19.3 C
Byron Shire
April 17, 2024

A health check as Medicare turns 40

Latest News

Man saved by Marine Rescue NSW after vessel capsized on Bruns Bar

A rapid response by Marine Rescue Brunswick volunteers has saved a man’s life after his 4.9 metre boat rolled on Brunswick Bar this morning.

Other News

Mullum refugee support group formed

A new group in Mullumbimby has formed to help settle a Syrian refugee family in the area within the next few months.

Itching for a Mullum flea market?

A new flea market will launch this Saturday, April 13 from 8am until 2pm at the Mullum Community College campus.

Grand opening in Casino on Saturday

Richmond Valley Council says the upgraded Casino Showground and Racecourse will be a major hub for events in regional NSW, with a focus on horse-related activities.

Aid workers killed

I along with the Israeli and Jewish community in general mourn with the rest of the world for the...

Invitation to get to know the real Nimbin

The MardiGrass Organising Body (MOB) say Nimbin's annual festival will kick off with the launch of a very special audiovisual book on Friday 3 May, 'Out There: a potted history of a revolution called Nimbin'.

If you’ll forgive the earnest tone, I’d like to propose a toast. 

To a friend who’s almost always there when you need them most. To a system that aims to treat people fairly and respectfully. 

To a quiet cornerstone of Australia’s civil society. 

Yes, it’s not perfect, it’s perpetually preyed on by profiteers, and its work can be patchy, sometimes. 

But here’s to Medicare. 

Happy 40th.

Painful birth

As some readers well remember, the birth of Australia’s publicly-funded universal health system was not easy. 

First delivered as Medibank by Whitlam’s Labor government in 1974, it was viciously attacked by doctors’ groups and conservative political parties, which effectively killed it off, a year or so later.

It wasn’t until 1984, after the election of Labor under Bob Hawke, that Medicare was formally launched. It reduced people’s big medical bills, cut the costs of healthcare nationally, and even drove down inflation. 

But the idea of a taxpayer-funded system of free or low-cost care remained abhorrent to many in the medical community and the Liberals. 

Doctors worried about falling incomes and government influence. The then opposition leader, John Howard, famously said the government should have ‘taken a knife’ to Medicare, describing it as ‘one of the great failures of the Hawke government.’

Popular success

Unlike John Howard, big majorities of Australians have consistently supported Medicare. Some political observers have even suggested that the Liberals only won government in 1996, and Howard became prime minister, largely because they finally ended their opposition to Medicare. 

Along with providing affordable access to hospitals, doctors, nurses, drugs, tests, and treatments, a strong publicly-run Medicare has also helped keep a lid on the overall costs of healthcare.

In Australia, we spend around ten per cent of total GDP on healthcare. This is similar to European countries, but just half of what’s spent in the US.

With its market-based system, the US spends close to 19 per cent of GDP. That’s one-fifth of the entire economy spent on ‘healthcare’, while at the same time Americans tend to have poorer health outcomes than comparable countries. 

I was lucky enough to study health systems during a Harkness Fellowship at Harvard University. 

I learnt a lot about the inequality, inefficiency, and inhumanity of US healthcare.

It’s not really rocket science. Health systems based on solidarity tend to be fairer, more effective, and cheaper. 

Of course, Medicare could be stronger on many fronts. 

On the one hand, access to needed care can be hard to come by, particularly in some remote and regional communities. Public hospitals in many places are hurting and waiting times unacceptable. 

On the other hand, Medicare is too often vulnerable to the vested interests which are driving the problem of too much medicine. 

From corporate-controlled general practices to giant pathology companies, from big pharma to pharmacies, private for-profit players all push to sell more. The result is increasing amounts of harmful and unnecessary care, and wasteful increases in costs, threatening the very viability of a universal system. 

The biggest challenge for Medicare, and health systems everywhere, is tackling this problem of too much of a good thing. 

In just 20 years, the number of annual subsidised prescriptions under Medicare has jumped from 160 million, to over 220 million today. And the annual drug costs from $4.5 billion to over $17 billion. 

There is incontrovertible evidence that many of those prescriptions are unnecessary and harmful. 


The problem of ‘polypharmacy’, particularly among the elderly, is so out-of-control that good doctors are now learning the art of ‘deprescribing’.

The Australian Commission on Safety and Quality in Health Care has repeatedly identified examples of overuse, including too many planned caesarean sections, too many colonoscopies, and too many inappropriate antipsychotics. 

Globally-renowned Stanford University Professor John Ioannidis told me a few years back that ‘we’re just spending so much, and we’re wasting so much, that healthcare is one of the leading public dangers for health.’ 

Ioannidis is one of the most cited medical scientists on the planet, and has sat on the editorial boards of some of the world’s most respected scientific journals. ‘I think at some point, we need to fight against medicine’, Ioannidis told me. ‘It’s becoming really dangerous.’

There are ways to tackle these challenges, collectively, to better manage vested interests, and strengthen this vital public infrastructure. And there are ways we can protect ourselves and our loved ones from the dangers of unnecessary care.  But they are columns for another day.  

Medicare is a manifestation of our humanity, so in its birthday year, let’s celebrate this solidarity.

♦ Dr Ray Moynihan has been known to break out in a rash when confronted with for-profit healthcare.  

Support The Echo

Keeping the community together and the community voice loud and clear is what The Echo is about. More than ever we need your help to keep this voice alive and thriving in the community.

Like all businesses we are struggling to keep food on the table of all our local and hard working journalists, artists, sales, delivery and drudges who keep the news coming out to you both in the newspaper and online. If you can spare a few dollars a week – or maybe more – we would appreciate all the support you are able to give to keep the voice of independent, local journalism alive.


  1. Indeed, Happy Birthday Medibank/care. How lucky we are that we had visionary leaders like Gough to break the stagnation of two decades of Tory rule. We could have headed in the same trajectory as the disastrous US health care system.

    I attended a book tour presentation by Prof Jenny Hocking, Whitlam’s biographer and author of The Palace Letters. Amid lots of questions about her insights into the great man, she emphasised his insistence on the importance of achieving government. It brings to mind his famous observation that “only the impotent are pure”.

  2. We indeed are so privileged to have Medicare in this country. I agree that there is probably over prescribing of medicine. We are so used to going to the doctor & expecting some drug or other when there could be a simpler way to a cure.


Please enter your comment!
Please enter your name here

Wallum showdown unfolds in Brunswick Heads

Around eight people have been arrested so far, since almost fifty police arrived at the Wallum development in Brunswick Heads this morning to escort machinery and other work vehicles on to the site. Police include local officers, members of the NSW Public Order and Riot Squad, and Police Rescue.

Northern Rivers Recovery and Resilience Program announces 36 projects

Bridge expansions, upgraded pumps, enhanced evacuation routes and nature-based projects are just a few of the 36 projects being rolled out as part of...

Reef snapshot details widespread coral bleaching on the Great Barrier Reef

Latest CSIRO research shows that the fifth major bleaching event since 2016 is still unfolding, but bleaching was just one of the disturbances on the reef over summer.

Invitation to get to know the real Nimbin

The MardiGrass Organising Body (MOB) say Nimbin's annual festival will kick off with the launch of a very special audiovisual book on Friday 3 May, 'Out There: a potted history of a revolution called Nimbin'.