The architect of the GP co-payment has hit out at the Turnbull government, accusing it of having no health policy. He also savaged the performance of Health Minister Sussan Ley and her predecessor, Peter Dutton over their inept handling of the policy.
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In a scorching address to the policy think tank the Centre for Independent Studies (CIS), Terry Barnes said the government had brought the so-called Mediscare campaign on itself by failing to set out its own plans for the healthcare sector. He said the coalition showed no sign of learning the lessons of the election campaign, despite it almost costing the government office.
He also suggested further radical reforms to the idea of universal healthcare, saying drunks, smokers and diabetics did not deserve free treatment because of their lifestyle choices.
Mr Barnes, a former advisor to Tony Abbott when he was the health minister, described pursuing structural reform within the Medicare system as a "diabolical task" because the system is a "sacred cow" and tinkering with it is like "killing Bambi."
He hit out the Australian Medical Association (AMA), saying the doctors' union is one of the country's most powerful "vested interests," and that his experience with the GP co-payment showed it was impossible to reform health policy without making a "blood sacrifice" to the AMA.
"It's up to governments and advocates to make clear how that change would work, what the benefits will be and how patients, consumers and taxpayers will be better off," he said.
"And from my own experience, it also means that you've got to be willing to make a blood sacrifice to the Ravenous Bugblatter Beast of Traal, for those of you who remember Hitchhiker's Guide to the Galaxy, which is actually known in Australia as the Australian Medical Association.
"I fail to understand why the Turnbull government went into the recent election campaign without a health policy ... they almost lost the election over Mediscare. I haven't seen any real evidence of them forming a narrative after the election and making it clear that they see health and health reform and health policy and stability of the system as a top priority for a second term coalition government."
Mr Barnes said "the bright spark" who proposed linking the GP co-payment revenue with a giant new Medical Research Fund should have been sacked.
"They had no sense of policy and they had no sense of politics and I suspect their knowledge of the healthcare sector could be written on the back of a postage stamp, and I name no names but you can possibly guess who I am talking about," he said.
And he said Mr Dutton's replacement, Sussan Ley, had not been much of an improvement in prosecuting the GP co-payment.
"The government's attempts at explaining and defending their changes were awful, and the change of minister in December 2014 made no real difference," he said.
Mr Barnes said people who choose to "destroy" their own health should pay more.
"The whole population starts to show the acute and especially chronic consequences of our 'soft and namby-pamby' sedentary, self-indulgent and lazy lifestyles," he said.
"Smokers, for instance, shouldn't expect to be top of the queue for expensive treatments arising from their habit. People who attend emergency departments to be patched up after alcohol-fuelled brawls should be given the bill, not expect 'free' treatment. People who contract Type 2 diabetes because of their lifestyle choices shouldn't expect everyone else to pick up the full tab for their imprudence."
Further, he called for a public debate about how long the elderly are kept alive with a poor quality of life and said certain types of patients should not receive taxpayer-funded healthcare.
"As medical science gets better and better at keeping people going, is there such a thing as providing too much healthcare?" Mr Barnes asked.
"And in areas like IVF, where the physical and emotional cost on patients is terribly high, the chances of successful outcomes depressingly low, and corporate imperatives manipulate demand, it's arguable that treatment subsidies should be strictly limited, if they are to be applied at all."
