Medicare Gold: a bird without wings.

"Medicare Gold", was the grand notion that was supposed to win the federal opposition party and the ghastly Julia Gillard in particular, the last election.

"All persons over the age of seventy-five will be eligible for free health care in private facilities", she boasted.

If you haven't noticed, the world's population is aging. You only have to look around you to know there are already a lot, and I mean a LOT of people over the age of 75. Moreover, the number of sick over seventy-fives is set to explode as so many of the baby-boomers fall ill with obesity-induced diseases.

Conveniently, the opposition party has forgotton that health care actually needs doctors. Not just surgeons but physicians as well.

As one of those physicians who, presumably, was going to have to look after all those over seventy-fives in the private sector, my response was "Ha!! You and what army are going to make me!!"

I'm sure most of my colleagues were thinking exactly the same thing.

Thankfully, Medicare Gold seems to have gone the way of the DoDo.

The case of the disappearing office.

If we put aside for one moment the very obvious benefits of staying well and not coming to hospital at all, I'm confident that most people in hospital would prefer that their medical staff (consultant, registrar and intern) discuss laboratory and radiography results in a private setting ie not in the middle of a corridor. Hence, an office for doctors, in which they could do this, would be useful.

It would be particularly useful if the office contained a computer terminal, as that is where one has the greatest chance of finding laboratory and radiography results (since pride in the careful filing of hard copy results is as rare as it comes).

There once was an office for doctors, with a computer terminal in it. Mysteriously, one day, the computer crashed and was unable to be resuscitated. I asked when it would be resurrected and was told "in due course".

A couple of ward rounds later, the computer was gone leaving only a dusty footprint on the desk. 'How amazing', I thought, 'they are actually going to get it fixed.' Then, when I looked again after a week or so, there was still no computer. I asked when the computer would be back and was told, "Well, you weren't using it so it has been permanently removed. "

The very next day, I found that a doughnut-hoovering senior-echelon nursing administrator had plonked herself, her computer, her filing cabinets and her pedestal fan in the office. When I asked about that, the reply was predictable as night following day: " Well, you weren't using the office, so it has been permanently reassigned."

I 'reassigned' myself to another computer terminal, the one in full view in the middle of the corridor and thought, 'Oh well, the situation is unlikely to get worse.' How wrong could I be! Now, the corridor itself has started disappearing! It's being partitioned into more offices for more nursing administrators, their computers, their filing cabinets and their pedestal fans!

You might think this is just a petulant whinge about a simple turf war and it's time I had a long hot cup of chamomile tea and a lie down. Although I readily admit I may have a few roos permanently residing in the top paddock (and the odd venomous hamster or two - thanks Jem), I'm pretty sure this sort of underhandedness portends a more malign state of affairs.

Uncle Beattie sets an ugly tone in this current government and it filters all the way down to the workplace. Just as it is with any form of governance, all is well in a socialist democracy if no one takes the politico-philosophical credo too seriously. Here, however, we have a man who despises and probably fears anyone who is prepared to think, to challenge and to take responsibility for decisions. He buffers all decisions at all levels of government, right down to the work place with faceless, nameless working parties.He sees an office for doctors as elitist and therefore dangerous and by definition, to be avoided at all costs.

If it were just about elitism, I could understand and agree. However, anti-elitism is, in this case, a label for dis-empowerment and subjugation.Historically, we have seen the tragic results of this sort of politics.

Consider, firstly, Nazi Germany where the independence of the medical profession was completely lost to the state resulting in unethical practice drift. At the other end of the spectrum, consider the late Soviet era when Eastern bloc doctors earning less than street cleaners, completely worn down and isolated from their international colleagues, had to stand back and watch a perfectly good health system go down the gurgler.

Some people ask me (when they're not suggesting the chamomile tea and the lie down), well, if you think it is so bad, why not go into full time private practice? I could do and would probably be happier and definitely wealthier but, you know, sometimes, it's not about me or about the money. Some of us need to stay and fight for proper filing and computers and offices and corridors because they contribute to getting people well again.


bm said...


Now now zimble... we've discussed this tendency to conflate socialism and bureaucratism. Perhaps some words from Che might help.

The following is from 'Against Bureaucratism' (Feb 1963)"Bureaucratism, obviously, is not the offspring of socialist society, nor is it a necessary component of it. The state bureaucracy existed in the period of bourgeois governments with its retinue of hangers-on and lackeys, as a great number of opportunists — who made up the “court” of the politicians in power — flourished in the shade of the government budget. In a capitalist society, where the entire state apparatus is at the service of the bourgeoisie, the state bureaucracy's importance as a leading body is very small. The main thing is that it be permeable enough to allow opportunists to pass through, yet impenetrable enough to keep the people trapped in its nets."

Those of us with long memories recall an era when the most rabidly right-wing government in our state's history presided over corruption, cronyism, and bureaucratic abuse that makes Beattie's (not-so-socialist) operation look like a sunday school picnic.

BM

P.S. Have you been reading Dr Miguel Faria's books? If so, you should know that when not railing about 'socialised medicine' he keeps busy by railing against gun control. He also described the British arrest of Pinochet as "holding Gen. Augusto Pinochet hostage".


BM many thanks for your comment.

I know, I know. My name is Zimble and I am a conflater.

In my totally inadequate defence, the 17th was a very bad day and who better to lash out at in the one breath than politicians and office stealing bureaucrats.

And, you must admit I have been very good lately: I haven't tried to conflate or conflagrate (or detonate for that matter) anything for some time now.

I really don't care whether Uncle Beattie is the re-incarnation of Mao Zedong or a descendant of Genghis Kahn. What I do care about is the loss of transparency in decision making and the devaluation of the small but important things that allow for good care.

The dark before it got darker.

I first met 'Uncle' Peter Beattie in the dining room of the Jardin Hotel on Thursday Island, when, as then health minister for the state of Queensland, he was hosting a dinner for the launch of a new health exercise video across the Torres Straits.

It was about 1995.It was buffet night at the Jardin. As I went back and back again to sample the various dishes on offer, the man introduced himself to me on no less than three occasions. "Hello, I'm Peter Beattie" his Macleans smile dazzled.

Later that evening, as I pecked at a piece of coconut crumble, I looked over and there he was, lording it up at a table of local elders. There were no women in sight. The elders seemed to hang off his every word. Who was schmoozing whom, I wondered.It was interesting at the time, in a sneer inducing way, to see a politician in full flight.

Little did I know the damage this man, as Premier, and his cronies would wrought on the state health system over the next decade.