Fairness, mateship, equality?

Lovely words. Who could disagree with them? These are the “Australian values” Prime Minister John Howard lives by - he told the world on SBS Television on March 2. Fairness, mateship, and equality.

Old Tom is not convinced. For a start he’s not sure why John “Orwell” Howard, as he calls him, needs to repeat the same concept three times.

Tom is in his 70s, a pensioner, still working voluntarily after a lifetime of toil, but he’s not complaining. Except about the myth that Australia has a free public health service.

When he broke his arm a couple of years ago it turned out to be the start of Tom’s annus horribilis as far as medical needs were concerned. He took his arm to a large general hospital about 8 o’clock on a Saturday evening and was told it would take four hours to get an x-ray and a further two hours to see a doctor, leaving him stranded in the city in the middle of the night. Not enough staff rostered on. Tom didn’t wait.

After a painful night he and his useless limb were taken to a different public hospital where he received excellent treatment followed by very good after-care. One-one for the public health service. So far so good, nearly.

Tom always believed everyone should have the same access to health care regardless of cash in the bank, home address or position in society so on principle he’d never invested in health insurance. He’d been blessed with healthy genes and over the years was happy with skilled general practitioners who “bulk billed”.

But ...

Because of the broken arm he needed a bone density scan. Private laboratory job - $100. OK, that didn’t hurt much.

An itch turned out to be a skin cancer and he was advised it could be dangerous to wait in the long queue for public treatment. In passing it seems odd there are not enough public skin cancer practitioners in Queensland, one of the sunniest spots on the globe with a large white-skinned population. Excising Tom’s cancer cost nearly $2,000. Plus, six months later, a further $70 for the routine five-minute check. That’s $14 a minute, a pay rate of $840 an hour. Tom was pleased with the physical result but his bank balance limped out of the consulting room.

Then he had angina pains. Fortunately he was able to see a cardiologist in the public system immediately, to have an angiogram in hospital within six months to see what was happening in the heart, and then angioplasty - the insertion of a stent or metal coil in a heart artery - two months later.

Tom found public hospital treatment excellent and after-care very thorough and counted himself fortunate he had to wait only eight months. He wasn’t complaining, but you do wonder if people with heart problems should have to wait in a queue for eight months.

Next were abdominal pains. The GP sent him for a colonoscopy, an internal examination of his bowel plumbing. Fortunately there was no pathology, but the exercise added a further $200 to the bill.

Now Tom’s eyesight was deteriorating. Rapidly. He was told he could go blind waiting four years or so for appropriate eye surgery in the public system. Living alone he needed his eyes, wasn’t prepared to take the risk, so went ahead with private cataract operations. He found the results magical, discovering a new world of colour out there. Wonderful work but again his bank balance was bruised to the tune of $2,000. Those who can’t afford it go blind, which is what prompted the saintly Fred Hollows to start his campaign to bring sight to the very poor round the world.

Finally, dental treatment, in Australia as scarce as hens’ teeth. Many people don’t even consider it, just let their molars rot. Tom wasn’t prepared to do that, but his course of treatment cost him over $2,000.

A general conclusion among people who have sampled public hospital care and associated services is they are efficient once you get into the system, even if many patients don’t see much of the consultant they were referred to.

Australia claims to have a free health service, but even a person who always worked, paid his taxes, and served his community well for a lifetime, had to find over $6,000 in 18 months to ensure decent sight, a functioning heart and the rest.

Prime Minister Howard is not directly responsible for Queensland’s health service but the way Tom sees it a PM in power for ten years must take responsibility for the nature of society including the culture of care when people are sick. Tom also accuses Queensland’s Premier since June 1998, Peter Beattie, of being asleep at the wheel as the state’s health service has fallen into disrepair.

Tom considers himself fortunate he lives in a capital city. Health services are much scarcer in small towns, in the country and the outback even though in some distant communities the sickness profile is among the worst in the world - in spite of Australia being one of the half-dozen wealthiest nations. Medical practitioners and other health workers are dedicated but the national health infrastructure, especially in far-flung Australian communities, seems to limp along with too few resources.

Let’s forget Old Tom.

How does fairness, mateship, equality apply to another basic of life, housing?

Elizabeth Allen of the Brisbane Courier-Mail quotes Queensland Housing Minister Rob Schwarten and the Queensland Public Tenants Association warning of “a coming explosion in homelessness” caused in part by rising private rents, with 37,000 people already on the state waiting list for public housing.

According to Brisbane Lady Mayoress Lisa Newman, the city “has one of the highest percentages of homeless youth of anywhere in Australia. We are looking at hundreds of homeless every night just in the central business district area. You can replicate that figure in every suburb”. According to the Queensland Council of Social Service, almost a quarter of Australia’s homeless people live in Queensland.

One age pensioner in rental accommodation was told, out of the blue, the rent was to increase immediately by $25 a week - a rise of 14 per cent - followed by a further $10 rise after six months and another $10 rise six months later - a 24 per cent increase in 12 months. This is legal, according to the Residential Tenancies Authority. It is a scary proposition. When a person can no longer afford the rent, and public housing is not yet available, the question becomes whether to sleep in the park or in the street.

This is the real meaning of the brave new world of neo-conservative free market economic rationalism based on competition. It is not about fairness but becoming the winner and others the losers. The end result of competition is violence, even war. Violence to the body or to the soul.

It doesn’t have to be this way: society could give co-operation and sharing a try. Cuba manages to provide a free health service to all its citizens, and to export doctors to other countries. Perhaps Australia should apply for some.