Say goodbye to universal healthcare

Tasmanians failed by system at a time they need it most, writes Martyn Goddard

THE

more we need a health system accessible to all, the further it retreats into a fondly remembered past. Universal healthcare is all but dead.

The great founding ideal of universal healthcare — Medicare, the PBS, free public hospitals — was that your health is too important to be left to the market.

So a system was created to make healthcare available on the basis of your need, rather than how much money you have.

No state needs such a system more than Tasmania. Our needs are greater and our capacity to pay market rates is less. We are reminded almost every day of how drastically that ideal has faded. Two new sets of figures demonstrate how badly we are failing.

According to a study by the Australian Institute of Health and Welfare, 9.5 per cent of Tasmanians delayed getting a test or going to the doctor in 2016-17 — or didn’t go at all — because they couldn’t afford it.

Cost has always been a serious barrier to people seeking care from privatesector specialists, who usually charge much more than the Medicare rebate.

But even GPs are out of reach for many thousands of Tasmanians, 7.5 per cent of whom delayed seeing their GP, or didn’t go at all, because of out-of-pocket fees.

Because the Medicare rebate has failed to keep up with costs, practices maintain their income by charging patients instead.

They still bulk-bill people they think can’t afford to pay — though this process is a lottery — which means those who aren’t bulk-billed have to pay much more.

The 24 per cent of Tasmanians who aren’t bulkbilled by their GP pay some of the highest out-of-pocket fees in the country.

The latest Medicare figures show the average gap fee is $38.45 — but it can be much higher.

Only 31 per cent of specialists bulk-bill and the other 69 per cent charge an average of $66.90 for each service. If you can’t afford a doctor, you can go to a public hospital — if you can get in.

At the Royal Hobart Hospital even urgent cases can wait for many months just to see a specialist. If it’s less urgent, it can take years.

It’s not only the treatment side of our health system that’s failing. The prevention side is failing too.

Another Australian Institute of Health and Welfare report shows rates of daily smoking have gone down everywhere in Australia except Tasmania.

At the Royal Hobart Hospital even urgent cases can wait for many months just to see a specialist. If it’s less urgent, it can take years

In 2016 an estimated 16.9 per cent of adults still smoked every day — exactly the same as it was six years earlier.

There is some other evidence that people tend to be smoking less every day, probably believing that will help their health prospects.

But the research clearly shows that if you want to reduce your chances of cancer, heart attack and stroke — the biggest killers — cutting down doesn’t cut it. You have to quit altogether.

That message hasn’t got across. Changing the rules on where you can smoke seems to reduce the amount people smoke but not whether they smoke. For that, you need hard-hitting, properly funded public campaigns.

But with a state government still firmly in budget-cutting mode, that has zero chance of happening.