The politics of health

Abstract

Medicare entered the new millennium nearly 16 years old. Throughout its life the core elementshave remained untouched; most changes have been incremental and marginal, including those ofthe present Government. This stability contrasts starkly with the preceding fifteen years - from1968 to 1983 - during which at least six distinct health-financing systems were tried. In thoseyears Australia was the ideal laboratory for studying health finance, given our constant indulgencein new systems. Yet the sixteen years of relative stability since 1984 have been accompanied by amedia babble stressing instability and crisis. Scarcely a year has passed without predictions ofeither imminent breakdown or slow decay. (With the formal acceptance of Medicare by theLiberal-National coalition in 1996, after thirteen years of unremitting hostility, the fact that suchheadlines have been less apparent suggests a political dimension to such predictions.) Yet thesystem itself has simply contradicted the doomsayers. Indeed by virtually any measure Medicareis in a rude state of health. "It has become', in Stephen Duckett's words, 'part of Australia's socialinfrastructure'.