Changed my mind already

Yesterday I said I’d post about national politics if anything happened to change my tentative intention to vote Labor at the forthcoming federal election. But I didn’t expect that to happen within 24 hours.

Last Sunday I watched Laurie Oakes interview Health Minister Tony Abbott about apparent ALP plans to reform Australia’s health care system by “pooling” federal and state funds and using them more efficiently. Oakes appeared to demonstrate pretty effectively that Abbott was just engaging in a typical pre-election fear and misinformation campaign, by claiming that Labor was intending to vest control of health care in an “unelected, unaccountable, undemocratic body runs the system in the same way the national health service in Britain is administered.”

Manifestly that wasn’t what they were proposing at all. The Australian Health Reform Commission announced by Opposition Health Minister Julia Gillard was just intended as a transitional and investigatory body. However, Tony Abbott comprehensively botched his attack on Labor’s proposal. It’s actually even more iniquitous than Abbott suggested, but Abbott’s presentation successfully obscured that fact (at least for this armadillo). Fortunately Oakes himself, having had his little bit of fun at Abbott’s expense, has explained the real issue as he sees it in his column in this week’s Bulletin:

While he might have botched the execution, Abbott is onto something. Gillard says she is planning dramatic changes to the way Australia’s health system is funded and administered. She told the Press Club last October that Labor was prepared to “take on the challenge of real reform”. Within a year of the election of a Labor government, “significant reforms” would be in place. Labor would “rebuild Medicare”. What is startling is that Australians are not to be told what these radical reforms are before they vote. They are expected to approve the rebuilding of Medicare without knowing the details of how it is to be rebuilt.

According to Gillard, to achieve a unified national health system, the money the federal government provides through Medicare, the PBS, nursing home subsidies and the Health Care Agreement would be pooled with funds the states now spend on hospitals and other health programs. The combined pool “would then be applied to the population’s health needs” but she does not say how. That and other issues would be determined by a summit organised by the National Health Reform Commission in the first three months of a Labor government. Federal and state ministers, heads of major statutory authorities in the health area, and representatives of hospital and health services managers, consumers, doctors, health unions and the private health sector would attend to draw up “an action agenda for reform of the health system”.

Gillard speculates about the possibility of some of the money being put into “a regionally administered pool”. She talks about projects involving “the cashing out of MBS and PBS to help provide services”. There are references to removing “artificial barriers between different categories of funding”. But to know exactly what is to happen to understand the shape of the rebuilt Medicare we would have to wait for the outcome of the summit. And the major reforms arising from the summit and given the imprimatur of the reform commission would be put in place a good two years before Australians have an opportunity to express an opinion through the ballot box. With Medicare pretty much a political sacred cow, Australians are likely to be alarmed if they wake up to the fact that Labor wants approval to make radical changes to the health system without saying what those changes would be. If Abbott succeeded in getting that message out, the election might not be so close after all.

If Oakes’ explanation of Labor’s position (or rather non-position) is accurate, this is an outrageous anti-democratic assault, fundamentally dishonest and contemptuous of the basic rights of Australian voters. There is no way in the world I’ll be voting for a party that promises to make sweeping fundamental changes to Australia’s health care system, but won’t tell voters what they are until after it’s elected!!!

Not even John Howard would try a scam as breathtaking as this one. I won’t write the ALP a blank cheque. Hopefully other swinging voters will feel the same, and send an unequivocal message to Latham that he’d better come clean about his party’s policies without further delay. Looks like I’ll be voting for that fuckwit Dave Tollner after all.

About Ken Parish

Ken Parish is a legal academic, with research areas in public law (constitutional and administrative law), civil procedure and teaching & learning theory and practice. He has been a legal academic for almost 20 years. Before that he ran a legal practice in Darwin for 15 years and was a Member of the NT Legislative Assembly for almost 4 years in the early 1990s.
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cs
cs
2022 years ago

By all means get on your soapbox and fulminate Ken. But it looks good to me, and I suspect will be pretty clearly understood by everyone who’s hung around health policy in recent years, if not to anyone else. All the funds go into one pool, and are released to service providers on agreed formula (that’s what the review is about settling, plus stripping away all the current intervening administration at all levels of government). To get the idea, think of the way travel agents currently operate around the country, with a multitude of different products by different providers, all in one giant travel pool, which can be accessed through virtually all independent agencies. No question, it’s the way to go.

The ‘cashing-out’ benefits idea has also been around for yonks, for it’s a method of introducing co-ordinated care. I can’t remember what the proportions are, but some minority proportion of the population consumes the major share of front-line resources, because they comprise unfortunate folks with recurring illnesss etc. Depression, for example, is a big user (as are hangovers, I’m told). In the case of chronic depression, for example, instead of a patient perennially circulating around a number of one-off service providers, some who qualify for medicare, others not, the benefits would be converted into a co-ordinated care budget with a lead co-ordinator, where all services needed for that patient would be eligible for medicare. Everyone who’s looked at the idea has concluded that the result of co-ordinated care wouild be significantly improved health outcomes at significantly less net cost. The sensitive points are privacy and ensuring voluntary entry.

In short, Gilliard is bravely heading in a direction where all serious disinterested policy makers have agreed the system should travel for over a decade. The Mad Monk of course knows this, as the Commonwealth has been a major player since the late ’80s, and elements of the direction have already been implemented in bits and pieces (co-ordinated care trials, for example). But I’d never underestimate his capacity to sow doubt at every turn, producing strong stances on behalf of staying with the crock of a health system we have now, as in your post. The alternative, for the ALP to try to provide a scheme with all the details without going through a full policy review process in consultation with all the players, would make Barry’s spagehtti and meatballs look anal retentive. Fuck it’s hard to introduce complex change for the good, and few policy areas are as seriously complex as health, when one party just plays the wrecker. If the view put by you and Oakes gets a head of steam, it’ll be more potential national good works down the toilet, alas … not that I can’t understand where you’re coming from.

Ken Parish
Ken Parish
2022 years ago

Chris,

All Latham/Gillard would need to do to reassure me would be to promise not to introduce any major changes without seeking a specific mandate (whether at the subsequent election or a purpose-held plebiscite). If they won’t promise that then they shouldn’t be trusted.

CurrencyLad
2022 years ago

I can see both sides of this but talk of ‘summits’ post-election strikes me as lazy and terribly 1983. And it’s not just health that worries me.

Granted, the Opposition is constrained somewhat by not occupying the Treasury Benches and not controlling the finances of the nation. But after eight years in opposition, and with a leader touted as both a visionary and an intellectual, there has to be more substantive policy offered to the electorate than a long ‘on the never-never’ list of enquiries and summits.

I though Bob McMullan spoke of, and around, this problem – of wanting to promulgate policy, yet being out of the budgetary loop as an Opposition – exceedingly well on Lateline Friday night. McMullan is one of the truly likeable figures on the Labor side and I think that freed from the obscurity of the Senate, he may become a major figure if Labor is elected. Certainly, I think he would constrain any Whitlam/Barnard-style silliness that Latham may be tempted to indulge in if elected PM.

However, Nick Minchin was also right when he said on Lateline that McMullan had perforce to clean up after his leader’s extravagant and ill-considered financial undertakings. Post-Fightback and post-GST, the electorate now expects detailed policy from an Opposition on all of the major areas of national policy: health, education, defence, foreign policy. The Opposition has to provide details on these matters or it deserves to be hammered by Oakes and others right up to election day.

I don’t remember the Whitlam Government but when McMullan spoke on Lateline of doing something with the prosperity the Coalition has been successful in developing and safeguarding, I immediately felt that Labor was drifting oafishly back to the ‘It’s Time (To Blow it All)’ mentality of yore.

Health reform – tabled in detail or not – won’t redeem Labor for me. I don’t believe Latham deserves the Prime Ministership, nor do I think he and Rudd have performed at all creditably on foreign policy. I remain a Beazley Restorationist.

cs
cs
2022 years ago

By all means stand on your digs Ken. But this isn’t an athenian democracy, it’s representative democracy. In this policy area, it’s the players that matter if the job’s going to be done. All you’re called upon to do is decide if you’re happy with the direction … or you can do some bloody work on the problem and become a player. What’s the point in playing the princess and the pea with the thing?

If a government doesn’t get the players to come around, it’s buggered, no matter what it says in an election. All a government or opposition can do is set a direction, and then see how far it can get in the review process. You don’t honestly think the the ALP is going to try to smuggle in a demolition of medicare, and believe that Jack hasn’t been trying to find a way do that ever since he was first elected? Bizarre! Your right of course. But bizarre!

Ron Mead
Ron Mead
2022 years ago

The health care system really does need comprehensive reform. It’s probably wise of the ALP not to be more specific before the election provided it promises not to introduce any major rehash in its first term. It could then, with full access to the Treasury benches, put together the nuts and bolts of reform for judgement at an election before its second term, just as John Howard did with the GST. As long as Latham doesn’t rule out any sensible specific option by saying “never ever”. But nobody in the Labor Party would be so rash, would they? Well perhaps they would. Latham seems to have succeeded in having his pre-accession (to leadership) statements wiped from the record, at least as far as his friends in Fairfax and ABC are concerned.

Ron Mead
Ron Mead
2022 years ago

Interesting to read Laurie Oakes sneering at Howard’s lack of ticker in not springing an early election in October last year, 23 months after the last election.

This is nothing but cheap baiting, typical of Oakes. We all remember his cheap shot at one of the Defence chiefs at a press conference last year, virtually accusing him of cowardice. Oakes is a sleaze.

The Howard-haters love to accuse Howard of cynicism. Just how cynical would it have been to have called an election in October 2003 just because he was well ahead in the polls and for no other half-plausible reason. Howard genuinely believes that governments should go full term (or near enough). Furthermore he also realizes that the Australian electorate is not composed of fools, and wouldn’t wear that.

cs
cs
2022 years ago

A pretty fair comment Ron. But still, it’s overwrought. All that matters for citizens is that they be assured that universal access and the overall levels of public investment are maintained, as the ALP has done. This is completely different to the gst in the sense that the changes are purely internal and won’t affect ordinary joe, except insofar as he might notice that his services have improved. It’s an internal machinery reform. I’ve advised several governments on health reform, and have chaired national intergovernmental review bodies. My point here is that I can tell you most assuredly that not even many senior public servants understand the internal machinery of the health system. Often I have wondered if I understand the goddamned thing. The idea that citizens can knowledgeably adjudicate on the complexities of reforming internal health machinery is Utopian in the extreme. If the thing backfired on patients, the government would be murdered in the following election, quite rightly. But there’s no way those same patients would be able to anticipate this result in advance in an election campaign. The changes should of course be taken forward with full public (as well as player) consultation, with ample input from citizens, etc. But all you’d be achieving by placing an internal health map forward before the public at election time is the staging of a public play for specialists and interest groups to quickly take the debate to a point where only insiders and the idle will have a snowflakes of knowing what’s going on. In the mounting confusion, the no vote would come down … and the system would stay a crock. Another great victory for democracy, not.

observa
observa
2022 years ago

You’ll pardon some of us for being just a wee bit concerned that Labor would like to ‘nationalise’ health Chris. On the other hand we are aware of the gathering storm clouds over health.

David Tiley
2022 years ago

I don’t think this is the kind of election where we as voters can rule a line down a piece of paper and write policy pluses and minuses on either side and add them up.

The trouble is, the Liberals will say anything to stay in power. I don’t need to go through the litany of shossy lying and evasion that we all know proves that.

In that context, it is tough to ask the ALP to create a large target by offering solutions which are so easy to build into a scare campaign. The Libs would do to a health policy what the ALP did to the GST, although at least with that Keating was building on something the electorate genuinely didn’t want.

CurrencyLad
2022 years ago

Sad to observe, but my suspicions about Labor’s unpreparedness for office are being exemplified. The theme above seems to be: the voters are a bunch of idiots so don’t tell them anything before the election.

This sort of elitism was the reason Labor was axed back in 96. But it’s alive and well! ‘Small target’ strategy, I think it’s called. Yes, give that another whirl!

And Chris, good luck selling that ‘internal machinery reform’. That may be sexy to public service bean-heads but it won’t advertise well. I suppose it could also be argued that citizens cannot “knowledgeably adjudicate on the complexities” of universities, foreign policy, water management, bank fees, free-trade, the War on Terror…anything really.

Now, Godwin’s Law doesn’t apply here Chris because I’m being quite serious: you seem to be advocating a kind of bureaucratic fascism. Its reminds me of Sir Humphrey Appleby telling Prime Minister Hacker that a hospital was quite the most perfect one in the UK – because it had no patients. People, after all, make things so complicated.

I don’t know whether Howard’s government has lied more than its predecessor governments did. I do know the last time Labor was in office unemployment ended up being about 11 per cent and inflation and interest rates went through the roof.

The ALP wants us to trust the largest economy in the southern hemisphere to a failed alderman. They lost their connection to genuine Labor (and my sympathy) when Beazley was banished to the backbench in favour of an apparently violent oddball whose heroes include Richard Nixon and Colonel Kurtz and whose equal-opportunity Deputy appears to be a muppet.

The horror.

zoot
zoot
2022 years ago

I don’t know whether Howard’s government has lied more than its predecessor governments did.
It has.

cs
cs
2022 years ago

And Chris, good luck selling that ‘internal machinery reform’. That may be sexy to public service bean-heads but it won’t advertise well. I suppose it could also be argued that citizens cannot “knowledgeably adjudicate on the complexities” of universities, foreign policy, water management, bank fees, free-trade, the War on Terror…anything really.

Don’t be silly. Have citizens had an opportunity to consider the government’s military plans for Iraq? The nation is at war, and you haven’t got a fucking clue where it will end. Fool. And now you turn around and want an election on the science of case-mix funding, and it’s weightings, which you won’t understand anyway!

And it doesn’t make any difference, because you probably have no idea about anything that government’s do to this level, even when it’s important, as in the Iraq example. Explain the social security system to me. Hah! It changes so frequently in detail that I receive quarterly updates from the authorities. Why don’t you stamp your feet in rage, and demand a referendum each quarter? Why don’t you demand the right to the micro-management of everything that government does, and go completely nuts?

On the other hand, I imagine you have some speciality in something. Bear that in mind. My advice is that you concentrate on your interests, and if you have some spare time, think about major citizen concerns (such as: will it cost you more? is it a new service? what is the underlying philosophy? does it mean war?). Don’t try to adjudicate stuff about which you haven’t a clue, and which won’t affect you anyway, like you already do with most things.

Or do whatever you want. I don’t give a bugger.

Ron Mead
Ron Mead
2022 years ago

That last comment is so typical of you, Chris. You just can’t tolerate anyone disagreeing with your point of view without losing your temper and resorting to personal abuse. Shame!

Mark Bahnisch
Mark Bahnisch
2022 years ago

I’m with Chris on this. I have some areas of professional and/or academic expertise, but I wouldn’t dream of claiming to be able to comment on the intricacies of health policy and administration (having found it difficult enough after having surgery to work out which percentages of the many bills I received were to be paid by me, my health fund, and Medicare respectively).

On one hand, we owe some thanks to people like Chris with expertise in these areas for unravelling them for the rest of us so we can cut through the rhetoric and get to the policy objectives that concern us as citizens. On the other, in order to comment on these policy objectives, it’s not necessary and indeed counter-productive to claim an expertise that we don’t have.

There are two dangers I think with regard to this phenomenon of expertise and complexity – first, that one can be blinded by the intricacies and the narrowness of an ‘expert’ perspective (a trap that Chris admirably escapes), and the second, that those of us who are not experts feel that we need to be in order to express an overall view – which is what I take Chris to be warning against.

I’m going to throw in my favourite Max Weber quote on this:

“No one knows who will live in this cage in the future, or whether at the end of this tremendous development entirely new prophets will arise, or there will be a great rebirth of old ideas and ideals or, if neither, mechanized petrification embellished with a sort of convulsive self-importance. For of the last stage of this cultural development, it might well be truly said: ‘Specialists without spirit, sensualists without heart; this nullity imagines that it has obtained a level of civilization never before achieved” ( 1930, p. 182).

Weber, Max. 1930. The Protestant Ethic and the Spirit of Capitalism. Translated by Talcott Parsons. New York: Charles Scribner’s Sons.

Ron Mead
Ron Mead
2022 years ago

Australians generally are rather sceptical of experts, not because they think they don’t have the knowledge they claim they have, but because their output is so often coloured by their own (the experts’) personal political views.

I’m convinced that Chris knows more about just about everything than I do (and heavens above he’s told us often enough, we have to believe him). I’m not convinced that he’s not slanting the telling of his knowledge in a way that reflects his own left-wing views. As a result we give his opinions more weight than those of the likes of Ken Parish at some considerable risk.

TJW
TJW
2022 years ago

Informed voters can review the arguments presented by experts and then decide which arguments they find most convincing. In a democracy, it’s not necessary, or possible, to become an expert in all areas in order to have a valid opinion on an issue. Even someone with an extremely broad area of expertise is still going to be a non-expert in 99+% of all possible areas of knowledge. In fact, all that matters is that voters have an opinion, even a warped or ill-informed one.

The fact that certain policies are more susceptible to scare-campaigns is a real impediment to progress and undoubtedly sees many valid reforms rejected. It’s frustrating, and far more so for those who KNOW the reforms will pay real dividends, to see them shredded to pieces by a sensationalist media but, on balance, that process is seen by many as a precondition for a legitimate mandate.

**On a side note, is this policy about case-mix funding on a federal level? After hearing the Victorian ALP’s criticisms of that policy at the state level (or at least Kennett’s implementation of it) from 1993-1999 I would have thought they’d sooner advocate a policy of forced baby drownings.

CurrencyLad
2022 years ago

Fair enough Chris. You obviously know a lot more about government than me. I don’t receive government reports on minutiae to digest every month and, if I did, my mastication wouldn’t be as lingering as yours. Government, however, is about people, not dessicated processes. I’m no more foolish than the next man and I’ll gladly drag-race my doctorate in history against your more specialist conveyance.

I note the following about the Howard government:

It has restored the economy through good fortune and good management. No, I do not fetishise surpluses to the extent that I refuse to approve of the social dividends Bob McMullan, for example, has been talking about. But I want to know what he has in mind, in reasonable detail. Ironically, a few months ago I told a friend I would vote for Labor if they undertook to do something definitive on water restoration in Australia. With all of the States under Labor management, Latham couldn’t even manage this. Too busy gigging with Peter Garrett. Howard did.

It has stabilised the situation in the Solomons, as even – gasp – Phillip Adams has conceded.

It has liberated East Timor, in rather telling comparison to Whitlam, Hawke/Keating and Evans who sold that would-be nation out shamefully in the 1970s, colluded secretly by green-lighting Indonesia’s invasion, and – in the case of Keating (who I voted for) – lied to the Australian people vis-a-vis the security treaty. That’s to say nothing of his lies about the Kirribilli Agreement and his lies about the budget deficit.

It engineered the gun buy-back, which – unlike many rightists – I supported strongly because I do not believe in the right of Australians to bear arms just because they feel like it. One of the older achievements I know, but curiously relevant again with Mike Moore lecturing Australians about the dangers of becoming too American. Only a thick-skinned bastard like Howard could have done this.

It made an honourable contribution to the liberation of Afghanistan, which was the first stage of the War on Terror. The left was horrified at the time, its principals saying Afghanistan would be – naturally – ‘another Vietnam’. Now it’s regarded by the left as having been the ‘good’ war, in contradistinction to the ‘bad’ one in Iraq. Hell, Kevin Rudd still seems to want every swinging dick in the ADF sent there.

It made (which is to say, Australian defence personnel made) a huge contribution to the liberation of Iraq. The pissant Tet strategy of the ‘insurgents’ currently blowing things up and chopping people’s heads off, will not work in the longer term. Through what can only be regarded as political brilliance, the PM angled the SAS into the real business of warfare, solidified Australia’s reputation, withdrew those men and left in place a practically useful force of security personnel, air-traffic controllers and military trainers, thus fulfilling Australia’s duties as a party to the original liberation. No Prime Minister probably in Australian history has ever leveraged such a boost to the nation’s power and prestige while avoiding an ‘all-in’ foolishness that would have been at odds with our size, geography and military capacity.

It has single-handedly destroyed the people-smuggling industry through Howard’s sheer, stubborn force of will. As Paul Keating said, “we can’t have people getting off boats here and wandering into Australian society.” Quite so – only he wouldn’t have ended the practice. That’s because by the time he was well into his Prime Ministership he had sold out to the basket-weavers he despised because he knew they were the ones who would write about and rate him as a PM. Keating – who I admire still – cared terribly about being remembered as something more than a ‘feral abicus’. It gets to them all eventually – this ‘how I’ll be remembered’ mentality.

The Howard government has been one of very big ideas and very big drive, as regards world-historical events. While I agree that health, education and social security are areas it may be seen to have sniffed at in the grander scheme of things during the last term, I do not believe these are in crisis to the extent Labor or its keenest supporters are claiming. I believe they hope things will be seen that way by a majority of the electorate – and even that they believe, according to some entitlement mentality, that they should be seen that way. But it just aint so. That’s why a totality of ideas and initiatives, presented to the public, is the best and most democratic strategy to pursue.

After all this time, all I know about Labor’s plans is that they wanna ‘do somethin’. Their apparent ability to match the government’s much larger vision of the world, in its political, security and economic dimensions, is exceedingly and – in the historical circumstances – breathtakingly limited.

Not good enough Mark.

cs
cs
2022 years ago

That last comment is so typical of you, Chris. You just can’t tolerate anyone disagreeing with your point of view without losing your temper and resorting to personal abuse. Shame!

I can’t tolerate comments like that Ron. There was no personal abuse there. I just cried in frustration and then shrugged my shoulders in despair. Don’t you dare disagree!

Re casemix: Kennett blew it because he introduced a combination of casemix and cutbacks – it was brutal, and he got what he deserved. Still, casemix is just an output based funding scheme and everyone uses some version of it these days, or, more properly, casemix-plus, as the deficiencies in the model are now pretty well known. Should anyone perchance be interested in the health direction that most disinterested people within the sector reckon (after 15 years of examining and discussing the thing, which would be, like, real real practical to now do in the context of the electorate at large in a week or so, not) is the way to go,I have a sketch over at Back Pages (and just for you Ron, here I praised Howard when it momentarily looked like he was going to take up the reform task).

Ron Mead
Ron Mead
2022 years ago

A really good comments posting, CurrencyLad. Well done!

sp
sp
2022 years ago

Really good points cs, well done.

Peter Ransen
Peter Ransen
2022 years ago

“It made (which is to say, Australian defence personnel made) a huge contribution to the liberation of Iraq”

Currency Lad, my bet is you would have had across the board agreement until this point. After that, your observations are terribly challenged, and I doubt you’d have majority support for them. For mine, the observations presented after that point are myopic at best, dangerously misread more likely.

Apart from that, a very useful and engaging post here.

David Tiley
2022 years ago

Actually Peter, perhaps not across the board agreement. Was the economy busted for Howard to “restore”? Was the Liberal Party standing up for the brutalised East Timorese? Was the Fraser government some sort of weird fantasy? Would we all say that “Australia liberated East Timor”.. Does the left think the coalition’s strategy on Afghanistan has created a “good war”?

And I am not sure that all of us would see Tampa, detention camps and a war of invasion as insignificant.

Even though currencylad is a historian, I am sure he is sometimes as amazed as I am that thinking people can live through the same period of history and have such drastically different interpretations of it.

But then I guess it is one of the traits about the human race that keeps us stimulated and on our toes.

CurrencyLad
2022 years ago

“…I am sure he is sometimes as amazed as I am that thinking people can live through the same period of history and have such drastically different interpretations of it…”

I’ve thought a lot about the present in just those terms David. That’s our zietgeist in a nutshell. I don’t expect people to agree with my view of anything, certainly not the war in Iraq, which is hugely controversial.

The war, in fact, is almost undebateable now for all intents and purposes, as you might have concluded as well. There are distortions and agendas on both sides. Plenty of ammo is available to the disputants, deriving from all that went on from the 1970s through to 1991, and beyond that till the present day.

I think it will become important soon for the conflict in Iraq to be discussed and treated of by historians as being – amongst more important things – a proxy war between the Western left and right; a kind of post-Fukuyamian historical process whose results for our civilisation are, as yet, undiscernible.

Given that Iraq is meant to be part of a wider war against terrorists, which campaign costs so much in lives and treasure, we might all feel regret eventually about the sport we make of Iraq and the politics surrounding its fate. I plead guilty to being a red hot partisan of the pro side, which I am content (and convinced) to remain.

To return to Ken’s topic, however, I obviously number myself among those who believe the Howard government deserves to be re-elected on multiple grounds. If, during a fourth term, the domestic agenda is sidelined by an internationalista mentality, then it may well become time for a change.

I know I’ve banged on about the Big Beazer, but I think his views on Labor at the moment would be fascinating. He can’t be hanging around on the backbench for the hell of it.

I think he likes his chances against Costello.

David Tiley
2022 years ago

“The war, in fact, is almost undebateable now for all intents and purposes, as you might have concluded as well”.

There’s another part of the zeitgeist – it is both undebateable but it is absolutely necessary to debate it. A paradox we all think in the middle of.

I do sometimes think it is the opposite of a proxy war between left and right – one of many points at which old divisions are becoming undermined and create new alliances. Or perhaps we are just back to the olden days in the 60’s when we all listened to both Manning Clark and Geoffrey Blainey.

Peter Ransen
Peter Ransen
2022 years ago

Fair call, David, and I stand corrected. Must admit I didn’t fully read Currency Lad’s post except for a quick brush through.. more in hope to find some common ground of sense. As it was, you provided it.

(And what is an historian? Does that title carry with it some unassailable notion of truth or validity? Give me two historians on any day, and you have me interested, or one cartoonist and a week).

Ken Parish
Ken Parish
2022 years ago

This has developed into a really interesting thread in my absence. I must say I’m a bit bemused by the stance initially taken by CS and a couple of others, that Labor’s health policies would be just matters of detailed machinery, and so boring and complicated that we ordinary mortals would neither understand them nor be interested. Therefore, no need to disclose them before the election!!!

Problem is, I’m sure that I and most other voters would have difficulty understanding the minutiae of many if not most policy areas without assistance. But that’s no excuse for failing to disclose them. It smacks of arrogant elitism at the very least.

When policies are released, they can be scrutinised by opponents, relevant experts, and industry and lobby groups who DO have the expertise in that policy area. As a result we, the ignorant voters, make our best assessment of whose arguments seem to make the most sense, and cast our votes accordingly. Of course, even that is a rather idealised version of what happens in practice, but at least public disclosure ensures a degree of policy scrutiny and democratic accountability that simply can’t occur when policies are deliberately kept secret until after the election.

I must say I’m rather astounded that someone like Chris could seriously advance this sort of arrogant elitist justification for Labor’s stance on health. I would have expected a somewhat greater ability to retain normal critical faculties, instead of kneejerk blind partisanship.

sp
sp
2022 years ago

I’ve no doubt that people could understand the complexities of our health system, if they took the time. It seems that most however haven’t got that inclination, including many health professionals who really only need to know how their little bit of it works. I’ve been amazed over the years how doctors and nurses in one state just assume that things are exactly the same in every other state. It is very complex – for example the states and commonwealth have just recently agreed to use the same terms and categories when referring to medical specialists. Lots of similar terms mean quite different things from state to state, and I have been in many discussions that have been at cross purposes because of misunderstandings about what terms actually meant. It is easy for a group to create an emotionally driven campaign that takes over any reasoned discussion or debate. It happens all the time. It would be great to see more people understand the health system.
What do you make of the latest AIHW data on hospital admissions and length of stay? A lot of people doubted that the government’s commitment to private health insurance would improve health care – and it looks like they were right.

David Tiley
2022 years ago

My understanding is that the ALP is doing Tax Summit Mark Two on health, on the grounds that they need to build consensus in a way you cant unless you are in government, that it leads to a fair bit of public scrutiny, and the results are cost and equity neutral for the public.

They also know that the Libs – who got into power with a “small target” strategy and have “core” and “non-core” promises – will drum up a huge amount of hypocritical hysteria if the ALP commits to technical provisions, probably dragging out the doctors, the health funds, the private hospitals etc etc etc, and accusing it of costing the earth..

As the ALP did to GST. And I have a strong suspicion that only happened in the end because the electorate believed the Dems would stop it so most people could have what they really wanted – Johnny sans his demented scheme.

Ken points out this is elitist and antidemocratic, and we would all agree it is a pretty anti-idealist approach to politics. But his solution is a plebiscite or to leave it to the next election. I can’t think of a single situation where something like that has been tried, except for our dreary line of referenda, and we all know they always fail. It is not a serious possibility.

After the next election? Smacks of indecisive, which is how it will be portrayed. I suppose a lot depends on the scale of the changes, which is not obvious from the thread. Are we talking about the consent of the states? Constitutional changes?

In some ways, as an ill-informed voter, I dislike the fact that health care is always politicised and becomes a question of private v public. I want it to be about guarantees of service, waiting lists, ambulances, mental hospitals and proper care for the elderly.

The deck chairs are important, but they are for technocrats. I just want to know where we are sailing.

cs
cs
2022 years ago

I must say I’m rather astounded that someone like Chris could seriously advance this sort of arrogant elitist justification for Labor’s stance on health. I would have expected a somewhat greater ability to retain normal critical faculties, instead of kneejerk blind partisanship.

Why is it arrogant? I don’t have an exagerrated sense of my own importance. On the contrary, my concern is that everyone votes, otherwise I wouldn’t bother commenting on the issue. Why is it elitist? It’s complex, and the pre-knowledge is held by a limited number of people, generally not including even politicians. That makes it rarefied, but not elitist. Is knowing more than most folks about anything at all elitist? On your faux-definition, almost everyone is elitist in some respect (sans Ron). Why is it knee-jerk? I’ve seen this direction setback or destroyed many times over the past 15 years. Jumping to the chase on the basis of past experience is not knee-jerk, it just saves time. Why is it partisan? I supported Howard when he seemed to be supporting the direction. Funny definition of partisanship. Why haven’t I used my critical facilities? I’ve done two or three posts on substance of the direction (see links in above comments). On your own criteria here, and in the absence of any substantive (as distinct from strrikeing an attitude) posts, you’re clearly the one not doing any critical work here Ken.

Why don’t you try applying the standards of your criticism of the ALP’s health direction to something that’s already real (as distinct from a direction that will involve a thoroughgoing examination and public consultation), like Howard’s war? We committed to war before the public was told, for reasons that turned out to be false, and there is no end to it. And you’re so upset about Labor going into an election on a review promise for the internals of health, an area everyone already agrees needs fixing even if few know how to do it, with accompanying guarantees about universal access (and promises of other significant enhancements) that you’re going to vote Liberal! And you have the audacity to call me a blind partisan!

cs
cs
2022 years ago

And while I’m here Ken, I’d also invite you to apply the same standards to the Howard government’s proposed FTA.

Guido
2022 years ago

What an interesting thread!

Ken makes a very good point that if a party wants his vote then it should make its intentions clear.

It shows how difficult is life for oppositions. Because if they outline detailed policy (which could be very well thought out policy – like Hewson’d Fightback!) the government can run a scare campaign (like the ALP did that everything was going to be taxed 10% -or whatever) and the detail gets lost in the noise.

On the other hand, what the ALP is doing now is also dangerous because its opponents can shout:”where’s the beef!” (to use a Democrat Primary slogan some years ago) and also be subjected to some scare tactic as Abbott (who’s is a master at this) is doing. And if it has convinced a swinging voter like Ken to stick with the Coalition then it seems to be working.

From what I read in the media it seems that the ALP has all of its policies ready Steve Lewis (I don’t know who he is) in The Australian says that: Privately, those in the know say Labor’s tax policy is a beauty and will be warmly received by voters, particularly those earning less than $52,000 who received diddly-squat from Howard in the budget.

The problem with this tactic is that by the time the policies have been released the government might have been successful in undermining Latham’s popularity thus the effectiveness of the policy will be reduced or that some event (like Iraq/terrorism) will swamp the news and the policy will be lost. Of course this is what happened last time. A popular opposition leader such as Beazley was successfully portrayed by the coalitio as ‘Mr flip flop’ and the ALP as a ‘policy free zone’ the policies were there but as 9/11 and Tampa came into the picture they were released and no one took notice.

I was interested in CurrencyLad posts. He claims that he is Beazley Restorationist. But he reads like a convinced Howardist. Would he really consider to chenge his vote if Beazley was leader of the opposition? ;) But he does make some good points why I suspect many voters may stick with Howard (even if they do not like him)The fact is thigs are going OK and there may not be enough reasons to change. So (and it pains me as an ALP member, and someone who likes Latham’s positive energy) I still think Howard is in front (despite the polling).

cs
cs
2022 years ago

Because if they outline detailed policy …

The problem here Guido is that you can’t make policy in this area by executive fiat.

sp
sp
2022 years ago

I think that is a key point. There are just so many players in health policy, and simple messages are so much easier to “sell”, trouble is a simple answer just won’t work when there are so many hurdles to overcome. The current government has basically done the private health insurance rebate thing, some tweaking around the edges with medicare, and kept well clear of difficult things like the nursing workforce. Now all they have to do is the tried and true scare campaign and we all left with the same mess we are in now.
There are 9 health departments in Australia, 8 medical boards, 8 nursing boards, 25 specialist medical colleges, at least one medical school in each state and that is before we even start thinking about the allied health workforce and the public private split.

CurrencyLad
2022 years ago

Guido:

When I say I’m a Beazley Restorationist, I mean two things: 1) I prefer Beazley as a person to Mark Latham, who is the reincarnation of H.V. Evatt; and 2) it would take the return of Kim (or perhaps the ascendancy of McMullan) for me to even consider voting for Labor. And yes, I have voted for the ALP a few times, at State and Federal levels.

Respectfully, there’s still a degree of copping-out going on in various posted comments. So the government will target Latham and his policies and seek to destroy the credibility of both. “Well”, as the youngsters say, “du-uh”. Welcome to democracy. What was it Keating said to Hewson after the then Liberal Leader had promulgated ‘Fightback!’?

“I’m gunna do you slowly.”

Now Labor is on democracy’s rotisserie – it goes around and it comes around.

I concede what I take to be Christopher’s central argument: that, as of now, the complexities of health reform cannot even be known, much less calibrated into meaningful financial projections. But I still argue that Labor is required to spell out reasonably substantive policy intentions well before the election. Not just headline stuff either but fundamentals that stake-holders and specialists can debate amongst themselves for the benefit of health-policy non-cognoscenti like yours truly. The same goes for all of the other major areas of governance.

I suppose you’re right Guido – I am a convinced Howardist, though I am a republican. (No self-respecting currency lad or lass can be otherwise). I also saw that Steve Lewis reference to Labor policy in The Australian. “Those in the know say it’s a beauty”. “Those in the know” being, of course, the ALP’s leadership and chief advisers. Lewis should be ashamed of himself for having his by-line printed above that. We’ll see, anyway.

My reading of politics has always been driven mostly by perceptions, rather than the kind of arcana preferred by policy pros. I go with how I feel and who I like. I think people are mistaken if they believe Labor will or should get away with putting generic vagueries to the Australian people – on health or anything else. Most people also vote on the basis of ethereal intuitions and I’m not at all sure their antennae will receive Latham or his ideas positively.

Finally, I’m constantly amazed that the Australian Left overlooks, and is in denial about, the fact that the two non-Labor parties federally – the advocates of justice and peace – are headed by two men known to be violent. This is disturbing. As Tip O’Neil tried to tell would-be President Ted Kennedy, “there’s a character issue out there.” One important enough, in my view, to rule Latham out as Prime Minister of this great country.

This, and many other factors besides – mostly regarding the government’s economic and foreign policy credentials – mean I’ll vote Liberal at least until the headline journalists are doubtless so eager to use is finally file-inserted: ‘Howard’s End’.

Mark Bahnisch
Mark Bahnisch
2022 years ago

CurrencyLad, Mark Latham isn’t fit to lick the Doc’s boots. The reincarnation of Doctor Evatt? Please!

Guido, I’m not sure ‘Fightback’ counts as a “well thought out policy”. It was more a case of photocopying the standard Washington consensus neo-liberal manual, with no regard to Australian history, culture or traditions. That’s one of the big reasons he lost – not necessarily because he put some detailed policy out there. As I understand it, everyone in the Liberal Party (including Reith and Howard) with any clue as to what the electorate might actually buy, was panicking madly – hence the December backdown on the GST on food – which instantly gained the Libs about 5 points in the polls. If Hewson had had his way, and gone to the poll with his “pure” vision, or if Keating had called a November election, the Libs would have been wiped out, and given their ten years of disarray prior to 93, it could have finished off them forever. Having attended one of Hewson’s ranting rallies in King George Square on the Thursday before election day, I’m also very happy to go with “the guy is a complete lunatic” explanation for his defeat. I dearly wish Australians really had voted for PJK’s “Leadership” in 93 rather than against a ludicrously inept opposition who basically promised to tear the country apart. Still, Keating’s victory in 93 was very sweet.

observa
observa
2022 years ago

And for all the talk about small targets and avoiding smear campaigns, it was Howard who went to the polls with a complex GST on the agenda and got it up and running with a hostile senate. You have been enjoying the economic and social benefits of this value added tax for some time now.

stan
stan
2022 years ago

Is anyone else out there besides me scared shitless that the likes of cs might be left alone to undertake health policy?

If it’s good enough for the likes of cs to comment extensively on the government’s foreign policy in the run-up to an election, then I dare say it’s good enough for the rest of us to comment on Labor’s health policy if they have the guts to reveal it before the election.

yobbo
2022 years ago

“I must say I’m rather astounded that someone like Chris could seriously advance this sort of arrogant elitist justification for Labor’s stance on health. I would have expected a somewhat greater ability to retain normal critical faculties, instead of kneejerk blind partisanship.”

You Are? It’s pretty typical of what he was like when he posted here. I don’t see what’s so surprising about it.

cs
cs
2022 years ago

Stay scared Stan, very scared!

Don Wigan
Don Wigan
2022 years ago

“…is in denial about, the fact that the two non-Labor parties federally – the advocates of justice and peace – are headed by two men known to be violent. ”

I assume this is some sort of typo error, CL. Anderson has always seemed pretty gentle to me, and even Howard doesn’t usually get much beyond a twitch and turning purple.

CurrencyLad
2022 years ago

D’ohhhh!!!!

jen
jen
2022 years ago

I’m a Beazley Restorationist

So I guess you wouldn’t be supporting any kind of ‘end obesity and associated costs’ policy would you? Go to Today Today – Triple j for my sources on this subject. Yesterday I was listening to a very engaging discussion about the relative merits of Kim and John as role models for the obese child. Kim was given the thumbs down, by our commentators, in favour of a morning power walk from Kirribilli house for the fat youth of the nation. – In costume (PM shorts and sweatshirt). Every morning. Howard Youth.

CurrencyLad
2022 years ago

jen:

As I guess Triple J stablemate, H.G. Nelson, might say: “Kimbo’s big of trouser, big of crack and big of heart! And is there any sight in politics more beautiful Roy than a big man in big pants? I don’t think so! I don’t think so!”

As a heavily taxed smoker, I pay the health costs of every rotund burger-addict in the country. I think the big should be left in peace – untracksuited and unmarshalled – to go the gnaw on salad-bowls’ worth of Coco-Pops every morning. Notwithstanding what the PM or the manssiere-wearing Opposition Leader want.

And who wants to live in a world without gorgeous chubby women? Not me – “fat-bottomed girls, they make the rockin world go ’round”!

jen
jen
2022 years ago

lad – and you my boy are big of bullshit. Sniff. We as a nation, moving relentlessly forward on the absolutely tremendous treadmill of the local bikepath where too much cycling running and bosom bobbling is barely enough. Fitness my boy can be fun.