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‘Killer Budget’ attacks prevention and primary health care

‘Killer Budget’ attacks prevention and primary health care Editorials doi: 10.1111/1753-6405.12276 creating barriers to primary care access for disadvantaged Australians and increasing ‘Killer Budget’ attacks prevention and burdens on hospitals. The Australian Medical Association president, Brian Owler, identified the impact on patients, “particularly those primary health care most vulnerable in our society: those in aged 1 1,2 care, children, and really, people that can’t Michael Moore, Heather Yeatman afford to pay this sort of co-payment”. 1. Public Health Association of Australia, University of Canberra 2. School of Health & Society, University of Wollongong, New South Wales Undermining good primary health care in the long term is a $5 co-payment for PBS-listed medicines, the abolition of the National n budget night, the Public Health life-changing medical breakthroughs. By Preventive Health Agency, General Practice Association of Australia broadcast contributing now through sensible savings in Education and Training Limited and the Oa media release with the headline our health Budget we can become a global Australian Medicare Local Alliance. These ‘Killer Budget’. Rather than a quick death, leader in medical research.” were preventive health and primary health this is a budget that is so inequitable it will His argument simply missed the importance care agencies focussing on reducing pressure invariably mean those who are less well-off of prevention. The $20 billion medical and costs in hospital and acute settings. will be even worse off. Nowhere will this have research fund in the 2014-15 budget referred National agencies with an emphasis on more impact than on the poor. to by the Treasurer was deliberately a medical, primary health care and preventive health are The Abbott government’s first budget rather than a health and medical, fund. vitally important. focused on dollars rather than economics. In marked contrast, the report of the The Federal Budget was a ‘killer’ in multiple A headlong drive for a surplus was applied, 1 Australian Institute of Health and Welfare ways and will be for many years to come. when the alternative framework using illustrated how chronic non-communicable And this is only considering the health cuts. Australia’s Triple A credit rating could have diseases were really going to be the major Cuts in social welfare, Indigenous programs, benefited the whole community. Almost challenge to better health outcomes. These education funding and the environment $8.6 billion was proposed to be cut from the will not be solved through “new cures and portfolio will have major ramifications for Health Budget over four years. This budget treatment”. health outcomes into the future. diminished further the investment in public The comments of the Treasurer echo a budget Most alarming was the process of creating health and prevention, already a poor 2.2% of reflecting the current worldwide reactionary significant policy change under the rubric the total health budget. political philosophy with its emphasis on of the generic budget process. This signals The attacks on prevention and primary health small government, less intervention and more a major change in the political process care may not be deliberate but simply fit into 3 personal responsibility. in Australia, with potentially far-reaching a part of a broader process of cost-shifting, There have been great advances in health impacts on public health. and responsibility to the States and Territories. through medical research and technology. While the Federal Government’s bottom line However, the greatest advances in health References might look better in a few years through such for all in the community have come through cost shifting, taxpayers will still be paying the 1. Australian Institute of Health and Welfare. Australia’s prevention. And prevention has been most Health 2014. Australia’s Health Series No.: 14. Catalogue bills – just paying different taxes to State and successful when government faces the No.: AUS 178. Canberra (AUST): AIHW; 2014 [cited Territory governments. 2014 Jun 29]. p. 46. chap. 4.Available from: http:// issues squarely, understands the extent to w w w.aihw.gov.au/Wor kArea/D ownloadAsset. The budget pushes all jurisdictions towards which health is socially determined and aspx?id=60129547575 an increase in the Goods and Services Tax 2. Treasurer Joe Hockey’s Address to the Sydney Institute. invests in efforts to improve health across the Sydney Morning Herald. 2014 [cited 2014 Jun 28] ;June (GST), a less equitable, regressive tax. Granted, 4 community. 12. Available from: http://www.smh.com.au/national/ at least the very, very wealthy are forced to treasurer-joe-hockeys-address-to-the-sydney-institute- Bowel screening received $80 million. pay some taxes – but regressive tax measures 20140612-zs5ok.html This was commendable. However, if they 3. Hall S. The neoliberal revolution. Soundings. 2011; expand the gap between the poor and the had applied root cause analysis, further 48:9-27. wealthy. The impact of the proposed GP co- 4. World Health Organization, 2012 Social Determinants investment would have been made into payment will be felt even more significantly of Health. Geneva (CHE): WHO; 2012 [cited 2014 research and campaigns around influencing Jun 27]. Available from: http://www.who.int/social_ by the poor and those living with chronic determinants/B_132_14-en.pdf?ua=1 diet to reduce the incidence of bowel cancer. illness. 5. Stewart B, Wild C, editors. World Cancer Report 2014. Conversely, there were cuts to Indigenous Lyon (FRC): World Health Organisation International In attempting to justify the $7 GP co- Agency for Research on Cancer; 2014 [cited 2014 Jun Affairs programs (exceeding $121 million payment, the Treasurer, Joe Hockey, ignored 29]. Available from: http://www.iarc.fr/en/publications/ over four years), dental health programs books/wcr/index.php the greater impact on the poor, preferring ($635 million over four years), the National 6. Transcript: AMA President, A/Prof Brian Owler. GP to focus on the reputational benefits to Co-payment. 2UE Sydney. 2014 [cited 2014 Jun 28]; Partnership Agreement on Preventive Health Australia’s medical researchers. He told the June 19. Available from: https://ama.com.au/media/ (exceeding $367 million over four years) ama-transcript-ama-president-aprof-brian-owler-2ue- Sydney Institute: “We must find new cures and the Partners in Recovery mental health sydney-19-june-2014 and treatments to make our health system 7. Keleher H. Planning for population health in Australia’s initiative ($54 million over two years). health reforms. Aust N Z J Public Health. 2011;35(2): sustainable and affordable into the future. The $7 co-payment for GP visits, out- 106-7. We are missing the financial scale that will of-hospital pathology and diagnostic Correspondence to: Mr Michael Moore, Public lift us from a clever partner for off-shore Health Association of Australia, PO Box 319, imaging services was a regressive measure, collaboration to a stand-alone initiator of Curtin, ACT, 2605; e-mail: mmoore@phaa.net.au 2014 vol . 38 no . 4 Australian and New Zealand Journal of Public Health 301 © 2014 Public Health Association of Australia http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Australian and New Zealand Journal of Public Health Wiley

‘Killer Budget’ attacks prevention and primary health care

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References (4)

Publisher
Wiley
Copyright
© 2014 Public Health Association of Australia
ISSN
1326-0200
eISSN
1753-6405
DOI
10.1111/1753-6405.12276
pmid
25091067
Publisher site
See Article on Publisher Site

Abstract

Editorials doi: 10.1111/1753-6405.12276 creating barriers to primary care access for disadvantaged Australians and increasing ‘Killer Budget’ attacks prevention and burdens on hospitals. The Australian Medical Association president, Brian Owler, identified the impact on patients, “particularly those primary health care most vulnerable in our society: those in aged 1 1,2 care, children, and really, people that can’t Michael Moore, Heather Yeatman afford to pay this sort of co-payment”. 1. Public Health Association of Australia, University of Canberra 2. School of Health & Society, University of Wollongong, New South Wales Undermining good primary health care in the long term is a $5 co-payment for PBS-listed medicines, the abolition of the National n budget night, the Public Health life-changing medical breakthroughs. By Preventive Health Agency, General Practice Association of Australia broadcast contributing now through sensible savings in Education and Training Limited and the Oa media release with the headline our health Budget we can become a global Australian Medicare Local Alliance. These ‘Killer Budget’. Rather than a quick death, leader in medical research.” were preventive health and primary health this is a budget that is so inequitable it will His argument simply missed the importance care agencies focussing on reducing pressure invariably mean those who are less well-off of prevention. The $20 billion medical and costs in hospital and acute settings. will be even worse off. Nowhere will this have research fund in the 2014-15 budget referred National agencies with an emphasis on more impact than on the poor. to by the Treasurer was deliberately a medical, primary health care and preventive health are The Abbott government’s first budget rather than a health and medical, fund. vitally important. focused on dollars rather than economics. In marked contrast, the report of the The Federal Budget was a ‘killer’ in multiple A headlong drive for a surplus was applied, 1 Australian Institute of Health and Welfare ways and will be for many years to come. when the alternative framework using illustrated how chronic non-communicable And this is only considering the health cuts. Australia’s Triple A credit rating could have diseases were really going to be the major Cuts in social welfare, Indigenous programs, benefited the whole community. Almost challenge to better health outcomes. These education funding and the environment $8.6 billion was proposed to be cut from the will not be solved through “new cures and portfolio will have major ramifications for Health Budget over four years. This budget treatment”. health outcomes into the future. diminished further the investment in public The comments of the Treasurer echo a budget Most alarming was the process of creating health and prevention, already a poor 2.2% of reflecting the current worldwide reactionary significant policy change under the rubric the total health budget. political philosophy with its emphasis on of the generic budget process. This signals The attacks on prevention and primary health small government, less intervention and more a major change in the political process care may not be deliberate but simply fit into 3 personal responsibility. in Australia, with potentially far-reaching a part of a broader process of cost-shifting, There have been great advances in health impacts on public health. and responsibility to the States and Territories. through medical research and technology. While the Federal Government’s bottom line However, the greatest advances in health References might look better in a few years through such for all in the community have come through cost shifting, taxpayers will still be paying the 1. Australian Institute of Health and Welfare. Australia’s prevention. And prevention has been most Health 2014. Australia’s Health Series No.: 14. Catalogue bills – just paying different taxes to State and successful when government faces the No.: AUS 178. Canberra (AUST): AIHW; 2014 [cited Territory governments. 2014 Jun 29]. p. 46. chap. 4.Available from: http:// issues squarely, understands the extent to w w w.aihw.gov.au/Wor kArea/D ownloadAsset. The budget pushes all jurisdictions towards which health is socially determined and aspx?id=60129547575 an increase in the Goods and Services Tax 2. Treasurer Joe Hockey’s Address to the Sydney Institute. invests in efforts to improve health across the Sydney Morning Herald. 2014 [cited 2014 Jun 28] ;June (GST), a less equitable, regressive tax. Granted, 4 community. 12. Available from: http://www.smh.com.au/national/ at least the very, very wealthy are forced to treasurer-joe-hockeys-address-to-the-sydney-institute- Bowel screening received $80 million. pay some taxes – but regressive tax measures 20140612-zs5ok.html This was commendable. However, if they 3. Hall S. The neoliberal revolution. Soundings. 2011; expand the gap between the poor and the had applied root cause analysis, further 48:9-27. wealthy. The impact of the proposed GP co- 4. World Health Organization, 2012 Social Determinants investment would have been made into payment will be felt even more significantly of Health. Geneva (CHE): WHO; 2012 [cited 2014 research and campaigns around influencing Jun 27]. Available from: http://www.who.int/social_ by the poor and those living with chronic determinants/B_132_14-en.pdf?ua=1 diet to reduce the incidence of bowel cancer. illness. 5. Stewart B, Wild C, editors. World Cancer Report 2014. Conversely, there were cuts to Indigenous Lyon (FRC): World Health Organisation International In attempting to justify the $7 GP co- Agency for Research on Cancer; 2014 [cited 2014 Jun Affairs programs (exceeding $121 million payment, the Treasurer, Joe Hockey, ignored 29]. Available from: http://www.iarc.fr/en/publications/ over four years), dental health programs books/wcr/index.php the greater impact on the poor, preferring ($635 million over four years), the National 6. Transcript: AMA President, A/Prof Brian Owler. GP to focus on the reputational benefits to Co-payment. 2UE Sydney. 2014 [cited 2014 Jun 28]; Partnership Agreement on Preventive Health Australia’s medical researchers. He told the June 19. Available from: https://ama.com.au/media/ (exceeding $367 million over four years) ama-transcript-ama-president-aprof-brian-owler-2ue- Sydney Institute: “We must find new cures and the Partners in Recovery mental health sydney-19-june-2014 and treatments to make our health system 7. Keleher H. Planning for population health in Australia’s initiative ($54 million over two years). health reforms. Aust N Z J Public Health. 2011;35(2): sustainable and affordable into the future. The $7 co-payment for GP visits, out- 106-7. We are missing the financial scale that will of-hospital pathology and diagnostic Correspondence to: Mr Michael Moore, Public lift us from a clever partner for off-shore Health Association of Australia, PO Box 319, imaging services was a regressive measure, collaboration to a stand-alone initiator of Curtin, ACT, 2605; e-mail: mmoore@phaa.net.au 2014 vol . 38 no . 4 Australian and New Zealand Journal of Public Health 301 © 2014 Public Health Association of Australia

Journal

Australian and New Zealand Journal of Public HealthWiley

Published: Aug 1, 2014

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