Croakey is so pleased to welcome back El Gibbs with this special #CripCroakey post.
El Gibbs writes
I had a different election this time around than I normally do. Instead of planning media releases, and finding volunteers for polling booths, I was in hospital doped up on morphine then home recovering for almost the whole eight weeks. I missed most of the stunts and promises and campaigns, but I didn’t miss ‘Mediscare’.
The ALP made much of the idea that the Coalition were planning to do something unspecified but awful to Medicare that would take away the power of those little green cards.
One of the reasons that a campaign about our public health system had so much impact was that people value what Medicare represents – universal, publicly available health system – and because being sick can be damn scary.
Three days after working late on the Federal Budget for work, I was sent to the local hospital emergency department for some IV antibiotics for a nasty skin infection. One scan later, and hello congestive heart failure.
I was admitted straight away, seen by specialists, cared for by nurses, given medications and had my wounds dressed. I got a bed in a ward, doctors, drips, and some very in depth conversations about exactly what heart failure was.
In the two weeks that followed this terrifying diagnosis, I barely paid any attention to the world outside my hospital room. I was instead occupied with questions, fears and my usual battles with doctors.
At night, when I couldn’t sleep, nurses checked in on me, and sat with me when I wept until I was able to get pain relief.
During the day, they explained what having heart failure meant, and organised the tests I needed to have done.
When I left hospital, other parts of the health system kicked in and it all mostly worked as it should. The community nurses came twice a week, my GP helped me understand what on earth was going on, the outpatient cardiac clinic at the hospital kept an eye on me and I started cardiac rehab, lifting weights and finding out more about my broken heart.
I had a frightening morass of new specialists to navigate, new terms to learn, a life-threatening diagnosis, and – literally – had to change almost everything about my life.
But not once in this whole awful time was I asked anything about money. All I was ever asked for was my little green Medicare card. That card meant that amid all this chaotic terror, I didn’t have to be afraid that I couldn’t afford the care I needed.
Those little green cards
This is hardly unique to my experience. Australians like our public health system. Research and opinion polling tells the same story – having a universal health system that isn’t only available to the well-off is a national treasure, is something we all value and fear any changes to. Those little green cards that we pull out in emergency, in the doctor’s office, when getting a blood test, are part of the safety net that catches everyone when they are sick.
Australians understand this and value it highly.
Threats to this system were flagged in the notorious 2014 budget with plans for a Medicare ‘co-payment’ for doctors’ visits. This meant that people would be charged a fee on top of Medicare to visit the doctor. Also announced were changes to Medicare rebates to doctors and for pathology tests, and changes to the management of chronic health conditions, like diabetes. All of these changes meant people were going to be paying to access these services, services they currently got as part of the safety net. I have been to my local GP and pathology collection centre a fair bit recently, and noticed the prominent signs up talking about these changes to bulk-billing.
All of these had added to a growing sense of concern around the future affordability of healthcare – moving away from the idea that Australia has a public health system available for all, to one where access to care is only available for those that can pay. Concerns are raised that health spending is out of control, yet it is the lowest it has been in 30 years.
This created fertile ground for a scare campaign about Medicare to take root and flourish. The most effective kinds of communication involve emotions, and political communication is no exception. An ad that triggers some kind of feeling – anger, fear, hope – is able to convey a message far better than a stark injection of facts or data. It also helps that the Coalition have 40 years of form around dismantling Medicare.
No other information about problems with the way Medicare is working or the rebate system to doctors or even the changes to the pathology funding system even got a look in. Neither did the actual inequities in the current health system that mean that many people don’t get anything like the health they need and deserve, even with Medicare.
The talismanic little green card though, and any threat to what that card represents, was used instead to trigger the emotions that everyone has around being sick. Everyone knows the horror stories about heart attacks or car accidents bankrupting people in the US. No one wants that here.
Being in hospital is just about always a pretty scary time. I have been in hospital many, many times, but usually for pretty boring and routine treatment. This time I was very, very sick, with a heart that was barely functioning, and an infection that turned septic.
I would have died if I had not ended up in hospital and got the urgent treatment that I needed.
Fears about Medicare are real
Since I left hospital, and moved into the next stage of my treatment, I have got the medication I need, and access to the facilities and expertise that have meant that I am recovering well. Again, at no stage has my ability to pay for this treatment been part of the conversation about having this treatment. The goal has been simply to improve my health, as much as is possible.
The very idea that there would be a threat to this kind of health system is terrifying to someone like me, with an existing chronic health condition, plus a crucial new exciting bit of me that doesn’t work properly. That access to the health care I need, in all its forms (community and hospital) would be dependent on how much money I have, is something that seriously keeps me awake at night. And I suspect that I am not the only one.
I only have the luxury of being awake at night to worry about it because of the Medicare safety net.
Fears about Medicare are real and need to be taken seriously by whoever is in government. Our public health system is a highly valued piece of social infrastructure that is used by everyone, sometimes at some of the scariest times of their lives.
Perhaps having a chronic health condition means that people don’t go into politics, or don’t end up working as a political staffer, or on political campaigns, so my kind of story doesn’t get talked about much, but I have done all of these things. I can only work, and pay taxes now, by virtue of our Medicare system. I’m a lifter and ‘taxed’ because of Medicare.
Perhaps instead of complaining about ‘Mediscares’, people in politics might benefit from actually talking to people who are scared by any threat to Medicare.
Because being sick is scary enough as it is, without having anything else to worry about.
You can track the #cripcroakey series here.
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