December 6, 2011
I am booked at a dinner function next week to mark a new book by Barry Cohen so I was drawn to an article by Mr Cohen in The Australian on the ALP’s need to “rediscover the core value of health care”. I don’t want to be picky but it is Monday and overcast and we are out of the particular food item that I fancied eating.
Apparently Cohen joined the Labor Party in 1963 because he became aware that large sections of the community were underprivileged; an honourable thing to do. So now where are we after the determined efforts to solve the social ills of the world on the part of Whitlam, Hawke and Keating, and those compassionate Liberals, Fraser and Howard? Well, without a hint of irony, Cohen explains that the priorities he had then in addressing disadvantage (Aborigines, pensioners, the blind and lame, working class kids struggling to get an education) are the same as now. The more things change; the more they stay the same. Or do they?
When I arrived in Australia in 1965 I was not struck by disadvantage but by the sense of optimism about the future. Unemployment was ridiculously low by today’s standards. Everywhere I worked in those early years, from labouring jobs to office jobs, in Western Sydney, in Townsville, in Perth, there was that same sense of optimism. I wonder, after all of that compassion spent on solving social problems whether there are now proportionately more or fewer people disadvantaged. Unemployment is far higher, Aboriginal disadvantage seems as acute as ever, there are definitely more single mothers living on benefits, and I certainly notice more beggars on the streets.
Mr Cohen, and those of his political ilk, should take some time to reflect on whether their good intentions actually do more harm than good. If only they would at least reflect on the evidence, instead of moving in robotic fashion to the next piece of social engineering. In Mr Cohen’s case that is more health care.
He notes that Australia spent 9.4 per cent of GDP on health care in 2008-9 which is about the average for developed countries, except for the US which spends around one sixth of its GDP on health care. Mr Cohen would like us to spend more. He notes that the population is aging and that medical science is on course to further increase our longevity. Here comes the rub. Who is to pay for the additional health care? I suspect those “other people” will be expected to foot the bill. If so we better make sure we keep them healthy (with the best possible health care) because fewer and fewer of them, who pay more taxes than they receive benefits, seem to be around these days.
Cohen reports the case of his wife who spent “eight days in hospital and had months of post-operative treatment including a quarterly visit from a nurses who travelled from Sydney to Canberra. And the cost? Not a cent”. Notice, and this is where I am particularly picky, he says that the cost was zero. How could it be? Magic you might think. In fact the cost would have been considerable. It just didn’t cost Mrs Cohen anything and Mr Cohen should have made that plain, because some people act as though it is a free good.
Cohen cites the case of a former colleague who required emergency medical attention in the US which but for the insurance he carried would have cost him $300,000. He concludes that this shows how well our health system works. How in the world does it show that? Would the treatment have been better or worse in Australia? Is the coverage offered by, or performance of, our medical insurance companies better or worse? I believe Cohen is implying that someone without the means to pay is likely to get better treatment in Australia than in the United States. That may be so (though it is not absolutely clear in the emergency situation he cites) but he is surely not suggesting that his former colleague, with the means to adequately insure himself, should have cavalierly relied upon other people to pick up the tab.
If people want better health care then they should reprioritise their expenditure patterns and pay for it. Mr Cohen said that he took out health insurance at the age of sixteen when he started working. That is laudable. My view is that if at, say, age 42 he required medical attention, and it was scarce, that he should have been put ahead of the 42 year old who had spent his money on booze and high living instead of taking out insurance. If everyone is to be treated the same; why take out insurance? But that is just me.
Sure let us spend more of national income on health care if we want – it will make doctors happy. However, so far as is practicable, each of us should face the extra costs. Voters should know that their particular pockets will feel the pain not just the pockets of those other people. Of course, we know that this will not be the way it will be sold by those on the Left, indefatigably intent, as they are, on demonstrating compassion with other people’s money.
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