Monday, July 27, 2009

Turnbull's Policy Placebo

Today the Government released the National Health and Hospitals Reform Commission report. It is a long (long!) report that contained 123 recommendations regarding the health system. Yep, 123!

It's actually a pretty policy-heavy document - and one that demands more detailed assessment than I am able to give (I'll leave that to people who get paid to write). But the politics is the important thing at the moment.

The report was conducted following the pledge by the ALP before the election to do something about the health system, because everyone knew it was a complete basket case. Prior to the election Rudd had said he would introduce a National Health Reform Plan and that if the states didn't get on board by mid 2009 he would consider holding a referendum for the federal Government to take over the running of the hospitals.

Prior to the release of the report the Government seemed to be sort of backing away from that - for example here's Health Minister Nicola Roxen on AM this morning:

SABRA LANE: So the Prime Minister, he promised when we was the opposition leader that he would consider a federal takeover if the states did not agree to fixing the system by mid-2009. We have reached that point. Are you hinting at now that there is going to be another 18 month discussion on this?

NICOLA ROXON: Look I think that the Prime Minister's commitments were very clear. We want the states to reform their system. We want to make sure and we are prepared to be partners in investing more to do that. But the report...

SABRA LANE: So you are signalling here that you are stepping away from that promise. That was an empty promise.

NICOLA ROXON: No look, the report makes absolutely clear - and it will be released in a short few hours and of course we will be delighted to talk with you again then - the report makes clear that we have to reform the system to deliver better outcomes for patients. It puts forward some clear options on how we can do that.It does involve the Commonwealth taking more responsibility for a number of areas of health…

The opposition - and Peter Dutton and Malcolm Turnbull in particular - thought they had the Government by the short ones. So before the report comes out, Turnbull (of course) barrels on in with this:

"Let's be quite clear about this. In 2007, Mr Rudd said to the Australian people he would fix the public hospital system by 30 June this year or he would take it over," he said.

"And he has done neither. He hasn't fixed it. Things have gone backwards and he hasn't taken it over.''

He said Mr Rudd's response was another broken election promise.

"He said he was going to bring down grocery prices. We had Grocery Watch - a complete flop,'' Mr Turnbull said.

"He said he was going to bring down fuel prices. Fuel Watch, another flop.

"He said he wasn't going to change the rules on the private health insurance rebate, he broke that promise too.

"One broken promise after another. At some point he's going to have to deliver.''

Mr Turnbull said the Coalition would not support the report's recommendation to raise the Medicare levy to 0.75 per cent to cover the cost of a new universal dental health care scheme, to be called Denticare.

OK, a couple things Malcolm, firstly Rudd never promised he would fix the health system by 30 June this year. He never promised to take over the hospitals by 30 June this year (might be nit picking, but it is nice to keep the facts involved here). This is what the ALP promised:

A commitment that a Rudd Labor Government will seek to take financial control of Australia’s 750 public hospitals if State and Territory Governments have not begun implementing an agreed National Health Reform Plan by mid-2009.
If by mid-2009 the Commonwealth and the States and Territories have not begun implementing the National Health Reform Plan, a proposition for the Commonwealth to assume full funding responsibility will be developed and put to the Australian people. Should the Australian people agree to a Commonwealth takeover of hospital funding, a model would be devised to ensure the future of State, private and community managed hospitals.

So the pledge was to hold a referendum on the issue if things don't seem to be going to plan (and importantly, the states were not playing ball). Why wouldn't Turnnbull want to mention the referendum? Perhaps they are a sore point with him...

A couple other things about his statement. OK, Grocery Watch failed - the Government should have funded Choice to do it right from the start - but to say Fuel Watch was a flop is a bit rich given the Liberal Party voted against it coming into place. You can't block something and then say it didn't work. It still seems to be working in Western Australia, and no one over there seems to be under any pressure to get rid of it. So that argument is just dumb. And given Turnbull likes to portray himself as some kind of person of intelligence, such arguments serve only to reinforce in my mind that he is prepared to say anything - including make things up - to become PM.

The other problem with Turnbull's quick out of the gate response is Rudd played him like a cheap violin. Here's the headline from the Liberal Party friendly Australian after Rudd's announcement of the report:

PM flags referendum on health reform

KEVIN Rudd has flagged a referendum to take control of the nation's healthcare system.

The Government has outlined a major transformation of health care in Australia. Commonwealth, state and territory leaders will meet later this year to examine the health system in the wake of the National Health and Hospitals Reform Commission report, unveiled by Mr Rudd today.

Australians face paying a higher Medicare levy to fund a universal dental health scheme.

A preferred reform plan will be discussed at COAG in early 2010, but the Prime Minister has warned he will hold a referendum if agreement is not reached. “If there's no agreement to a comprehensive reform plan the commonwealth will proceed to seek a mandate from the Australian people for the proper reform of our health system,” he said.

Err, hang on. You mean Rudd is doing exactly what he promised to do? That's not right!!!!!

Now look you could say that Rudd had promised that by now he would have decided whether to hold a referendum at the next election, but seriously why would he do that now? The report doesn't even recommend the Commonwealth Government taking over the whole lot, and let's say he did come out today and say we're going to referendum on it. First thing I'd ask - what's the question? Then I'd ask if the referendum passes what will happen? Then I'd ask, do the experts think it's a good idea? Will it do any good? Then I'd ask was he going to consult with the public and medical sector before deciding to do this massive upheaval?

The experts have come out saying (according to The Australian):
The commission has recommended the commonwealth should run and fund all primary health care, basic dental care and aged care as well as indigenous health. It also suggested the commonwealth fund all outpatient services and 40 per cent of emergency admissions. The report also leaves open the option of eventually funding 100 per cent of hospital admissions, but explicitly said that should not occur straight away.

So the report gives Rudd an excuse not to take over the whole lot - but does put the onus on him to do something - and something drastic. I actually think that sounds like a good idea, but it obviously is not going to be easy to do.

However let's go back to Turnbull's criticism that Rudd has broken an election promise and that he should take over the hospitals. Does this mean the Liberal Party is now in favour of this idea? They're against the recommendation of introducing a dental cover (little wonder given the Liberals got rid of the Commonwealth Dental Plan), and yet he seems to be urging the Government to go further than the reports recommendation of taking over 40 percent of the funding. So he appears to be arguing the Government does less and more. Or is he arguing the Government should do something even though he thinks it is bad policy?

I have no idea - and I suspect neither does anyone else (including most of the Liberal Party MPs)

And you have to love this line:
"In 2007, Mr Rudd said to the Australian people he would fix the public hospital system by 30 June..."

Which suggests to me that Turnbull agrees the public hospital system was broken in 2007. Gee who was in power then?

So now we have the national political debate being fought on two issues at the moment - Health and Climate Change - both ALP favoured issues. Does Turnbull really want to go to the next election arguing against the Commonwealth Govt taking over 40 percent of the hospitals? He should wake up. At least he has realised on Climate Change that the Liberals are stuffed. Here he was on Insiders yesterday:

BARRIE CASSIDY: What's your view? Can you win the fight [on climate change]?

MALCOLM TURNBULL: Your que... Well Barrie, every fight can be won. Every political, every election is winnable. Some elections will be harder than others. Certainly an election on climate – well, we've already experienced one election on climate change so we know what... Look, can I say this to you Barrie: the overwhelming mood of the community, wish of the community, is to have effective action on climate change.

You could see as he spoke that he realised just in time that he was about to admit the Liberals got slaughtered at the last election on climate change, and would be beaten next time as well. So expect him to do a deal come November on the ETS; and also expect him to get into line on Health by this time next year - once the utter lack of logic of his current position is used to hit him over the head during Question Time next month. At best he'll blather about the cost, and the more debt Australia will be in (or not - facts won't come into play).

But if Turnbull wants to fight Rudd on Health he will have to come up with more than "you sort of promised to do this and you haven't". He will actually have to come up with a policy. However, given the performance of Turnbull on this score in the last 10 months, I wouldn't hold my breath.

For Turnbull and the Liberal Party, any policy pills are just substitutes for the real thing. Unfortunately for them, the public can spot the fake ones a mile away.

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