Michael ThornEarlier this week, Adjunct Associate Professor Lesley Russell, of the Menzies Centre for Health Policy at the University of Sydney, asked the question on Twitter: Why can the Australian Government think big (to the tune of $50 billion) and into the future (late 2020s) for submarines, but not for health or education?
Why can Aust Govt think big ($50b) and into the future (late 2020s) for submarines but not for health or education? #healthbudget16
— Lesley Russell Wolpe (@LRussellWolpe) May 1, 2016
After digesting ScoMo’s first budget it would be fair to say Associate Professor Russell’s Tweet pretty well sums up the problem with this year’s health budget.
There is no long-term strategy and certainly no meaningful investment in preventive health.
When I worked for a State Health Minister in the late 1980s and early 90s, I always had the feeling that the Commonwealth’s approach to health funding was mainly about fiscal policy and not health policy. Unfortunately, not much has changed.
The Australian Government’s approach to health policy is to treat it as a fiscal measure: limit the cost impact on the budget and minimise the consequent political damage.
There has been report after report about Australia’s growing burden of chronic disease. The Australian Institute of Health and Welfare will publish the latest data on the nation’s burden of disease next week, and yet we still have no viable plan to tackle chronic disease and meet the international target to reduce premature mortality from non-communicable disease by 25 per cent before 2025.
Limiting health expenditure to four per cent might satisfy a short-term fiscal goal but, without a plan to mitigate chronic conditions costing nearly $30 billion annually, merely shifts the problem to the longer term.
Where is the preventive health strategy? It’s completely absent.
Hitting up smokers with further tax increases has become the lazy policy intervention. It is unfair in two ways. First, we must be nearing the price point where the number of people that are influenced to give up by the price increases has become marginal, while the number that continue to smoke, and subsequently put their family’s financial circumstances at risk, continues to grow. Second, there has simply been nothing given back to preventive health. How on earth can government collect an additional billion dollars a year and not return a small proportion of this to preventive health programs?
A lot has been said about fixing Australia’s tax system. The Rudd Government’s chief villain was Treasurer Wayne Swan. He made a hash of Ken Henry’s fine work.
Scott Morrison has made some progress this week, albeit by largely appropriating the Opposition’s thoughtful and progressive work on superannuation and tax avoidance by multinational corporations.
But one area the government has again assiduously avoided, dare I say it, is reform to Australia’s ‘incoherent alcohol tax system’. In some respects, this budget makes things even worse.
First, by the modest scaling back of the outrageous Wine Equalisation Tax (WET) Rebate and not its abolition, it has reinforced the wine industry’s continuing sense of entitlement. And second, by introducing a new subsidy scheme for domestic ethanol producers (read spirit makers). Agrarian socialism lives on!
FARE’s Pre-budget submission called on the government to address the massive deficiencies in the alcohol tax system in the interests of improving Australia’s health.
FARE proposed abolishing the WET, taxing wine like other alcohol, and making an across-the-board ten per cent increase to all excise duties, to raise nearly $3 billion annually – some of which would be tagged to support a half-decent preventive health strategy.
This simple tax intervention would have done more to address Australia’s ailing health system than all the other measures put together, including the increase in tobacco tax.
It would have reduced alcohol consumption by ten per cent and provided funding for a long-term preventive health program – something an increasing number of Australians want and need.
Instead we have measures such as pausing the indexation of funding of alcohol and drug treatment programs, which will reduce the living standards of Australia’s low wage health workers further and limit the number of services available to people with dependency problems.
Sadly, on preventive health, the Australian Government continues to think small or worse; not at all.
Late breaking news
As if to emphasis my point that there is certainly no dearth of reports on chronic disease, and the gaps in its prevention and management, The House of Representatives Health Committee has just today released the report for its Inquiry into Chronic Disease Prevention and Management in Primary Health Care.
What is lacking of course is clear and strong recommendations on prevention.
Add comment