. It would be impossible to run such an inner-city practice on current bulk-billing rates.

    Yesterday’s procedures would have cost $85 just for the consultation for a non-bulk-billed patient but this specialist kindly accepted a mere $37 from Medicare (Item 105). Each ear procedure would have cost $160 at most clinics but this surgeon’s clinic charges only $135 (Item 41647). The Medicare refund is a mere $94 for each procedure. These details were provided by the receptionist as my preferred specialist totally shares my concerns about current levels of bulk-billing remunerations. I have no reason to doubt the accuracy of the data.

    Where does our Health Minister get his data on positive rates of bulk-billing?

    Be an activist by being curious about medical costs and understanding towards doctors who simply cannot afford to bulk-bill their patients.

    Maintain a similar empathy for financially stressed private health funds which are badly affected by low levels of bulk-billing remunerations to their clinics. Be careful of less ethical funds which require you to pick and choose the benefits you select to compete on price with the more responsible funds. Going down-market is not the best option. Who would honestly go to a used car salesman and ask for the cheapest car in the yard.

    Thought I would pass on these details in the interests of citizens’ journalism.

    Do share your own experiences online and challenge the rhetoric which is coming out of the offices of federal LNP members and ministers. Regrettably, many constituents are still in love with the Low Cost State as a symbol of freedom. Like Debbie and Kim, the most gullible constituents are also in love with their own tax minimization strategies which contribute to the current Medicare rebate problems. “We pay the tax we think that we should pay”, is always the excuse offered.

  13. Proactive Being

    Thanks Denis for your enquiries about health costs. You are fortunate to access good specialists. One of my specialists refuses to bulk-bill even biopsies because he is so opposed to national health schemes. He sends his patients down to MyGovernment offices to collect rebates for biopsy charges. But he is also one of the best specialists In Town and knows it.

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