In an at-times peevish post-election speech on Saturday night, the Prime Minister singled out "an extraordinary act of dishonesty" by Labor as the reason for the big swing against the Coalition – thereby ensuring that 2016 will be recalled long after as the year of the "Mediscare" poll. The speech was widely characterised as ungracious, but no one's rebutted Mr Turnbull's suggestion that Labor's campaign warning the Liberals would "privatize" Medicare was a highly effective vote-changer. Some commentators have even concluded that a shell-shocked Coalition will shy away from efforts to make healthcare delivery more efficient and cost-effective.
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Scare campaigns are an intrinsic aspect of federal elections, and Mr Turnbull's complaint about Labor's Medicare tactics deserve short shrift, since the Coalition has benefited extensively from them at past elections. In claiming, loudly and often, that the ALP's negative gearing policy would "smash" house prices, Mr Turnbull was himself guilty of inciting fear and loathing about Labor.
Mr Turnbull's chief bone of contention is that the Coalition said nothing about privatising Medicare pre-election, and that for Labor to suggest it was even being considered was an egregious lie. Even after Mr Turnbull categorically ruled out Medicare payments being outsourced (the basis for Labor's claims) Opposition Leader Bill Shorten continued to claim the Liberals couldn't be "trusted with Medicare". Mr Shorten told an ABC interviewer just days out from polling that "you can have Malcolm Turnbull or you can have Medicare; you just can't have both".
If Mr Turnbull has reason to feel aggrieved about such gross distortions, he cannot object too loudly. The Coalition may now accept the legitimacy of universal healthcare, but it vigorously opposed Medicare's introduction, and fought for years afterwards to wind it back. Political type-casting can be every bit as difficult to overcome as actorly typecasting.
Where the Coalition has not changed its spots is in its enthusiasm for privatisation and outsourcing, including involving the private sector in government payments. The 2014 National Commission of Audit touched on the "complexity" of welfare payments, arguing there was a good case for private sector involvement as this would enable "services to be delivered more efficiently and effectively, and at a lower cost".
The claim that a future Turnbull government might outsource Medicare payments was not borne of idle conjecture, then. And Labor was able to cite attempts to introduce a co-payment, to freeze rebates and end bulk-billing incentives for pathology tests as further evidence of the Coalition's contempt for Medicare and universal health cover in general.
Saturday's endorsement of universal health care, if that's how the vote can be interpreted, is welcome. However, it remains incumbent on both parties, particularly Labor, not to treat it as a sacred cow, but to ensure it remains efficient, affordable and sustainable. Failure to do so will see ever larger slices of state, territory and Commonwealth budgets being swallowed up by healthcare costs.
