Tory Shepherd: People are primed to worry about their health and ripe to distrust the government

Medicare changes are coming soon, but so is an election. Political parties should not prey on the public’s legitimate worries about their health, writes Tory Shepherd.

On a balmy (well, balmy for Canberra) December evening in 2016, then-prime minister Malcolm Turnbull hosted Christmas drinks at The Lodge. Amid the hubbub, bubbles and canapes, he gave a bitter speech about the Mediscare campaign Labor had waged against his government during the election campaign earlier that year.

He’d won, in the end, but was fuming. He was also livid on the night of the election when he accused the opposition of running “some of the most systematic, well-funded lies ever peddled”.

Because the tactic had nearly worked.

Mr Turnbull’s government was planning to outsource some background administration work for the Medicare system. His opponent, Bill Shorten, seized on that and distorted it into an attack on Medicare’s core. He campaigned in front of “Save Medicare” posters.

It forced the Coalition to waste precious campaign energy battling on its turf. On the backfoot, Mr Turnbull ruled out privatising any aspect of Medicare, while labelling Labor’s moves “disgraceful”.

Now the Mediscare banners are being unfurled once more thanks to planned July 1 changes. There are many. The Medicare Benefits Schedule Review Taskforce spent five years looking at more than 5700 government-subsidised items, formed more than 100 committees and working groups and recommended changes to about 900 MBS items. It was tasked with looking at how the items “could be aligned with contemporary clinical evidence and practice and improve health outcomes for all Australians”.

Which sounds pretty smart, really. The taskforce members took into account feedback on the initial recommendations, and say they addressed all the important concerns.

Some recommendations started being implemented in 2016. There were more changes each year after that, and the timeline for changes continues through to 2023.

Which all sounds like a pretty good process. Except it seems to have come as a total shock to many people – doctors as well as patients.

That’s because changes, which mainly affect surgeries, were revealed just three weeks before they’re due to come in – even though the taskforce’s final report was handed down in December. That means people already booked in for operations might face big changes in what they have to pay.

The Medicare changes, which mainly affect surgeries, were revealed just three weeks before they’re due to come in.

The Australian Medical Association and federal government announced Tuesday they would work together on the rollout and make sure the system was “ready”. The AMA had initially responded by saying doctors and patients were “bracing for chaos”.

“Release of the changes so close to the start date has let the private health sector scrambling to prepare and patients potentially left out of pocket,” it said.

AMA president Dr Omar Khorshid said doctors didn’t even have all the information they needed to work out their schedules, and what to charge patients. It didn’t have to pan out like this.

Most experts and doctors think the changes are good. There are obsolete item numbers that had to go. There were procedures that were old-fashioned, and had been superseded by better ones, that had to go. In all the outdated mess of the MBS there were too many opportunities for unscrupulous doctors to charge for multiple items, or more expensive ones.

Some costs to patients will go up. But others will go down.

Even if the AMA manages to steer changes through, to clear up the confusion, and to reduce the chances of people being left out of pocket, damage has already been done.

Politically, the government has exposed its soft flank to Labor, which is already pouncing. It should have realised it was creating the perfect conditions for Mediscare 2.0, because any changes to Medicare do scare people. Politically, Labor stands to gain from hyping that fear. But ethically, it shouldn’t. Just as the Coalition shouldn’t have capitalised on fears about a Labor “death tax” or “retirement tax” in 2019.

Both sides risk increasing anxiety in an already anxious public. People are primed to worry about their health because of the pandemic, and ripe to distrust the government’s management of the health system amid doubts over the vaccine rollout and the containment of the coronavirus.

The changes to Medicare may be the cure for its ailments, but they should have been delivered with a better bedside manner.