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The article below was published in "Nation Review", Vol. 3, No. 31, May 18-24, 1973, p. 946.



The folly of nationalizing Australian doctors



By John Ray (M.A.; Ph.D.)

The Labor government's attempt to deny doctors the right to choose their employer is a violation of one of our most basic democratic rights. Labor has made it clear that its ultimate objective is to turn all doctors into salaried public servants.

Anybody who has had firsthand experience of government bureaucracies (and who hasn't?) ought to be resisting with all their might and main this attempt to bureaucratise medicine.

We all know how contemptuously public servants already treat us. Do we really want to convert our friendly family doctor into this sort of indifferent, impersonal public employee? Under the present system, the doctor has some incentive to communicate with, and endeavor to understand, his patients. He might lose our custom (and his income) unless he does. By contrast, nothing but a bomb can shift a public servant.

One also wonders where Mr Cameron is now. We are so used to hearing him defend unionists and their strikes by talking of their right to withdraw their labor if things don't suit them. What about doctors? Don't they have similar rights? Mr Cameron's guiding rule seems to be that a Labor government should champion any claim that unionists make and do everything to see that unionists get their way.

What about the AMA - the doctors union - why aren't they included in his patronage? To be consistent he should be defending their right to determine their working conditions as vigorously as he has defended the rights of other occupational groups.

It is also clear that there is a shortage of doctors. Anybody who has had to spend hours in a waiting room knows that. It is equally obvious that totally free medicine would encourage yet more people to go to doctors for even minor complaints. Do we really want to wait even longer in waiting rooms while doctors see all the extra people? That is what Labor seems bent on condemning us to.

Are they suddenly going to create a couple of thousand of extra doctors out of thin air to cope with all the extra patients? It is about time they told us. As far as one can see at the moment, we are going to have poorer medical service under Labor - not better.

Perhaps the saddest aspect of the whole affair is that better alternatives that would achieve Labor's stated objectives of improving the availability of medicine are already available. If only Labor had the imagination to learn from other peoples experience, there would be no need for any of the present commotion.

One alternative that would achieve more than Labor's present scheme, and do it with a minimum of unwelcome change, would be to pass a law requiring medical benefit funds to give special low rates to people in the low income brackets. If, as Labor says, the funds are making too much money, this should certainly cure it while at the same time providing the social justice that Labor is so concerned about. In these circumstances, Labor could also then afford to protect people from themselves by passing a law making it compulsory for everyone to join a fund of their choice. Since Labor is going to take compulsory health contributions out of our pay anyhow, why not make those contributions payable to private funds if people so desire?

The best alternative of all, however, is probably prepaid medicine. This was an idea initiated in the United State by the Kaiser corporation for its employees. Under this system, you have a network of private hospitals or medical centres and you subscribe a regular monthly amount to the hospital nearest you - not to some independent medical benefits fund.

You are then entitled to free treatment at that hospital (or, alternatively, very cheap treatment) and all other hospitals with which that hospital has a reciprocity agreement. A small additional charge could also be made if you go to a hospital other than your own.

The effect of this arrangement is that the hospital has an incentive to get you cured as quickly and as efficiently as possible. You have already paid them your money. They don't gain any more by you staying in longer. If they are inefficient, they will have to charge higher subscriptions to cover their costs and this would encourage you to transfer your subscription elsewhere. In other words, inefficient or unpleasant hospitals would lose all their subscribers and would soon go broke. They would have every incentive to make your stay as pleasant, as effective, and as short as possible.

If the Labor government is going to spend money on health, it would be best spent giving loans and subsidies to encourage the setting up of such private comprehensive medical centres and hospitals.




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