Unhealthy State of hospitals?
Mr Howard is once again going on about how States are bad hospital managers and how, because the Commonwealth contributes about half the funding to state hospitals, it would like to have more input into their operations. I won't argue with the contention that State governments are not always great managers of hospitals. Hospitals need money and some governments (State and Commonwealth) prefer to use their funds for more important things than public health - such as corporate tax breaks, increasing their budget surpluses, building casinos or advertising themselves. In that regard, State governments are unlikely to be any better or any worse than the Commonwealth government.
One can wonder why the Howard government, which is responsible for undermining medicare, demolishing the Commonwealth dental program and doing precious little to advance public health during its time in government is suddenly showing such an interest in our state hospitals. Could it have something to do with the advice given by the Liberal party pollsters that Howard's best chance to cling to power is to attack the States? Perhaps he hopes that by pointing the finger at the States we'll forget the damage his government caused to public health or that, thanks to his government, most of us now have no choice but to purchase ludicrously expensive private health insurance, which increases the prices and decreases the benefits every year. (Anyone who wants to see the "advantages" of such privatised system of health, should take a look at US health expenditure, which is by far the highest in the OECD, but the level of health in that country is below the OECD average).
It is not clear why Howard thinks that his government would be well placed to contribute to management of hospitals in any event. In the article cited, he as good as admits to knowing only about NSW hospitals - because that is the State where he resides. That was the whole point of having States in the first place - the government closest to the governed should have the most responsibility for management of smaller units (eg individual hospitals). The further the government, the less able it is to manage the smaller units, but it may be better placed to manage larger units (eg. medicare). This may not always work in practice, some State governments can be dreadful hospital managers, while others may be quite good. But that is the theory on which the Australian system of government was built.
Howard complains about States having control of hospitals when the Commonwealth contributes almost 50% of the money for hospitals (incidentally, doesn't it mean that it has half the responsibility for under-funding of hospitals?), but he is forgetting two very important things. The first is that it is not the government's money. It is our money, the taxpayer's money. We want it used for our benefit and most of us don't much care who uses it, so long as it is to benefit us. Unless Mr Howard can prove that he can do a better job using our money for our good (and bombarding us with ads doesn't qualify), he can spare us his whining. The second very important thing is the Australian Constitution. The States run the hospitals because there is no constitutional Commonwealth power for this activity. And yes, it is true that specific purpose grants allow the Commonwealth government to bring to its aid the oldest law of all - "he who has the gold makes the rules", but the bottom line is, if Mr Howard doesn't like how the powers are distributed between State and Commonwealth, he should hold a referendum so we, the Australian people, have a say about his attempts to undermine our constitutional system.
Better yet, perhaps he can focus on performing his job properly. With five interest rate rises since 2004, food prices skyrocketing and housing affordability at its lowest level ever, there ought to be plenty to do. He could even try doing something about the fact that almost half of all Australians now can't afford necessary dental care.
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