I am about to make some shocking suggestions:
Health is not a human right.
The Morrison-Turnbull budget cuts to Medicare Rebates are not completely bad.
Running in the dark this morning, I noticed the illuminated sign outside the local hospital. It read:
I felt unhappy reading that. A hospital is a place where human beings help other human beings with their health. The meaning of a hospital cannot be realised with that label. ‘Private’ tells the reader that some humans will be admitted and others turned away. Privacy as a personal property might well have been eclipsed by the internet, but ‘private’ survives with this message, unkind to some, saying ‘keep out.’
If health were a right we’d need to outlaw Down’s Syndrome, premature death and disability. We would legislate and make ourselves ridiculous. The error of language here betrays an error of thinking. We cannot assert a right to health, but we can create a right to equal access.
I am a private doctor. I am a public doctor. The public is composed of private persons. I treat one person at a time, privately. That is, personally, confidentially; two humans together, doing what every human does in a lifetime: ordinary transactions of care.
Doctors generally share a number of characteristics. We are serious, careful, committed and proud. We are defensive of our liberties, self-righteous and voracious of cures. We are expensive; I mean someone, somewhere, always pays for cures. In its new budget the government has pegged Medicare rebates. This skewers doctors and patients: either the doctor loses or the patient loses. There is nothing new in this.
When Hayden-Whitlam introduced Medicare I bulk-billed everybody. I thought it was a wonderful thing that a person, be she rich or poor, might consult a doctor equally. I thought so then and I think so still. To assure doctors they would not lose, the Hayden-Whitlam Government set up a referee who increased the rebate in pace with the rising costs of practice. This was costly. So the government told the referee to stop indexing rebates. And I stopped bulk billing. Often patients found themselves facing a choice – see the costly doctor or feed the family. When this occurred all doctors I know abated their fees so the patient might afford both cure and food.
What a government does in tightening benefits is to create the need for a new force to operate in care. The force is not one of rights but of grace. The doctor and the patient gaze upon each other as we did through all history, unmediated by refunds and rebates, freer now of the obscuring presence of the insurer. Two humans in a situation of human need.
The words ‘Private Hospital’ jolt me. They remind me that health is not merely a matter of economics or of civil rights, but of civil opportunity.
Quite right – re the blurring of rights and equity of access . Also the notion of ‘private’ in health provision has long been a screen for medical professionals keeping equity in access and charges ‘private’ from ‘public’ and systemic scrutiny. More dubious when it’s done in the name of protecting people’s freedom to choose ‘better’ treatment via ‘private’ practitioners . We’re are just witnessing ongoing ideological push back against universal insurance systems eg public health and bulk billing.
I agree emildvz1
Doctors always blest about the interests of patients as if we had no material interests of our own
I think we ARE concerned for patients but often express ourselves with such purity we seem unaware of multiple interests
The problem here is one where true altruism and respectable self-interest intersect seemingly unaware of each other
As the lady remarked in ‘the importance of being ernest’ -the truth is seldom pure and NEVER simple
In this, as in so many things, we seem to have lost our way. That same government that sabotaged the indexation of payments gave away millions of dollars in tax cuts to middle class families to pay for televisions and holidays. It’s bizarre that there was no outcry.
Thank you for writing,Lisa hill
Great blog, Howard. Thanks,
Susanne and Ross
______________________________________ in Spain for the time being phone: +34 608 946 123
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Come back you delinquent exile:
I have a stuttering child who needs you
Wonderful to hear from you susanna Goanna