Image for Can the Liberals change on health?

*Pic: of Malcolm Turnbull by Bob Burton.

Well, at least he said it. Three days after a dismal election result, Malcolm Turnbull, faux-contrite, finally admitted that his party’s record on health might have had something to do with the result.

‘We have to recognise that a material number of Australians were sufficiently concerned about our commitment to Medicare that they changed their vote.’ he said. ‘And that is, that’s something, you know, we need to address.’

And that was it. None of his ministers were prepared to accept that actual policy, rather than Labor’s ‘Mediscare’, had anything to do with their defeat. Peter Dutton, the former health minister who was behind the disastrous $7 co-payment, dodged questions on the issue. Julie Bishop , far from offering any word of contrition, said the Coalition should have been more negative.

Scott Morrison, who more than anyone must bear responsibility for the result, continued his familiar one-note tune as if no election had intervened. He was prepared to accept that Tony Abbott and Joe Hockey made some mistakes, but not him. Not his own refusal to reverse previous cuts, not his own decision to continue the Medicare rebate freeze for another four years.

If they are able to form government, Morrison told AM, the Coalition will stick with its current approach to health. ‘We can’t have the health system being a money pit where the argument is just about how much money you throw down the hole. The system has to be effective and it has to be efficient.’

No mea culpa there.

Eric Abetz blamed GetUp.

Nobody in the government accepts the basic reality of health economics: that when governments stop paying for health care, those costs do not magically cease to exist. They are instead transferred to individuals who have to foot the bill themselves whether they can or not, through insurance premiums or out of their pockets. And because the government has much more market power than any individual or any insurer, we inevitably end up paying more for a privatised system that’s much less efficient and much less fair.

In Tasmania, the electoral price paid for the Liberals’ long-standing approach to health policy has been uniquely high. The state party now has no members in the house in which governments are made.

Will Hodgman says his federal colleagues, though not himself, have lessons to learn from the result. His own government’s health and education policies, he apparently believes, are going swimmingly.

‘I think the biggest take-out was that clearly issues of health and education are critical to Tasmanians,’ he said. ‘We have issues here in Tasmania that we are tacking head-on. We are investing more, and reforming a system that has not worked well.’

There was no acknowledgement that he has cut real hospital funding in three successive budgets, or that by the end of the current forward estimates, long-term hospital costs will exceed funding by 30%. No acknowledgement of the rolling crises and regular scandals. No acknowledgement that the state’s doctors, nurses and patients may have a point when they say his government’s budget-cutting is having disastrous results.

If the Liberals really did reverse their long-standing discomfort with universal health care, the nation and the party would be far better off. There is no doubt about what the majority of voters want. And if the conservatives’ historical attitude does not change fundamentally and convincingly, winning elections will continue to be more difficult than it needs to be.

The problem, though, is that universal health care ‒ the right of all citizens to hospital and other health services ‒ strikes at the heart of conservative views on what governments are for.

That view is based on the supremacy of free markets as the only reliable way of distributing wealth, and the notion that governments are invariably less efficient than private enterprise. That has been the essence of classical and liberal economics for three hundred years.

Its weakness is that it tends to ignore the instances in which markets fail to be either efficient or fair. And it transcends any split within the Liberal Party between ‘moderates’ and ‘conservatives’. Those differences are about power and social attitudes, not about economics or the role of government.

The rhetoric may change, as it has before. But the Liberal Party is prevented by its core beliefs from giving the Australian public the kind of health system they have been demanding for the past seventy years.

*Martyn Goddard is a Hobart-based policy analyst specialising in health issues. He is a former journalist and ABC documentary maker who became involved in health policy during the AIDS crisis in Sydney. Since then he has been a member of the main Commonwealth advisory bodies on AIDS and hepatitis and was the first consumer member of the committee that lists drugs on the PBS. He was also health policy officer for the Australian Consumers’ Association. For the past decade he has concentrated on examining and explaining Tasmania’s health issues.

Crikey: Pssst, Abetz: GetUp is not a charity, does not care what you think GetUp donation’s aren’t tax-deductible, so you’ll have to try harder, Senator.