Tag: Health

Jargon devours our body politic, degrades our national identity and destroys our duty of care.

aaa child and doctor

Australians are a plain-speaking people who prefer simple, direct speech in their everyday dealings. We also, however, have a fondness for the vernacular, our unique, colourful, colloquial language.  Our national conversation is enriched by vivid images and vital figures of speech and it is often underscored by a capacity for ironic understatement which keeps us from having tickets on ourselves and which can also act as a reality check on others’ pretensions.

The Australian tradition is under attack today, however, from all sides, from spinners who could sell their own grandmothers to experts who wilfully pepper their conversation with jargon, happily losing whole audiences in the quest to bolster their own status and to have the last word. No wonder disillusionment with politics appears rampant. We have forsaken substance for smoke and mirrors. We are hungry for information but we are served up regurgitated often ill-digested remnants of someone else’s haute cuisine. We are talked at endlessly; jawboned by asses with diplomas in communications and public relations and wannabe economists who know the price of everything and the value of nothing. The worst of these merchants may convince themselves of their own importance but they end up talking to themselves in public. Best we not dwell any further on the failures; far better we turn to our successes.

Our finest political discourse is typically vigorous, succinct and to the point. When Paul Keating sought the leadership from a resistant Bob Hawke, his words were. ‘I was after his job. He didn’t want to give it to me.’ Keating was a master of memorable speech, he could effortlessly change register to mine rich colloquial idioms or even invent some:

Well, the thing about poor old Costello, he’s all tip and no iceberg, you know. You know, he can throw a punch across the parliament, but the bloke he should be throwing the punch to is Howard. Of course, he doesn’t have the ticker for it.

Neither man nor politician was ever lost for words and their best left no-one in any doubt as to where he or she might stand. At the same time there is a robust, sentient vitality: as Sydney Baker, who published several works on slang: the Australian’s ‘greatest talent is for idiomatic invention. It is a manifestation of our vitality and restless imagination’.

Keating’s masterful debating style was acerbic and theatrical but informed by living Australian language and culture; drawing strength and power from the vital oral traditions of the nation at work and at play, at home and in the street. His entertaining but deadly debating style has gifted a number of acidulous one-liners to our lexicon. These can still be relished today:

The Leader of the Opposition is more to be pitied than despised, the poor old thing. The Liberal Party of Australia ought to put him down like a faithful old dog because he is of no use to it and of no use to the nation.

The image is engaging, outwardly familiar and couched kindly, almost sympathetically, but there is a stiletto twist within the bouquet and the deadly main message is spelt out with unhurried, unmistakeable, declarative clarity. Keating was inventive in the best Australian tradition, with a surrealistic twist as and when required: Decrying John Hewson’s debating he said:

‘It was the limpest performance I have ever seen … it was like being flogged with a warm lettuce. It was like being mauled by a dead sheep.’

Our public speech, however, has been increasingly undermined as exotic linguistic forces have done their colonising. Flash as a rat with a gold tooth, the expert undermines the field if not the high ground of our national conversation.

Experts, of course, come in many guises from the hired pun, the lone ‘communication consultant’ to entire agencies dedicated to helping you get your message out. The PM spends millions on his stable of spin doctors and speech writers and cannot leave the office without his talking points, a list of empty phrases every parliamentary party member parrots but never owns. Could he do without them? We have his words for it. ‘You bet I am! You bet I will.’

The government pays experts with our money to exclude us from dialogue in the aim of ‘selling its message’ or ‘touching base with the electorate.’ The professional explainer pops up amongst us at every turn. He or she may take many forms, from the tax expert with his ‘bracket creep’ to the weather person with her ‘rain event.’ Jargon has colonised our discourse, laying waste plain speech, promoting indirection, evasion and enhancing mightily the prospects of those who would baffle in order to pull rank, exert power or dodge responsibility.

Like a rat up a drain-pipe, jargon has raced onto the stage of our national consciousness. It has infested mass media and it hovers over popular discussion ready to strike. It squats, today, upon our nation’s public discourse like a cane toad, an ugly and noxious foreign invader, dulling our senses, poisoning our hearts often crushing our spirits with its bulk. Nowhere is the poison better exemplified in than in Health. Our new minister, Sussan Ley, has wasted no time in announcing that the principle of the co-payment is to send a price signal. She wants to raise doctors’ fees but dare not put it plainly. She may be new to the job but she is already confounding us with jargon creep, Wronski’s new term for the invasion of technical language and the exodus of real communication.

Jargon creep, gets its name from bracket creep, a term first heard from the lips of Peter Costello a former Federal LNP Treasurer who frittered away the profits from the mining boom on tax breaks to sweeten his party’s electoral appeal and thus keep John Howard’s government in power well beyond its use by date. Jargon creep is all pervasive. Everywhere around us, in our newspapers, social media, advertising copywriting, on our radio and TV, even in online newspapers our senses are assaulted from breakfast to bed time by the steady, insidious infiltration of jargon into our everyday lives, especially, but by no means exclusively, the misuse of economic jargon to explain, regulate or justify human activity.

No longer do we expect to ‘see results’; ask ‘what happens,’ we must instead, increasingly be prepared to see how this plays out. Within this gem is the idea that we are spectators at some game. We are not responsible agents ourselves but instead we are bemused onlookers who must hang around to see some random result. See how this plays out is heard everywhere and unless we can resist the implicit sidelining or abdication of our own agency, it will be all over red rover.

Jargon makes us passive onlookers. It excludes us and it transfers our right to be in charge to other agents. Just in case you thought you are just reading this, for example, let me put you straight: you are in fact an electronic text consumer, consuming a product. I am not writing to you, I am engaged in content delivery. Meaning is of course, in the best postmodern fashion relegated to a secondary and optional extra. The black cat is white if that’s your take on it. What do I mean? It is whatever you care to take from this, a ludicrous overstatement of subjectivity in understanding. Next thing you know we will that have one man moved to tears by looking at our asylum seekers’ deaths in custody whilst another may applaud our toughness, a brave stand to protect of our borders.

One of the lowest, most disgraceful points ever reached in our national history occurred last year when the Federal Immigration Minister, Scott Morrison, typically anguished in his expressions of regret to parliament at having to keep asylum seekers in detention centres when they could have otherwise been working for a pittance in Australian fields and factories. ‘I don’t have a product!’ was his protest. Of course his ‘lack of product’ was all the fault of the senate and the Labor Party but then jargon is handy that way. It helps shift the blame for our own reprehensible actions on to others. And it obscures the truth, which in this case was that the minister could have issued temporary visas if he had really wanted to. There are still, it grieves me to note children in detention men and women languish in indefinite detention while the government unaccountably pats itself on the back for honouring an empty slogan: stopping the boats.

Jargon is the language of experts in a particular field of endeavour, which has jumped the fence. For example, a challenged Federal Treasurer may explain his government’s decision to increase doctor’s fees by claiming that we need to send a price signal.

What he means is that he wants to put the fees up. He just wants it to sound less arbitrary and somehow fairer and more reasonable. He is deluded enough to believe that the jargon will sweeten the bitter pill of deception. The jargon is always a lie and an obfuscation. Only in our present political regimes it will be parroted by the entire mob of galahs with their talking points and their people in the background doing meaningful nodding; as if repetition and mindless endorsement somehow strengthened rather than undermined meaning. Politicians talk of the team being ‘on message’ but what they mean is they are happy to have everyone ‘singing from the same song sheet’ or endlessly duplicating slogans that never bore inspection in the first place. Take Mr Abbott’s government’s real solutions pledge:

The Coalition’s Real Solutions Plan will build a diverse 5-pillar economy to build on our strengths, including in manufacturing. I will spare you the detail because there is none. The package is a set of glib slogans that nonetheless have been endless recycled by the sections of the tame media as if they were ever a meaningful commitment to anything. And so it is with price signal an asinine compound noun which has been dragged from the neo-con economics textbooks out into the wider world of Health where it sticks out like a shag on a rock. Not only does it not belong in public health it should be expunged from all political discourse instantly.

Price signal has become a familiar term recently because of our government’s plans to increase GP charges by decreasing the Medicare rebate.  Economists invented ‘ price signal’ to explain their theory that higher prices send a signal to buyers to reduce their consumption. Now without wading into economic theory and competing notions of price setting, the analogy is outrageous. It’s not only nonsense, it’s the worst kind of nonsense and completely injurious to your health. Moreover, it’s dangerous nonsense. How can a visit to a doctor be compared with buying a loaf of bread or any other commodity? How can health be compared to the supply and demand of commodities of any kind?

“Health and health care,” Greek Physician Dr Benos said in 2012, “are not commodities that exist to drive the economy. They are among the social goals which we have an economy to achieve.” Yet we are being driven mad with meaningless jargon about the Market, about the need to pinch our pennies, to tighten our belts; the ‘virtue of austerity, when what we need to ask is “Why?’ Why is there an economy? What is the goal of production? Surely it is to provide a society equipped to care for every one of its members. Let’s reject the price signal jargon and everything it stands for including the cruel myth propagated in the United States of America that when we support the core needs of the most vulnerable, we weaken the economy. Let’s not be hoodwinked by experts and jargon into getting it arse about face. Taking care of people comes first. It’s not the economy, stupid.

Wronski’s rule of thumb states that: Very little in human affairs can be explained in market terms; the best things are inexplicable, especially in market terms; the more we resist market jargon, the more things will make sense and the happier we will be. Above all health is our society’s lifeblood and an inalienable right for each member not a commodity that needs its price signalled.

Australia dismantles its Healthcare system to suit its government’s ideolgy and not its peoples’ needs.

111 A paul bongiorno on health

Seeing the doctor is about to become greatly more expensive for all Australians in a government move which will alienate both doctors and patients across the nation whilst it adds to the suffering of those most at need. Next week GP’s fees will rise suddenly by around $20 or more per visit because the Federal government has cut Medicare rebates and made other changes to GP’s consultation schedule by regulation.

Applying its “10 minute” rule will increase GP waiting times while from January 19, Medicare will pay $20.10 less for consultations lasting six to 10 minutes, consultations it has long paid $37.05 towards. Such “Level B” visits are required by millions each year for prescription renewals, blood pressure and other vital but routine check-ups. It will now pay $16.95, a reduction the medical profession fears will “destroy” free universal healthcare.

There has been no community consultation and no negotiation with the AMA, the professional body representing our doctors, a body which is now understandably angry at its exclusion by a government which has failed to negotiate with key stakeholders before making its decision. The decision constrains a vital part of the doctor-patient relationship, the time a doctor has with a patient, limits appointment-making by extending consultation times and will restrict access to medicine amongst the elderly, poor and needy. It is ill-advised, unnecessary and high-handed. It has not been well-received by the medical profession.

AMA President Associate Professor Brian Owler says the Government’s unilateral move to slash the rebate for GP consultations lasting less than 10 minutes, cut Medicare rebates by $5, and extend the indexation freeze on the Medicare Benefits Schedule through to mid-2018, has provoked the angriest response seen from the profession in many years.

Thwarted by being unable to get its GP co-payment legislation through the Senate, the LNP has chosen regulation to achieve its aim of ‘sending a price’ signal’. Whatever this piece of jargon may mean in plain English, the government is certainly ‘signalling’ not only a contempt for democratic processes but an alarming willingness to govern by any means possible, including if necessary, by decree. Democracy, for all its constraints, is infinitely preferable to the desperate ‘ad-hoc-racy’ of the current Federal government as it panics to implement its radical rightist agenda at any cost.

Sending a price signal is jargon for making a visit to your doctor cost you more in order to cause you to see your doctor less often. Around Budget time, we were treated to Joe Hockey’s assumption that some, if not many, visits we make to the doctor are not necessary. Hockey’s scenario is ludicrous, yet it has powerful adherents in the government: the price signal will bring us to our senses and eradicate malingering at a stroke of the regulator’s pen. Where he gets his information is never divulged because it proceeds from ideology rather than empirical fact.  At worst, it is a palpable lie for the purpose of withdrawing funding from those who need it most: the elderly, the needy, those on low incomes. Discriminatory against key groups in society, given the structure of our economy and society it will punish women most, in what seems like a calculated act of callous indifference if not cruelty – all to meet a commitment to its grab bag of neo-con, radical hard right ideology.

Peter Dutton, until recently our self-effacing, under-achieving, Federal Health Minister, threatened late in November that the LNP government would introduce changes by regulation if necessary to send its coveted price signal.  He sounded desperate if not petulant in his newly resolute tone, an understandable shift given his own failure to consult or negotiate his ill-fated GP co-payment before it appeared in Joe Hockey’s dud Budget.

If there were a crisis, it would be a crisis born of incompetence, a crisis of his and his government’s making, by its distaste for adequate public discussion prior to any policy formulation.  A responsible political party might even have taken such a controversial idea to the people in the election campaign, but complete silence or misleading lies formed the course chosen by our current Federal politicians in the last election as they promised anything to get elected, whatever their subsequent commitment might prove but who carefully left out any detail of their real intentions. Soon after his bullying comment, Dutton was shoved sideways into Immigration’s contingent vacancy, a vortex of incalculable dimensions created by Scott Morrison’s move into Social Services and has not been heard of much again apart from his announcement that he would arm Customs Officials, a move which no doubt will suit arms suppliers but which is unlikely to increase safety, efficiency or public confidence.

‘It shows we are serious about border protection,’ is his line and he’s welcome to it.

Dutton’s successor, Sussan Ley, a Health Minister whose ministry is combined with Sport describes herself as a “recovering punk rocker from a time when it really mattered,” doubtless brings other strengths to her new portfolio such as an interest in regional and rural health and a commercial pilot’s licence, both of which commend her to our flying doctor service.

Too little is known of Ley’s post-punk and piloting credentials although much has been made of the fact that she is a woman. A former accountant with the tax office in Albury, it remains to be seen how she will position herself politically in her new job. Her performance, to date, however, as Assistant Minister for Education suggest strongly Ley is an economic dry who will happily follow a hard right agenda as articulated by fellow new blood, Assistant Treasurer, Josh Frydenberg.

People need to realise health care isn’t free and must be prepared to make ‘modest’ contributions to it, he said whilst new assistant treasurer, Kooyong colt, barrister, writer and tennis player Josh Frydenberg, was on message trotting out the ‘tough but necessary medicine’ line:  ‘Hard reforms are sometimes unpopular,’ he continued, furthering his party’s abuse of the word reform when it means change or simply, cutbacks. Making a virtue of necessity, perhaps, as his government faces continuing decline in all opinion polls, he opted for a self-reassuring but utterly unconvincing lie: ‘We don’t seek to win a popularity contest.’

Frydenberg, appointed in December whilst his predecessor Arthur Sindodinis stands aside to better assist ICAC, has been a senior adviser to Downer, Howard and was Abbott’s parliamentary secretary in charge of the government’s deregulation agenda.  His perspective fits the Abbott government’s hard right policy of dismantling our current system in favour of one in which the patient or ‘consumer’ will face prohibitive costs. The price signal is a key part of the myth. As Professor Jeff Richardson, director of Monash University Centre for Health Economics argues: ‘The unsustainability of government health expenditure in Australia is a myth that has been carefully nurtured to justify policies to transfer costs from government to the public.’ ­Sustainability panic argues Steven Duckett, Director of Health at the Grattan Institute, is often used to justify shifting the burden of controlling health spending from the wider society to a vulnerable few – people with poor health who frequently go to doctors and hospitals, for example, or those with high needs and potentially shortened life expectancy.

People need to realise health care isn’t free and must be prepared to make ‘modest’ contributions to … Frydenberg asserts disingenuously. He fails to acknowledge that we know all too well that our health care is not free, we have been paying taxes for it all our lives. Public understanding or support is ill-served by patronising and derisory comments implying the opposite. A little listening to the people is recommended before you tell us what’s best for us, Mr Frydenberg.

Australians are not mugs. Although it will be challenging, given the inertia and indifference dictating your government’s consultation by-pass, an operation made necessary by its sclerotic heart, you need to heed the message: the public is not fooled into being falsely reproached for its delusions: taking Healthcare something for nothing.  It never did. Give the people some credit. They pay taxes, read newspapers and they also vote.

Setting up a straw man, a misconception which can only be destroyed by a price signal is irresponsible. Just give us the facts, Minister Ley. You are about to make Healthcare more expensive and elitist still as you dismantle a system which we pay taxes for so that it may look after all of us, not just the wealthy. Why? It is simply because it fits your mumbo-jumbo Hayek meets tea party ideology of letting the market rule, your slogan of ‘user-pays’. It is the price of your infatuation with ‘small government’, self-reliance and similar meaningless slogans and unworkable assumptions. The new fee rises are a travesty of any respectable health policy, and a betrayal if not outright abnegation of community, compassion and conscience.