If we health and medical researchers do not stand up now, we will be left with the moral blight of having silently colluded in the destruction of universal healthcare
Health is a basic requirement for an individual to lead a good life. Without health you have nothing; when we are sick, it’s difficult to work, to care for others, to participate in the things we enjoy. We seek treatment so we can get back to our normal lives.
Because health is so important to our wellbeing, there is widespread agreement— including among ethicists —that a fair and accessible healthcare system is something that we should pursue. And although the Australian healthcare system is far from perfect, it has provided universal access to healthcare for almost 40 years. A universal healthcare system – one that is open to everyone, whether or not they can afford to pay – is a basic feature of a good and just society.
Tony Abbott and Joe Hockey want us to panic about a “budget emergency”, including the idea that our current health system is unsustainable. Rising healthcare costs pose a challenge to governments everywhere. But this is not a new problem, and will not bring about economic or social catastrophe any time soon.
This amplified threat is being used to justify measures that are now well known: introducing co-payments for GP fees; disestablishing Medicare Locals; transferring health agencies to the department of health with reduced funding; and stripping $80bn in funding from the states, particularly in health and education. This will not only force the states to increase their own goods and services taxes, but reduce the public services they can afford to provide. It will end universal access to health care, make Medicare a mere “safety net”, overwhelm hospitals, and increase the inequities that are increasingly a feature of Australian society.
With breathtaking cynicism, the Coalition has also engaged in the oldest strategy in the magicians’ handbook: distraction. The rabbit they have pulled out of their hat is the $20bn medical research future fund, to be financed – they claim – largely through the new taxes and cuts in health services. This is supposed, we can only presume, to buy the quiescence of health and medical academics and researchers, and to distract citizens from the damage being done to our health system. Given that polls consistently show that Australians strongly support Medicare, it’s likely that the government has underestimated our ability to concentrate on what’s important. There are also strong ethical reasons why the Coalition’s proposed changes are unjustifiable.
Hockey encourages us to imagine that the medical research fund “may well save your life, or that of your parents, or perhaps even the life of your child”. Medical research is clearly a good, and has achieved remarkable breakthroughs in the last century. The medical research future fund may yield benefits. But, as any medical researcher knows, medical research is not a steady production line of cures. It is frequently incremental, with many dead ends, and scope for progress may in fact be diminishing.
More importantly, history shows that, without government intervention, the new treatments produced from medical research are often available only to those who can pay, broadening the gap between rich (who can afford top-shelf care) and poor (who receive little). This means the proposed cuts and fees will burden the least-well-off in the present to fund research that may benefit a few, likely wealthy, people in the future.
More fundamentally, we have known for decades that improving health in communities often relies on social change, rather than high-tech biomedical research. Ready access to GPs and other community-based health care, established vaccinations, good education, affordable healthy food: things like these make a big difference to population health. This is why Hockey’s championing of the medical research future fund as a panacea to service cuts is so offensive. Not only does it overstate the role of medical research in a just healthcare system, but it takes funding away from the agents of social transformation that can effectively and efficiently improve health.
Some health and medical researchers are organising against this unjust policy; others seem willing to support it. As health and medical researchers we could benefit from medical research future fund. But we believe that anyone who cares about the health of Australians is obliged to resist both the proposed healthcare changes, and the deceptive trick of linking them to the good of medical research.
If health and medical researchers do not stand up now, we will be left not only with a less coherent and less fair health care system, but with the moral blight of having silently colluded in the destruction of universal healthcare. Once destroyed, this will be almost impossible to claw back. We should reject this governments’ urgency rhetoric, lack of compassion for the least well-off, and rejection of solidarity and equity as fundamental Australian values.
Hockey and Abbott should put their rabbit back in their hat. We have not taken our eyes off the real issue: a fair health care system.