Back(wards) to the Future: The ethics of trading present health care for research

Those outside of Australia are probably at best peripherally aware of the furore that the current budget announced by the new government last week is causing – it is in many ways an unsurprising budget for a broadly rightwing socially conservative government and quite reminiscent of the policies the Con-Dems have brought in the UK (attacks on public services, deregulation of higher education) against the background of a similar rhetoric of economic necessity and being all in it together, needing to clean up the mess left behind by the (kinda, almost, nominally) leftwing former government. It has managed thus far to reverse the popularity of the preferred leaders, and political parties so the fall out may be quite significant.

One interesting winkle it introduced was the introduction of a new medical research future fund (we are told ultimately it will be the largest in the world) which the majority of the significant cuts to public expenditure on health care would be channelled into and in particular of the new $7 co-payment that patients would be asked to pay to go to the GP(doctor) $5 would go to this new fund.

Obviously this is at least partially a cynical attempt to force the health cuts through the Senate (since if Labour votes against it as they say they will and succeed in stopping this policy then the Liberals can cast them as wanting the electorate to die of cancer…) sort of the equivalent of what is known as pork barrelling in the US.

And here you go a direct quote from the Minister for Health:
‚ÄúPeople should understand that if they don’t want to put money into medical research then they can go down the obstructionist path of Labor and the Greens,”

Nonetheless there is an interesting question of whether this tradeoff is ethically acceptable? I wrote a little something about it here.

Unsurprisingly I think typically it won’t be because the cut backs to public health and new co-payments being imposed disproportionately disadvantage those worst off in society and the benefits will disproportionately accrue to those already well off – due to the cost of entry for new medical treatments, differing life expectancies and the likely focuses of medical research.

If the fund focused on disadvantage, health generally conceived and there was a guarantee that evidence generated would be listened to by government then it could be a force for good, but how likely is that?