Modern politics is a stage managed business dominated by focus groups and carefully scripted sound bites.
But occasionally a politician says something that gives a real insight into the thinking that informs their political world view. So it was when Joe Hockey went off-script and opined about the bad choices that people make that prevent them from having enough money to see a doctor.
Why were people "screaming" about a $7 co-payment, which is much less than a packet of cigarettes and about the same price as two middies of beer at the local pub, asked the Treasurer? "Is a parent really going to deny their sick child a visit to the doctor which would be the equivalent payment of a couple of beers or one-third of a packet of cigarettes?”
No one should understand this struggle better than the Treasurer. Last year Mr Hockey went public on his decision to have bariatric surgery, an expensive and highly invasive procedure that involves removing most of the stomach. While we don't know what medical advice prompted Mr Hockey's decision, the procedure remains controversial within the medical profession and outside it precisely because it goes to the question of choice.
Much criticism has already been levelled at the Treasurer for implying that welfare recipients are simply bludgers who stay at home boozing and fagging while their kids are denied the healthcare they need. The proposition that this is just a choice - between the VB or the GP, between a puff of the Winnie Blues or a puff on the Ventolin - is downright offensive to many people. Often the real choice is deciding whether to buy a train ticket for a job interview or a loaf of bread for the kids, paying the phone bill or paying the rent.
But that analysis alone is incomplete because it ignores the fact that sometimes people do make bad choices. I saw this every day during my work as a GP in a drug and alcohol clinic. For people struggling with drug and alcohol dependence, every day was a battle between the desire to stay healthy and the drive to get short term relief from emotional pain. Some might say that they lacked will power or strength of character but as a doctor I saw my role as caring for and empowering them to make better choices rather than punishing them. When it comes to changing behaviour, the remote threat of a future consequence is far less powerful than conservative politicians seem to believe. Cutting people off from help and support only pushes people further down the path of temporary escape rather than long term improvement.
No one should understand this struggle better than the Treasurer. Last year Mr Hockey went public on his decision to have bariatric surgery, an expensive and highly invasive procedure that involves removing most of the stomach. While we don't know what medical advice prompted Mr Hockey's decision, the procedure remains controversial within the medical profession and outside it precisely because it goes to the question of choice. To someone who has never had to struggle with weight issues, it's hard to comprehend why anyone with weight issues can't simply follow traditional advice of cutting down their food and alcohol intake and doing a little more exercise, especially when the alternative is a major operation or dying from a heart attack. But changing behaviour is not that simple. The fact that this surgery is so common today, despite our understanding about the dangers of obesity and the seemingly obvious remedy, is a testament to just how difficult it is.
Asking someone with a drug problem to simply stop using drugs, a depressed person to cheer up or an overweight person to eat less while at the same time restricting their access to health care and to social support is as simplistic as it is counter-productive.
Much has been written about the subject of individual choice but suffice to say that the choices we make are influenced by a host of different factors and sometimes, despite our best efforts, we need help. The Treasurer made the pragmatic decision (a sensible one in my view) to spend the $10,000 or more necessary to have the surgery done in a private hospital and reduce his risk of premature death. Unfortunately most people don't have that luxury. Asking someone with a drug problem to simply stop using drugs, a depressed person to cheer up or an overweight person to eat less while at the same time restricting their access to health care and to social support is as simplistic as it is counter-productive. The treasurer's own actions demonstrate that the obsession with incentives and individual choice that underpins conservative social policy is heartless and futile. Human beings are not economic units. We are – thankfully - much more complicated than that.
This budget is cruel not just because it suggests that people struggling to make ends meet have all made bad lifestyle choices but because it also punishes those people who have. It is not only lacking in empathy, but also lacking any understanding of why people find themselves in a position of disadvantage and how they can best be helped, rather than punished. It lacks an evidence base just as it lacks a moral compass.
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