I have no doubt Richard that what you are saying has a lot of merit in it.Good on you for having a go at trying to improve the Health system, trying to make it more equitable etc. You say however that "Once again, politicians are using taxpayers money to bet on the wrong horse". Well, politicians use tax payers money to do even worse ....they use it to fund abortions Richard, to kill little babies, as you a doctor know full well. Here in Victoria your
Greens Party intends voting for the removal of abortion from the Crimes Act. What is very concerning about this is The Greens intention, as listed amongst their policies in their 172 page manifesto released before the last Federal elections, to "force private religious hospitals to undertake abortions". Force Catholic nuns to kill little babies? Legalise abortion and what then? Make it compulsory for conscientious objectors to perform them? If you really wanted to improve the health of women and 100,000 preborn babies a year Richard, you would agitate to spend tax payer funded Medicare money on helping women have their babies, not kill them.

I am always fascinated as to why those on the left wish to abolish the private medical rebate.

The question I would ask is "Who would benefit"

Because those with private insurance still have to pay something I think it is reasonable to assume that if the 30% rebate were abolished, the government could then use the funds to finance 25% of the private hospitals.

What would happen then would depend on how many people abandoned private insurance. If more than 25% did so, and the surplus private hospitals were put to some other use, as there would be no money to finance them, then the net medical resources available to the community would decline. Considering that abandoning the rebate would push private fees up by 43%, I am sure that many more than 25% would abandon it.

Of course the government could take over the redundant private hospitals, but this would require extra taxpayers money to do this.

Unlike private education, I would not have thought private hospitals are ideological. If you go to one they just treat you, and do not try to convert you to any other belief.

Of course it could be that some people are so obsessed by the idea of equal treatment that they would not mind if everyone had worse health care, just so long as it was equal.

I always find it immensely ironic when someone argues that the government is screwing something up and making bad decisions and so therefore the government should try and take on even more responsibility and control of that very thing.

If governments are so bad at things, they should be less involved in the area, not more involved.

I have studied this problem which first started with the idea of moving mental health out of the hospitals and into the community. Hence all governments have failed to make the same types of resources that were once available in mental hospitals, available in the community.

The next step began in 1990's with the slogan of improved efficiencies, increased productivity and cost effectiveness. Subsequently the numbers of avalible public hospital beds have fallen.

Much was said about closing down ineffiecent hospitals and subsquently services were transferred to the major hospitals. The costs of these hospitals go up and the bureaucrats look at the budget and then tell the bigger hospitals to live within the budget.

So the squeeze is on, a vicious cycle.

What is really interesting is that health care consultants from the most expensive health care system in the world were hired to tell us how to make our system more cost effective.

It must be remembered that if you are poor in America and cannot afford health care then you life expectancy is about the same as living in a third world country.

Around the same time as the cost effectiveness, the intake for medical schools were slashed.

So right now we are paying for the decisions and plans made at least 17 years ago, and things are going to get much much worse.

Even if an extra 3 or 4 billion was made available tomorrow it is going to take years before any difference is made.

There are not enough intensive care beds, and it take time to train the staff. there are operating theatres laying empty, but not enough hospital beds or nursing staff to care for the patients.

Our politicans may make pleasing sounds, but when it comes to action they are not following through.

The public think public hospitals are wonderful but the taxpayers don't want to pay for them.

The Federal State arrangements are an ongoing public farce , to echo Kevin , it is a blame game where no-one scores and no-one wins.

Politicians tell hospital managers to do a lot more and give them more but not enough to do what they are asked to do.

Hospital managers are on the whole pretty useless and get promoted for making plans and implementing changes to administrative structures. Health invariably has 3 managers (a doctor, a nurse and an accountant) where everyone else has 1 manager.

Doctors, nurses, and other health workers are territorial and pointless professional demarcations are rife. They put the wharves to shame.

There are far too many fat smoking couch potatoes who want pills and operations rather than diet, nicotine patches and exercise.

Don't get me started on the cynical futility of the Mersey stunt...

The private health subsidy has not delivered any cost benifit to the consumer at all. Along with most other handouts, subsidies and tax concessions they simply increase demand for the product causing prices to rise. All of these rebates like private health, child care rebates, water tank subsidies, LPG conversions etc have simply forced prices up. In general, the price rise being the same as the subsidy. It is an apalling waste of money.