Friday, 28 November 2014

Coalition's GP co-payment strategy foundering on the rocks of confusion

The government briefed the press gallery it was shelving the co-payment, but then the health minister Peter Dutton suggested it could be imposed via regulation. Photograph: Mike Bowers/Guardian Australia.
A brief history of political barnacle cleaning shows how comprehensively the Abbott government is botching it.
John Howard popularised the “cleaning the barnacles” metaphor to explain abandoning or shelving policies that were becoming a political liability. In the lead-up to the 2007 election, for example, the term was applied to his decisions to abandon legislation paving the way for an Australian nuclear industry and securing the return of prisoner David Hicks.
But barnacle cleaning only works if the difficult issue is neutered. It works best if the media can be persuaded to present a government’s acceptance of parliamentary or public opinion defeat as some kind of victory for strategic realpolitik and listening to the electorate.
The Abbott government appeared to be successfully executing this manoeuvre. It briefed the press gallery it was shelving the $7 GP co-payment (which it effectively already had, having long given up on attempts to persuade the implacably opposed Senate crossbench to pass it) and that it was “going back to the drawing board”.
But then the leader of the government in the Senate, Eric Abetz, insisted the government was, in fact, standing by the policy, the treasurer Joe Hockey said “our policy stands” and the health minister, Peter Dutton, suggested the government could try to impose it via regulation.
The government could indeed regulate to reduce the fee paid to doctors by $5 per visit – as its co-payment policy envisages – effectively trying to force doctors to implement a policy the parliament has rejected (and 66% of the electorate disapproves of, according to an October Essential poll).
But that regulation could also be disallowed. (All regulations can be disallowed if they are “legislative in character”, which this would surely be). The only advantage for the government is that to pass legislation it needs 39 votes, whereas to survive a disallowance motion it needs 38 – because a tied vote fails. Given the public statements of the eight Senate crossbenchers, it seems unlikely the government would manage 38.

It seems especially unlikely after one of the government’s own senators, Ian MacDonald, indicated he could cross the floor and vote against any attempt to sneak the change through via regulation (at the same time blasting his own government for ramming through the reintroduction of fuel tax indexation in that way).
And in any event, the government is making it absolutely clear that it continues to believe the co-payment is correct and essential policy.
The approving “barnacle cleaning” headlines have been replaced by “confusion reigns”. And with different ministers apparently saying different things, it really is confusing.
“Barnacle cleaning” is a sound bite intended to convey the impression of a satisfying exercise that leaves the ship of state clean and unencumbered to sail into smoother political waters.
This confusion just adds to the government’s mounting political disarray - it cops all the flack for sticking with the unpopular policy and continuing to try to implement it, with none of the policy benefits it claims it would achieve. It angers the doctors and the Senate and the public. It angers everyone concerned about the impact of the policy on the health of all those groups in society who can’t afford to pay.
It looks like a worst-of-all-worlds strategy, similar to the Rudd government’s hopelessly confused attempts to “shelve” its defeated emissions trading scheme for at least three years, while continuing to say it would be implemented eventually, and without any idea what policy would replace it.
Presciently, Tony Abbott told his party room on Tuesday (in the same speech in which he promised to clean the barnacles) that the government’s “historical mission is to show that the chaos of the Rudd/Gillard years is not the new normal.”
The Australian Medical Association president, Brian Owler, told Guardian Australia on Thursday, “We just need to know who is running health policy in this country and what it is … right now it looks like a total mess.”

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