Health and Politics: The policies and promises at play in 2019's Federal Election

by Edwin Kwong

With the Federal Election just days away, political campaigns have well and truly hit fever pitch. As with any election cycle in Australia, health has once again become a topic of intense focus for politicians and the public alike.

Medicare Rebates

According to a recent survey by the Consumers Health Forum, one of most significant concerns raised by respondents about health was cost. Both major parties have made various commitments in terms of health policies that address these two areas. Regarding the cost of visiting doctors or specialists, Labor has promised to lift the freeze on Medicare rebates for 100 GP items in its first 50 days in office. The Coalition is also due to lift the freeze on Medicare rebates for medical procedures by July this year, but rebates for 90% of diagnostic imaging won’t be indexed until July 2020. However, whether this will actually make visiting a doctor cheaper for patients is unclear, as the government cannot set GP prices.

While the Royal Australian College of General Practitioners has welcomed the lifting of the freeze, it has also recognised that the indexation rates do not reflect the actual value of general practice, and has called for an 18.5% increase of the Medicare rebate.

Election Promises

Labor has also proposed a plan to reduce out of pocket costs and waiting times for cancer patients through a $2.3 billion plan, and $2.8 billion will be spent on hospitals, including $1 billion for emergency departments, and $1.8 billion to restore the equilibrium between federal and state hospital funding, as opposed to the current 45-55% ratio imposed by the Coalition. It has also promised to establish a permanent Health Reform Commission to develop long term reforms, reduce health inequality, and improve the universality of the health system.

The Coalition, on the other hand, has promised additional spending towards the Pharmaceutical Benefits Scheme, mental health services, and aged care. $461 million has been allocated towards a youth mental health and suicide prevention strategy. It has also allocated $448 million into primary care funding as a part of the 2019 Budget.

The Greens  have promised to include dental care into their Medicare reform plans, as well as ending private health insurance rebates.

Commitments Towards Prevention

While both major parties’ proposals and commitments fall short of the holistic approaches that various health experts have called for, there are certainly some very commendable pledges from all sides of politics towards preventive health. The Greens’ proposal of creating an Independent Preventative Health Commission, and Labor’s commitment of $115.6 million on preventive initiatives, including $39 million on a three-year national anti-obesity strategy. The initiatives will include considerations to make the Health Star Rating system on foods mandatory, as well as food reformulation targets for manufacturers. There will also be renewed funding for the Stephanie Alexander Kitchen Garden Program, a $40 million anti-tobacco campaign, and a commitment to developing a national alcohol strategy.

Political Messaging

Whilst there are certainly multiple overlaps between the two major parties’ health policies this election, there is a significant difference in messaging. The Coalition has an overall message this campaign of maintaining the status quo, and responsible management of the economy. Hence, its health policies tend to focus on re-announcing existing policies, such as its policy on youth mental health and suicide prevention, where it states that it will “not place additional costs on the Budget”.

On the other side, Labor’s campaign on health has focused on tackling the rising cost of living. As such, Labor has made various commitments that will address cost of living pressures, as well as reshape the health system in a long-term fashion. However, it will incur a significant cost: more than $8 billion over the next 4 years, funded by closing tax loopholes to multinational corporations and very high-income earners.

The Need For a Comprehensive Prevention Plan

At election time, we often find political parties promising more and more funding for bigger and better hospitals, new medicines, and various downstream forms of treatment. But it is far more prudent and responsible to invest in, preventive health care, as there is strong evidence that preventive health interventions are cost-effective, and comprehensive primary health care can reduce both the dependence and demand on our already-strained public hospital system. A definite commitment to tackling our growing obesity epidemic is also crucial if the elected government is serious about improving the health and diets of Australians, as well as addressing myriad preventable illnesses.

Currently, the Australian government spends less than 2 cents on every health dollar on prevention each year. Yet, the cost of treating obesity-related diseases is estimated to rise from $12 billion in 2014 to $21 billion in 2025. Essentially, for every dollar that we spend on prevention at the moment, we will lose 10 dollars on treatment due to our lack of action on obesity.

The longer we delay developing a strategy for prevention, the more money we waste on treatments that could have been entirely avoided in the beginning and the more the next generation of Australians will suffer. For the sake of all Australians and our collective futures, we need a comprehensive plan and a firm commitment on preventive health strategies.