Misleadership The Liberal Party of Australia hates Medicare. They hate it purely on the basis that it was introduced by the Australian Labor Party and has been a great, transformative success; and that it is a benefit to the poor. Opposition to Labor is ingrained in this mob. They preference the big end of town on the basis that it from this source that they derive their legitimacy. Therefore any success by Labor must be rolled back. That Medicare has been so successful and so popular presents a challenge to them, however, so they must be duplicitous in how they reverse the program. Deep-seated resentment of the poor in a philosophical matter: like puritanical conservatives of the American Republican party, they believe the poor deserve their condition, that it is a moral failing. This extends to the elderly and sick. Wealth and good health are the rewards of providence for virtue and the evidence of it. So when the current Minister for Health, Sussan Ley, announces a review of Medicare, this would be a welcome development, from any other set of politicians. The review will include all procedures, tests and treatments, on the basis that there is a need to reduce “inappropriate tests and procedures”, because, primarily, many are no longer used. Of course, a test, treatment, or procedure that is no longer used isn’t costing anything, but that’s not the point. The point is to simply to stop spending money on health care. The review will also examine new ways of paying GPs, which is fine, potentially working towards a better system of managed care, to reduce the need for more complex procedures and interventions such as now inevitably arise from the lack of management of conditions such as obesity, diabetes, heart disease, etc. Early intervention and management over the longer term means fewer people needing emergency and more costly interventions later. This, of course, costs money now, but reduces spending overall. Don’t expect this to be an outcome of the review. Instead, expect GP care to become part of private medical insurance coverage, shifting the cost from Medicare to the consumer and killing off bulk-billing as effectively as the previously mooted co-pay and rebate reductions. New rules are expected to be implemented to address the issue of Medicare cheats. But it’s actually doctors rorting the system more so than it is patients, and you would be foolish to believe that’s going to be the focus of the review. Instead, the “Medicare cheating” to be addressed will be rules to make it more difficult for the poor and middle class to access Medicare on the basis they are accustomed to, requiring more out-of-pocket expenditures and a reduction in services. The Australian Medical Association and Consumers Health Forum may welcome the review, but they should be cautious in their embrace of it, like the farmer and the viper. We know who these Liberals are, and their nature.