In his speech on election night, as reported by The Guardian, Malcolm Turnbull:
… accused the Labor party of running “some of the most systematic, well-funded lies ever peddled in Australia” in a campaign in which Labor claimed the Coalition was planning to privatise the government funded health insurance system, Medicare.
Turnbull questioned whether there would be a police investigation over the Labor campaign and he accused Labor of sending texts to voters claiming the Coalition would sell Medicare.
The Daily Mail (Australian edition) reported it this way:
“Today, as voters went to the polls, as you would have seen in the press, there were text messages being sent to thousands of people across Australia saying that Medicare was about to be privatised by the Liberal Party,” Mr Turnbull said in the speech.
“The SMS message came from Medicare. It said it came from Medicare. An extraordinary act of dishonesty. No doubt the police will investigate.”
And George Brandis said this:
I think that the thing that made the difference between a reasonably comfortable win and, if this is the case, a very narrow win for the Government, was the fact that the Labor Party threw the kitchen sink at one of the most mendacious and disgraceful campaigns that we’ve ever seen. The proposition that the Government planned to sell or privatise Medicare was … a nonsense.
So they accept that the Medicare campaign by Labor had a major effect but they insist it was a lie. Why?
As I pointed out in Turnbull’s Medicare backflip — or is it? the government had begun the process of examining how the Medicare payment system could be outsourced or sold to a private provider. Although the Liberals described this as only the ‘back office’ operations of Medicare, payments are the central role of Medicare. When this first became public news in February, there was no denial that it was taking place.
It was only after Labor aired its Bob Hawke campaign advertisement, that you don’t create a Medicare privatisation task force unless you intend to privatise Medicare, that Turnbull eventually came out and guaranteed that Medicare would not be privatised and that updating the payment system would take place ‘within government’.
Thus, when Labor continued its Medicare campaign, Turnbull and other Liberals claimed that it was based on a ‘lie’. Firstly, remember that denying privatisation came late in the election campaign and only after Labor’s message was obviously having an impact. Before that, or in other words for the first few weeks of the election, privatisation of the payment system was still on the Liberal agenda. Turnbull’s ‘guarantee’ was a decision made on the run and not reflective of what had previously been Liberal policy. It was purely a last minute and desperate political decision.
Secondly, Turnbull’s denials and ‘guarantee’ did not address the other issues surrounding Medicare: namely that Medicare rebates will now be frozen until 2020, making no increase for six years; and that the removal of bulk billing incentives for pathology and diagnostic imaging services was still on the table and would be reconsidered after the election. Even the new president of the AMA, Dr Michael Gannon, not a natural ally of the Labor party, pointed out that the freeze would force GPs to charge higher fees and to abandon bulk-billing and that some GPs had already advised the AMA that they were doing so.
Turnbull’s response was that doctors could charge whatever they liked and that if the freeze was removed it would increase the scheduled fee by only 60 cents, or up to $2 if backdated. Those amounts are probably fairly accurate and sound small but if a doctor is seeing between three and six patients per hour for six or seven hours a day, five days a week for 48 weeks of the year, even at 60 cents that could add up to an extra $6000 per year which would no doubt assist in meeting the surgery’s running costs. If there are four doctors in the surgery that is potentially up to $24,000 a year, or about $80,000 if the increase is $2. So despite Turnbull’s attempt to downplay the effect of the freeze, its real impact can be quite substantial for a surgery’s business model over a full year.
The other issue relating to Turnbull’s response is that it continued to ignore the concern that people will have to pay more. By taking the approach he did, he was basically abrogating any responsibility for medical costs — that is not what people expect of the government. What they do expect is that if medical costs rise the government will assist in meeting those costs, not say it is nothing to do with them, that doctors can charge whatever they like. If anything helped raise the profile of Labor’s Medicare campaign in the last days of the election campaign then I think Turnbull’s response did.
Turnbull and the Liberals also tried to emphasise that the freeze had initially been introduced by Labor. That is true. It was introduced by Wayne Swan in the last Labor budget in 2013. What the Liberals didn’t say, thus lying by omission, was that Swan’s freeze was for a total of seven months, from November 2013 until June 2014 — of course, the savings made in that time would be built into future budgets. There was however another reason for that ‘freeze’, not just the need to save a few dollars. Indexation of Medicare scheduled benefits in November was associated with the old budget timetable when budgets were presented in August and new measures (costs) could only apply from 1 December. Since budgets have been presented in May all new measures can apply from 1 July and the change Swan made was to align Medicare indexation with the new budget timetable (most other indexed government payments had already been realigned and Medicare was one of the last). The freeze on Medicare rebates since June 2014 has been purely a Coalition government decision but, of course, they didn’t mention that.
So who was lying about Medicare? If the Coalition plans to continue the Medicare freeze until 2020, surely that is a valid point that Labor can make during an election. And if Medicare is covering less and less of the cost of seeing a doctor or specialist, that is also undermining the very purpose of Medicare. Again it becomes valid to argue that Medicare needs ‘saving’ because the Coalition’s approach would certainly mean that over time it would become worthless as health insurance. So Labor’s campaign of saving Medicare was not a lie. Medicare may not technically be ‘privatised’ but the continued impact of the freeze and removal of bulk billing incentives would have very much the same effect, pushing consumer costs higher and reducing both the health and social benefits of Medicare.
If voters responded to that, Turnbull has only himself to blame. His denial of privatisation came late so it could be questioned: the obvious response being that if you did not intend to privatise Medicare why didn’t you say so on day one of the election campaign? — why wait until you were forced to respond to Labor’s Medicare campaign? And if you only responded when forced to, can your decision really be trusted? If you are supporting Medicare, why is there a freeze on rebates for six years which is five years and five months longer than Labor’s original freeze? Why are you going to force pathologists and diagnostic imaging services to charge patients upfront and then have the patients claim a proportionally reduced rebate from Medicare?
They are questions that Turnbull just refused to address when Labor raised them. So it wasn’t simply a ‘privatisation’ scare campaign by Labor but a campaign that raised legitimate questions about Turnbull’s and the Coalition’s approach to Medicare. For Turnbull to come out and claim that Labor improved their vote because of a lie about privatisation is missing the point and is itself a lie because he will not face the truth that his other actions were still a threat to Medicare. People could see that and did believe that Medicare was worth saving.