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Showing posts with label Mediscare. Show all posts
Showing posts with label Mediscare. Show all posts

Saturday, August 6, 2016

Unpublished Progressive letters to The Age and the Herald-Sun over recent months



Above:  Hawke's policies of 'Consensus' and 'the Accords' were popular vote winners - But not all of those policies' long term ramifications were positive


What follows are another series of letters - sent by myself (Tristan Ewins) to The Age, The Herald Sun, and QandA over the past few months.  Again: none were published.

Dr Tristan Ewins

Is a new ‘Hawke-ian’ Consensus ‘The Way Forward’ in Australia?

“Mark Kenny (11/7) looks forward to a new, ‘Hawke-style’ consensus – nutted out between employers, unions, welfare groups.  As opposed to the “partisanship” and “populism” recently on-show. But the Accord Era was in some ways only made possible by a particular conjuncture of union coverage, mobilisation and capacity to deliver. In any case, the wage restraint that was delivered by organised labour was rewarded only with modest social wage measures. (not with transition to some Swedish model)  Employers won-big under Hawke and Keating. Their support was of assistance in Hawke’s assumption of power. But as industrial demobilisation took hold, union militancy became  reviled.  The hope of union policy influence was steadily quashed as demobilisation meant unions had not-enough to bargain with.  Today organised labour still declines slowly; and many employers see no interest in multi-lateral compromises which offer unions a meaningful ‘seat at the table’.  We are left with ‘convergence politics’ based on neo-liberalism, technocracy, cosmopolitanism and globalism. What we really NEED is deep pluralism and authenticity in politics.  Where democratic conflict is an accepted feature of liberal/social democracy. Where labour, welfare, environmental and other movements join together in solidarity with a broad ‘counter-culture’ or 'counter-hegemonic historic bloc'.”


What are our priorities on gender equality?

Jessica Irvine (‘The Age’, 24/7) argues advancing women’s interests and the economy involves making men feel “less confident” and to “sense…their…limitations”.   She sees men’s competitiveness and over-confidence as shutting women out, helping precipitate disasters like the Global Financial Crisis.  Women’s and men’s learned behaviour may be a factor: so long as we don’t resort to ‘attributing a bad essence’.  But perhaps more importantly capitalism involves instability, waste, crisis, painful ‘corrections’.   Is the ascent of women to positions of power within capitalism an answer to this?  Or is it a problem with the dynamics and resultant priorities of the capitalist system itself?  It is right to elevate women’s position in the labour market, public life, in sport – with the aim of ‘flux’ around the point of equality. If our principle is equality, though, we should also be concerned with the decline of men’s participation and performance in education. Also, for most women, labour market regulation and social wage enhancement could be more substantial than ‘a woman in the US Federal Reserve’. That is: “lift up” and respect ‘traditional women’s vocations’ in nursing, aged care, retail, hospitality, tourism, teaching, cleaning, child-care.  We need solidarity between women and men to  ‘lift us all up’, and not leave anyone behind.
 

Economic Inequality in Australia

Social research by the ‘McKrindle Group’ (Herald-Sun, early August  2016) observes increasing inequality between Australians. The top 20% have 12 times the income of the bottom 20%. And the top 20% have 71 times the wealth of the bottom 20%. There are many causes.  The impact of labour market deregulation on the lower end.  Threadbare, punitive welfare.  A weaker labour movement.  Prevalence of part-time, insecure work.  Retirements are pushed back until 70 ; and for some the intensity of work increases to increase profits, and expand markets and purchasing power - which prolongs the viability of capitalism.  Outcomes we get from labour markets and the inheritance of private wealth are not always fair.  Some skilled workers (eg: aged care nurses, child care workers) are exploited because private labour markets cannot sustain more without government subsidy. Some do unpleasant work, perhaps with unsocial hours. (eg: cleaners) – But this is not factored in where ‘demand and supply’ for skills rules. This unfairness shows why we need a ‘social wage’,  ‘social insurance’ and welfare state – financed through progressive taxes.  And also labour market regulation and labour union rights - to prevent unfair outcomes.  Hence the centrality of the principle: “from each according to ability, to each according to need”.
 

Loneliness amongst the Aged ; and Aged Care Priotiries

James Bartholomew (‘The Age’, 29/7) identifies the scourge of loneliness amongst the elderly: and the responsibility of family to ameliorate that.  But this is not solely a private responsibility. Just as charity cannot replace welfare for want of resources, neither can all families manage alone without assistance.  A National Aged Care Insurance Scheme would surpass ‘user pays’ for Aged Care, improving the quality of care, while provided from an egalitarian Levy.  There would be ratios for Registered Aged Care Nurses, as well as for other Aged Care workers. Standards would be upheld not only in areas like food quality, but in resident health, satisfaction and happiness, and access to communications and information services and technology.  To tackle isolation, social interaction would be facilitated for a variety of interests -  both for those in care, and those at home.   And combatting the trend to suicide—which mainly affects men. There would be home visits, and greater mobility ; with social outings, travel vouchers and associated services. Finally, pensions must be increased to end deprivation– and financial support given when dealing with unforeseen emergencies. (eg: a broken washing machine)   Yet all this would require billions ; so is undoable without tax reform.
 

From a Discussion in Facebook on Choice in Disability Services and Aged Care

I'm potentially well-disposed towards allowing Not-for-Profits to offer services alongside the public sector. IF they do a good job. (but the public sector must be a viable choice also) The problem is - a) that ALL the providers need enough funding to provide the services at a very good level of quality ; and b) that aged people and their families benefiting from the Scheme need the flexibility to move between providers without significant disadvantage. That is: if there's a strong element of user pays that neutralises the very 'choice' schemes like NDIS are supposed to provide. It means people with limited means have no 'practical choice' in reality where user-pays mechanisms are onerous..... So what we're talking about is getting rid of the old user pays mechanisms - which could run into the tens or even hundreds of thousands. Perhaps there could be a small co-payment just to encourage people to think carefully about their choices. And progressively scaled to capacity to pay.  But that would have to be utterly negligible when compared with the existing system. To be acceptable the new system would have to overwhelmingly rid itself of user-pays mechanisms ; leaving nothing but a 'functional co-payment' - whose role is not to FUND the system ; but only to encourage careful choices.

 
On the issue of Debt in the Economy

Ron Fischer (Herald-Sun Letters, 3/8) points out that without mechanisms of debt the economy would no longer function.  To elaborate: debt is often necessary to get a concern started. And certain kinds of investment (sourced from debt) have a multiplier effect on productivity. Take investment in certain kinds of software (eg: accounting, word processing) – or investment in skills-development– with improvements in the pace and quality of production thus ensuing. ‘Priming the pumps’ in various ways: direct payments to consumers; government fiscal policy including investment in infrastructure and services – can also have a stimulatory effect, boosting confidence of investors and consumers alike.  Welfare itself can contribute as those thus-dependent spend a greater portion of their incomes on necessities. Austerity on the other hand (cutting spending, services, welfare, infrastructure investment) can have a deflationary and contractionary impact.  That said: debt cannot expand forever – though the real problem in Australia is household debt rather than government debt.  The economy needs structural change so we are able to address household debt without declining living standards. Industry policy to create high wage jobs with a ‘flow on’ or ‘multiplier’ effect which creates additional work based on the ensuing consumption.  And re-establishment of ‘natural public monopolies’ and other investments in areas like socialised medicine – which actually improve consumption power through more-efficient service provision.   For example the social democratic Nordic economies contain health costs to about 9 per cent of GDP . While In the US private sector coverage is 40% - but health costs make up 18% GDP!  (Lyons, McAuley, 2015)  Australia is ‘in the middle’ here – but can definitely do better!
 

Refuting the claim of ‘Mediscare’ : ie: Why the Liberals really are about privatising Medicare

(to ‘The Age’ and the ‘Herald-Sun’)  The message from much of the media approaching the Federal election was that the erosion of universal healthcare in Australia did not comprise ‘privatisation’. Privatisation was narrowly defined as ‘selling an asset off’. Labor’s message was therefore deemed a ‘scare’. Yet upon reflection Labor’s implicit definition of privatisation is legitimate. Medicare is a relatively modest scheme of socialized medicine by some international comparisons:  providing for the costs of a variety of consultative services and procedures publicly.  Nonetheless, Medicare contains national health costs radically compared with the overwhelming dependence on private health cover in the United States. The danger, though, is that we are developing into a ‘two tiered’ health system in health as in education. With increasing degeneration into Galbraith’s ‘private affluence, public squalor’. This - accompanied by growing out-of-pocket expenses - would be both inefficient and unfair: an expression of the principle of privatisation as opposed to socialisation.  But Medicare must be extended as well as defended. Medicare does not include dental and physiotherapy , or medical aids like glasses, hearing aids or prostheses.  We need a reforming government which provides for this through the progressive reform and extension of the popular Medicare Levy without austerity elsewhere.

Hanson’s Pitch: as ‘an Ordinary Australian’ against ‘Left Elites’

Watching QandA it appears to be a deliberate strategy from Pauline Hanson to appear inarticulate;  'kind of naive';  an ‘outsider’ amidst so-called ‘elites’.- There are people who can identify with that ; and when we attack Hanson in some ways they just identify with her even more.  It makes her look like 'the victim'. Pauline Hanson’s 'comeback' was stirred up in sections of the media ; appearances on morning television etc.  Thankfully, her party is not strongly organized. It is built around a 'personality' and will fade again when she leaves the political scene. Also, thankfully her organization perhaps detracts from the 'United Patriots Front' and similar extreme-right groups... Perhaps it detracts from a full-on ideologically-committed and violent fascist organization.  But the fear and disrespect she sows nonetheless disrupt the cohesion of our society.  The best place to start for progressives is to acknowledge and address the insecurities that Hanson and other Right-wing forces take advantage of.  Exploitation of foreign workers undercutting local jobs. Confusion in the wake of the erosion of ‘traditional’ Australian identity and communities.  Pockets of isolation, insecurity, and exclusion.  A failure to engage with those affected; dismissed casually as ‘bogans’. (perhaps itself a ‘class-based put-down’)

A Question to QandA for Sam Dastyari that was not Used
Senator Sam Dastyari ; You are on record identifying $31 Billion yearly in Corporate Tax Avoidance. But earlier this year Bill Shorten announced policies which would wind back only $2 billion of this over four years. Why has no political party moved to wind back a significant proportion of Corporate Tax Avoidance? ALSO: With US Company Taxes up to 39% - would Labor reverse Company Tax cuts so business 'pays their fair share' for infrastructure and services they benefit from?

Saturday, July 23, 2016

Labor needs to Develop Stronger Policies and Mobilise Early to Beat the Liberals Next Time


above:  ALP Shadow Treasurer, Chris Bowen (a member of the NSW Right) has argued for "Equal Outcomes in Health" ; Let's see that principle fully acted upon in Labor policy approaching the next Federal Election.

In the wake of the federal election result there has been a good deal of introspection and analysis of the result: including analysis of Labor’s strengths and weaknesses. 
But leading up to and after the election I was saddened to see some in the Party inferring Greens policies were ‘unaffordable’. Arguably that is not the right way to differentiate ourselves from the Greens party.  Rather Labor needs to consolidate its credentials as the party of the ‘Red Left’ in Australia ; with strong social justice policies which inspire our organisational and electoral bases.
Dr Tristan Ewins

It's upsetting when some of us in Labor complain about "unaffordable" "pie in the sky" Greens policies. The Greens' policies were more ambitious than Labor's policies, yes.  And perhaps were less credible as a consequence of their lacking access to quality costings.  But at the end of the day the difference between Labor and the Liberals is perhaps around one per cent of GDP annually.  (also add other policies not related to spending – like support for penalty rates)  And the 'unaffordable' Greens policies maybe add up to in the vicinity of one to two per cent of GDP/year more than ours at the most. (these are just rough estimates though I admit)

The problem with the Greens is not 'unaffordable' policies. That's 'Liberal-Speak'.  It’s rhetoric which can rationalize opportunism on austerity for instance.  It’s loaded-rhetoric which ‘locks in’ small government.

The real problem for the SL is that Greens gains are losses for the ALP Left within the PLP (Parliamentary Labor Party): affecting our policy influence as far as policy is determined by Cabinet.  (or the Shadow Cabinet as it is for the time being) And a common accusation is that sometimes the Greens distort facts on Labor Policy to achieve that.

But despite claims to the contrary, people who were insisting that we needed Greens preferences to win were proven right.  We cannot escape from the fact Labor and the Greens need each other.
So for the most part "big spending" promises are 'not the problem'. Promoting incremental extension of social insurance, social welfare and the social wage - should go without saying for Labor. We did not go far enough on tax reform and superannuation concessions reform. Yet nonetheless it was the most promising economic platform we've promoted in years. By this I mean it was the first election in years where we had not locked ourselves arbitrarily in to a policy of holding spending and tax down as a proportion of GDP.  

Probably  we retreated on policy in the face of bad responses in focus groups and polling. (take our retreat on Aged Care funding)  This suggests that while we began selling our message earlier than usual, we could have began even sooner. Because selling a message which challenges 'common sense' Ideological assumptions (as Gramsci may have put it) takes time and effort. (especially with a hostile media)   Our aspiration should be to raise social expenditure and investment by perhaps 2.5 per cent of GDP upon taking government after the next election.  (maybe more if you factor in cutting superannuation concessions)

If people want evidence of the need to begin campaigning early then look at the disinformation on Medicare privatisation in the media and from the Liberals. Privatisation was narrowly interpreted as ‘selling an asset off’. Labor’s message was therefore deemed a ‘scare’. Yet upon reflection Labor’s implicit definition of privatisation is legitimate. Medicare is a relatively modest scheme of socialized medicine by some international comparisons:  providing for the costs of a variety of consultative services and procedures publicly.  Nonetheless, Medicare (and the PBS – Pharmaceutical Benefits Scheme)  contain national health costs radically compared with the overwhelming dependence on private health cover in the United States. The danger, though, is that we are nonetheless developing into a ‘two tiered’ health system in health as in education. With increasing degeneration into Galbraith’s ‘private affluence, public squalor’.   The more this progresses the more entrenched the situation becomes ; and the more divided the country grows on the basis of social class.

This - accompanied by growing out-of-pocket expenses - would be both inefficient and unfair: an expression of the principle of privatisation as opposed to socialisation. 

But Medicare must be extended as well as defended. Medicare does not currently include comprehensive dental , podiatry and physiotherapy , or medical aids like glasses, hearing aids or prostheses.  We need a reforming government which provides for this through the progressive reform and extension of the popular Medicare Levy without austerity elsewhere.

It’s also notable that we sold NDIS (National Disability Insurance Scheme) well in the past. But we can't sustain an argument that improved social wages and social insurance can be provided without significant tax reform elsewhere. $7 billion from negative gearing and Capital Gains Tax concession reform was important. (adding up to 0.4% of GDP)  At least we were somewhat on the front foot. And Labor’s defensive stand against $50 billion in Company Tax cuts was crucial to its message ; and to a revolt in sections of the electorate against ‘corporate welfare’.

But I think we can and should do better. It requires planning and arguments put well in advance. It requires promoting a public debate which challenges peoples' assumptions about the desirability (or undesirability) of 'small government', low taxes, the importance of social investments, social insurance and so on.  It requires a party of activists – mobilized to a significant degree throughout the whole electoral cycle.

In short: we need an ALP with a vision reconceiving of a 'forward march of labour'. An idea of what 'progressive' actually means. That is 'how we want to progress things’. And that must mean an extension of social insurance and the social wage ; an emphasis on public infrastructure and services ; a more progressive tax system - and so on.  Which takes real resources-  Hence the emphasis on tax reform.

But both sides capitulated to short-term opportunism on superannuation concessions - which will be costing tens of billions to benefit the rich and the unambiguously well off.  With the new parliament it is to be hoped that the impending $50 billion bill for superannuation concessions will drive policy by necessity.  And Labor can use its position in the Senate to ensure these changes are fair for middle and lower income Australians.  Hopefully Xenophon can be convinced of this also. His votes will be crucial.   Also thankfully while Labor did not develop a strong enough policy, here, at least at the early leaders’ debate Shorten kept his options open on future reform.  Turnbull by comparison locked into ‘no further reforms’.  It will be interesting to see if he sticks to that.

The Liberals will accuse us of being 'big-spending'.  But that is rhetoric we need to refute vigorously. My personal ambition was to see Labor increase tax and related social expenditure by maybe 2.5% of GDP in its first term. (that that is considered 'radical' shows how far we've regressed in this country from anything like social democracy)  

But even increasing progressive tax and associated expenditure by 1.5% of GDP (or $24 billion/year out of a $1.6 trillion economy) in a first term Labor government would be meaningful. That should be ‘the policy floor’ – which we resort to only if necessary - and below which we compromise no further.

Crucially: there are vulnerable people who need our help sooner and not later. That includes the elderly, the ill, the disabled, the poverty-stricken, and the long term unemployed for a start. This requires tens of billions new spending to be meaningful.

With Shorten’s election campaign appearance on QandA, he was confronted by an aged pensioner who argued that an unforeseen contingency (eg: a broken washing machine) could send her broke.   In other words, that it may come down to a choice between paying bills, seeing the doctor, or feeding oneself. Shorten conceded there was ‘nothing he could do’.  Which probably translates as: ; ‘internal polling shows people don’t want higher taxes’ or that they ‘resent pensioners’, and hence Labor was ‘cutting some of the most vulnerable loose’.   We have to do better than this next time.    And the way we do that is through a solid campaign footing for a full three years between now and the next election.

But keep in mind that's in the context of a $1.6 TRILLION economy. We're talking about affordable reforms that the media and Conservatives will portray as 'radical' and 'irresponsible'. The Liberals especially don't want to compromise at all on their 'small government, neo-liberal, laissez faire' Ideology and agenda.  No matter what the cost to vulnerable  and disadvantaged Australians.

In fact we need to develop a public debate about how low social spending and how small the public sector are in this country - and why moving closer to the OECD averages - even if only gradually - would be a good thing.

I have argued to increase spending and taxes by roughly 2.5% in the past.  I don't think we can just transplant the entire Swedish model over two or even three terms. But I do think gradual progress is possible. And depending on unforeseeable circumstances perhaps it could be less gradual.  (history is interspersed with ‘watershed’ moments which had not been predicted)

Let's say we had a pool of $40 billion extra a year to work with out of a $1.6 trillion economy. (ie: 2.5 per cent of GDP) And then maybe cut superannuation concessions by around $15 to $20 billion to start as well. (out of approximately $50 billion)

With that we could do a great deal if not all of the following:   

·         Fully Implement the Gonski education reforms, and NDIS

·         reform and extend Medicare into dental, prostheses, optometry, physio, psychology, podiatry ; cut waiting lists ; stop the encroachments of increasing co-payments

·         increase investment in public and social housing

·          implement a National Aged Care Insurance Scheme

·         reform Mental Health with more proportionate resourcing of the sector and policies to tackle mental-health related early mortality – with perhaps 300,000 Australians suffering schizophrenia, for example,  dying 25 years earlier than the general population. ;

·         introduce a Universal Basic Income (UBI)  as proposed by NSW Labor policy activist Luke Whitington, and begin eliminating poverty.

·         also fund various infrastructure projects publicly as opposed to creeping privatisation- with the consequence of passing efficiencies on to the broader economy.

·         top up local government with federal funding - redistributing resources to help local government in working class and disadvantaged areas to provide better quality services and infrastructure.

·         Pay for a reparations component of a Treaty with indigenous Australian peoples


 

·         Implement a trial 'co-operative incentive scheme' to support the development of co-operative enterprise in Australia  - supported by tax breaks, cheap credit, advice., and in some instances government co-investment

·         Reform welfare payments – Aged, Disability, Sole Parents; Student Allowance; Carers etc; increasing by $50/week plus inflation perhaps over two terms

 
·         Finally we could reform higher education and make the HECS system far more progressive. Raise the minimum repayment threshold for a start.   And implement Industry and Labour Market policies which bring us closer to full employment: with a big boost to the Budget bottom line.

What's important over the next year or so it that we adopt the posture necessary to promote the next wave of reforms in what they used to call ‘the forward march of labour'. ALSO even in the wake of our election loss we should still aim for a Company Tax rate of 30 per cent or higher and not back down from that. (ie: whether in government, or vetting legislation in the Senate)  Because it is both necessary and reasonable for the corporate sector to contribute to the services and infrastructure it benefits from. The alternative is neglect - or otherwise 'corporate welfare'. 

Sam Dastyari’s estimate that corporate tax evasion is costing $31 billion a year is also relevant here.  And you would think Labor needs a stronger policy than it took to the last election.  That is: Labor’s policy only aspired to claw back $2 billion of this over 4 years.

Labor desperately needs a sense of what its professed ‘forward march’ comprises ; and why that is desirable and right.  Let’s begin a debate sooner rather than later: moving Labor onto ‘the front foot’.  This means shifting straight away to a ‘permanent campaign mode’ based on ‘solid but partial mobilisation’ through the activism of our rank and file.  (full mobilisation throughout the entire electoral cycle could prove exhausting, however)  Also we need to implement an early release of ambitious policies which our activists and supporters could mobilise around.  We don’t want to be pressed again to retreat on crucial policies (for example Aged Care funding)  due to public fears re: the presumed need for a Budget surplus and low taxes – as occurred in the recent federal election campaign.

A non-binding ‘policy conference’ some time over the next year could also help mobilise the enthusiasm of Labor’s rank and file ; inspiring innovative policy development to drive Labor towards the next federal election.  Contrary to Bowen this Conference should not replace the binding ALP National Conference which determines Labor's Platform.