AccessMyLibrary provides FREE access to over 30 million articles from top publications available through your library.

'The best friend Medicare ever had'? Policy narratives and changes in Coalition health policy.

Health Sociology Review

| June 01, 2006 | Elliot, Amanda | COPYRIGHT 2006 eContent Management Pty Ltd. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

ABSTRACT

As Leader of the Opposition in 1987, the current Prime Minister of Australia John Howard, stated unequivocally that he would dismantle Medicare at his first opportunity. By April 2000, the Health Minister in a Howard-led government proudly proclaimed to the Australian Parliament the Coalition was 'the best friend Medicare ever had'. Such a shift in ideology and policy position appears remarkable, overturning more than 60 years of conservative opposition to a universal, publicly funded, health care system. This paper traces the shift from the lead-up to the 1996 election until 2000, interrogating official policy texts to map how the Coalition reconfigured its own policy narrative about the Australian health care system. This paper argues that in order to understand contemporary reforms to the health care system, we must consider the way in which those reforms provide solutions to discursively, rather than objectively constructed, policy problems.

KEY WORDS

health policy; Medicare; private health insurance; social policy; sociology

Introduction

Throughout his tenure as Australian Leader of the Opposition in the 1980s, John Howard was unequivocal about his dislike for Medicare and firm in his commitment to dismantle it. His view resonated with the strong position historically held by the Liberal Party and its commitment to a voluntary insurance system. In the 1996 election campaign Howard, this time as leader and Prime-ministerial aspirant, announced a change of mind: the universal publicly funded health care system Medicare would be retained by a Coalition government. The Coalition has essentially kept its promise. Medicare and bulk billing still exist, and there has been no explicit limit on access to Medicare services. (1) However, between 1996 and 2000 substantial reforms, designed to promote private health insurance membership, were introduced. These reforms were justified to the electorate through a new policy narrative which broke with the traditional political division over health financing. Beginning from the position that in order to understand contemporary reforms to the health care system we must consider the way in which those reforms provide solutions to discursively, rather than objectively, constructed policy problems, this paper traces the shift, interrogating official policy texts produced between the 1996 election campaign and 2000, in order to map the Coalition's reconfiguration of their own policy narrative about the Australian health care system.

Drawing on the work of Schon (1979), Bacchi 1999) and Bessant (2002a, 2002b) this article focuses on the official rhetoric employed by the Howard government in reforming health policy. In the process, it maps the construction of narratives justifying and presenting particular policy developments. With regard to the politically charged policy arena of Medicare, such an approach draws attention to the underlying and often unspoken goals of such reform. Often policy analysis explores the technical changes--and their potential ramifications--in policy delivery, or the philosophical shifts driving policy change. These two levels of analysis are of central importance to the understanding of social policy. However, understanding the implementation of policy change, particularly in a politically charged area, also requires examination of the way in which such changes are publicly represented through policy texts. It is through such representations that policy actors articulate, and through such articulation create, the need for change. This article concentrates on exploring the creation of a new policy narrative about the organisation and operation of the Australian health care system. In particular, it examines the way in which this new narrative has promoted the view that the Australian health care system was in disrepair and required significant modification in order to be transformed into a successful health care system.

Related articles from newspapers, magazines, journals, and more
Managed care: employer's influence on the health care system.
Magazine article from: Nursing Economics Corder, Karen T. Phoon, Janet Barter, Marjorie July 1, 1996 700+ words
...care is having on the current health care system and how it will affect the...consider the evolution of our health care system. It is necessary to know who...the roles each plays in the health care system's evolution. However, no...
Profession, practice and profits: competition in the core of health care system.
Magazine article from: Systems Research and Behavioral Science Polder, Johan J. Hoogland, Jan Jochemsen, Henk Strijbos, Sytse November 1, 1997 700+ words
...profession; medical practice; health care system; governance problem; competition...transaction costs INTRODUCTION: THE HEALTH CARE SYSTEM Health care consists of two...macro level is called the `health care system'. This health care ...
Restoring fairness to Rhode Island's health care system.(Health Care Fairness...
Magazine article from: Providence Business News April 2, 2001 700+ words
...significant improvements to the health care system in Rhode Island. It will help...balance in Rhode Island's health care system. It will result in better, fairer health care. We encourage all Rhode Islanders...
Powell shares views on issues. (Boone Powell Jr., chief executive officer of...
Magazine article from: Dallas Business Journal Mabray, D'Ann October 28, 1994 700+ words
...and chief executive of Baylor Health Care System, is considered by many to...it: Columbia/HCA; Baylor Health Care System/Methodist Hospitals of Dallas...appetite for it." On Canada's health care system: "It only works because the...
Should the U.S. have a national health-care system? Health care is likely to be...
Magazine article from: New York Times Upfront Edwards, John Tanner, Michael September 17, 2007 700+ words
...your own care. A universal health-care system would translate into reality...everything right with America's health-care system. But there's a big difference...compared with what a national health-care system would cost. There are steps...
Diagnosing the U.S. health care system; health care cannot be fixed piecemeal;...
Magazine article from: America England, Mary Jane December 3, 2007 700+ words
...uses social commentary to hold health care in the United States up to shame...the patient he observes--our health care system--his film prods viewers into...the dark and the bright sides of health care with a view toward future improvement...
Baylor Health Care System and Healtheon Team to Deploy Integrated...
Press release article from: Business Wire December 23, 1998 700+ words
...HealthWire)--Dec. 23, 1998--Baylor Health Care System, one of the nation's largest not-for...chief medical information officer at Baylor Health Care System. Baylor Health Care System's senior vice president and chief information...
Decreasing the Cost of Health Care, Increasing the Quality: Nation's Fourth...
Press release article from: PR Newswire June 26, 2007 700+ words
...Connection, the collaborative care system is designed to apply a comprehensive...compilation of claims data, health care provider records and self...level of care throughout the health care system. Health Care Service Corporation, a Mutual...
Defining a role for states in a federal health care system. (Health Care Reform...
Magazine article from: American Behavioral Scientist Hanson, Russell L. July 1, 1993 700+ words
...Florida blazes trail to a new health-care system. New York Times, pp. A1...including H.R. There is a health care crisis in the United States...For many in the United States, health care is becoming prohibitively expensive...
Georgia Baptist plans to serve all counties. (Georgia Baptist Health Care...
Magazine article from: Atlanta Business Chronicle Goldman, Melanie D. January 10, 1997 700+ words
Georgia Baptist Health Care System, a 95-year-old private hospital...Harrell, CEO of the Georgia Baptist Health Care System. The marriage of nonprofit Georgia...quality and reduce the cost of health-care services to patients. Georgia...
For more facts and information, see all results
©2009 Gale, a part of Cengage Learning. All rights reserved.
About us | FAQs | Contact us | Privacy policy | Terms and conditions
Other Gale sites: Encyclopedia.com | HighBeam Research | Acquire Content | Books & Authors | Goliath | MovieRetriever | Smart QandA