Health guru Professor Stephen Duckett writes:

I’m sick of the sniping at Medicare Gold – the latest being Christian Kerr’s aside in today’s Crikey. Medicare Gold is the only health policy around that does anything about one of the problems which bedevils the health system: the discontinuity between the Federal and state Governments in health care. Having one level of Government responsible for care for a significant user group would allow for better designed systems and better care for the elderly. It would give the Commonwealth government a financial incentive to deal with people who are in public hospitals (consuming high cost resources) while they are awaiting federally-funded residential care etc etc.

It is not/was not financially irresponsible, but rather provided a platform to deal with the issues of an ageing population. There are no other policies in the public domain which do anything about these issues.

Professor Stephen Duckett FASSA
Professor of Health Policy, Dean of Faculty of Health Sciences and Pro Vice-Chancellor (Learning and Teaching)
La Trobe University

CRIKEY: Stephen Duckett was head of the federal Health Department under the Keating government and is one of the big names in Australian health policy, so we’re honored to have him writing to Crikey. And he’s certainly right about the problem of state vs federal responsibility. Whether Medicare Gold was a good way to go about addressing it is another question – one that we’ll probably now never know the answer to.

Why Stephen Duckett defends Medicare Gold

Subscriber email – 20 January, first edition

Consumer advocate and political reformer Vern Hughes writes:

There is a reason why Stephen Duckett is “sick of the sniping at Medicare Gold” – he is the intellectual father of the policy. At a pro-Labor Health Summit in Canberra in 2003, he presented a proposal for extending Medicare for the over 70s, which was Medicare Gold in all but name.

The trouble is, Duckett’s thinking is still locked in a framework that can’t look beyond the public sector, and still places its faith in public sector bureaucrats to make the right decisions on behalf of patients. By consolidating Commonwealth and state money and private insurance into a single bucket of funds for the elderly, the number of financial controllers is cut to one. But what if it is still the wrong one?

The rhetoric of “better designed systems” was always alluring in socialism, it was just the practice that didn’t work out. Yes we need to consolidate health spending, not in one or other agency of government, but in the hands of the consumer and their agents or brokers. That’s the starting point for health reform that is centred on the consumer – not the bureaucracy or the medical guilds.

Stephen Duckett’s love affair with Labor Governments

Subscriber email – 20 January, second edition

A feral right wing thinker writes:

I enjoyed Vern Hughes’ wonderful little note on the esteemed Stephen Duckett. Duckett is a long-time Labor activist who parachutes from one Labor Government to another.

As Crikey will well remember, he headed up the Health Department under former Victorian Premier Joan Kirner, but lost his job under Jeff Kennett. He then went up to Canberra to work for Keating but when Keating lost, he came back to Victoria and scored a chair at Latrobe and continued to make overtly partisan criticisms of the Kennett Government. Now with Bracks back in power, he is on a string of health advisory boards in Victoria.

Duckett parachutes from one Labor Government to another. There is no doubt that he would have had a major role in Medicare Gold. There was probably an expectation on his part that in event of Latham victory he would have been heading up to Canberra to run the Health Department for a Latham Labor Government.

It was a little disingenuous of him to attack Christian Kerr over his bagging of Medicare Gold which, after an initial good splash, did nothing for Labor in the election. Julia Gillard is still trying to live down comparisons with Peter Shack whose stuff-ups did the Liberals no good in 1987 on health.

No one wants to seem want to own up to being behind Medicare Gold. It would really appear that while victory has many fathers, defeat is an orphan.

Stephen Duckett on Medicare Gold again

Subscriber email – 21 January

Health guru Professor Stephen Duckett writes:

It’s good to see some debate about Medicare Gold emerging, although it’s a pity it so quickly involves ad hominem attacks from the feral right wing thinker. Almost nothing about my career in his/her comments is accurate: I didn’t head up the Victorian health department under Kirner, I was promoted under Kennett not sacked etc. For the record, I was appointed to a ‘string of advisory boards’ by the Kennett government as well as the Bracks government.

In contrast, Vern Hughes makes a contribution arguing the merits of the policy. Medicare Gold essentially abolished the public:private divide for people over 75: people over 75 would have been given the right to chose whether to be treated in a public or a private hospital. The policy is close to Hughes’ approach of ‘putting the money in the hands of consumers’. It was something of a ‘Third way’ policy incorporating both equity elements but delivery including the private sector (hence the support from private hospitals in the campaign).

In terms of provenance, yes I was involved in the design (publicly so during the campaign) so defeat is not an orphan after all! Medicare Gold polled well for Labor but the election was lost for Labor on grounds of John Howard’s choosing, not Medicare Gold.