It might be characterised as the Labor Party's electoral burden. Responding to Opposition Leader Bill Shorten's efforts to fight the 2016 election battle on what he considers to be ground favourable to Labor, healthcare, the Coalition swiftly retreated to return fire from the terrain where it too has always felt supremely comfortable – fiscal rectitude and Labor's lack of it.
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When Mr Shorten promised last week that a Labor government would end a freeze on Medicare rebates – at a budget cost of $2.4 billion over the four years (the "forward estimates") and $12.2 billion over the next decade – he announced it would be funded by reversing the Coalition's pledge to cut company tax cut over the next decade. On Sunday, Mr Shorten announced that Labour would reverse the 2014 budget measure increasing the Pharmaceutical Benefits Scheme co-payment each year over four years – estimated cost $971 million over the forward estimates and $3.6 billion over 10 years – to be paid for, again, by not proceeding with the $50 billion company tax cut.
Mr Shorten framed it as a matter of sensible judgement. "We choose the health of everyday Australians. They [the Coalition] choose the bottom line of large multinationals". It was a well-crafted line from a leader intent on casting the election as a "a referendum on healthcare".
The Coalition's response was equally rehearsed, with Malcolm Turnbull claiming Mr Shorten "was yet again, putting some more hundreds of million of dollars, nearly $1 billion, on what he calls the spend-o-meter. He think it's a joke [but he] has no way of paying for these additional expenditures, no way at all other than higher taxes, and he's yet to tell us what they will be".
Savings, costings, and forecasts, whether budget or campaign-related, are highly contentious, the more so if they extend beyond the forward estimates. About the only thing on which there is any consensus is that both Labor and the Coalition are wont to blur, fudge, massage or trumpet them to suit their own political purposes. Indeed, Treasurer Scott Morrison dismissed concerns last week that the continued freeze on Medicare rebates would have a detrimental effect on bulk-billing rates by suggesting the aforementioned corporate tax cuts would help compensate GPs affected by the rising costs of running a medical practice. Truly a magic pudding of a tax.
Evidence is emerging that the rebate freeze – which was originally initiated by Labor – has led to lower bulk-billing rates, with particular impact on low-income or welfare-dependent individuals. The Coalition, however, prefers not to dwell on the obvious implications of government parsimony for the universal access principles of Medicare, let alone of the need to maintain a strong and effective primary healthcare system. Then again, Labor's willingness to explore cost-effective improvements in the health system does not stand close scrutiny either. Until the major parties put aside their grandstanding, primary care services, already at full stretch, are likely to continue to erode.
