Self-interest rules in Premier's plan

WHO you think has the better health plan, Kevin Rudd or John Brumby, depends entirely on what you think the plan should attempt to achieve.

If the answer is a hospital system better able to cope with soaring demand, go with Rudd. On the other hand, if you think the most pressing issue is the need to shore up Victorian state Labor's re-election chances, the answer would have to be Brumby.

What else can you say about a proposal that is riddled with dubious claims, shares all the weaknesses of the Rudd plan but few if any of its strengths, and puts naked state self-interest ahead of the need for a proper rejig of the system?

The Brumby government goes to the polls in November and would almost certainly face opposition claims of selling out Victoria if it agreed to Canberra's proposals without a fight. In that context, yesterday's document makes some political sense, but in health policy terms, not so much. First, it's a plan for the status quo, with minor tinkering, not reform - and a plan to retain the state's sweaty grip over services it already controls.

Part of Brumby's pitch is that the commonwealth plan contains little or no new money for hospitals, which begs the question, from where will the extra money needed in future come? It can hardly come from the states, which is where more of it will have to come from if Brumby succeeds in winning a return to a 50-50 share of hospital costs between the states and Canberra.

Second, it's a plan for hospitals (and Victoria's hospitals at that), not the wider health system.

A new national health "fighting fund" would be set up to combat the nation's five biggest killers, but the details are impossibly vague. Worse, the Brumby plan first backs properly co-ordinated primary and community care services, but on the next page rules out handing over to federal control community services it already controls..

As a health plan, it hasn't got much chop. But as a spectacular exercise in sticking a spanner in the works, it's hard to beat.