Kevin Rudd will take over the hospital system and everything will be dandy.
That's the election pitch to voters in New South Wales, South Australia, and Queensland, who are desperate to have the Prime Minister wrestle hospital control out of the hands of the state governments those voters elected.
Rudd's proposal displeases John Brumby, who believes that comparing Victoria's health system with that of New South Wales is defamatory, if not outright seditious. If both leaders hold their ground, we have the edifying prospect of a state premier defending his state against a prime minister of his own party, while they both head to an election.
It's probably some kooky factional thing. No doubt a few Labor heavyweights know the "real story" behind it all.
But Brumby is right to fight. It is very altruistic of the Prime Minister to "end the blame game" by granting himself more power.
After all, this "blame game" is entirely Canberra's fault. Over the past one hundred years, the Commonwealth just hasn't been able to stop itself interfering more and more with areas that are state responsibilities. Well, according to the constitution.
It's understandable the states are so unpopular -- the New South Wales government has become little more than a succession of coups d'état. Queensland looks to be heading that way too.
But put aside any notion of states' rights, of the virtues of a federal structure of government, of having the government closest to the people to be the one that makes the decisions. Or of the danger of concentrating power in just one level of government.
Right now, the biggest delusion in Australian public debate is that the federal government is inherently better at running policy.
There are calls to have Canberra take over: occupational health and safety laws, more workplace laws, disabled parking permits, taxi drivers' training standards, the timing of daylight saving, the date for ANZAC day, travel concessions for seniors, safety standards for poultry, taxes on racing and wagering, the rules governing firearms management, inheritance laws, public transport, building standards, childcare standards, pokies licensing, bikie gang laws, carbon emissions plans, and on and on and on.
That's only about half the list I have in front of me -- every man, his dog, and his dog's government relations officer seems to wants Canberra to assume responsibility for some state policy or another.
Last October Kevin Rudd even argued urban planning should be subject to a federal takeover. Urban planning is about as far from a Commonwealth responsibility as you could get.
Dissenting against the Howard Government's Workchoices industrial relations takeover, Michael Kirby, called this "opportunistic federalism". There's no political theory, no policy consistency, or coherent direction governing what policy areas Canberra chooses to suck into its vortex. Just whatever federal politicians reckon will be most popular.
And there's no doubt the health takeover is popular. Eight out of 10 Australians want a federal takeover of health.
But this isn't that. The states will continue to fund 40 per cent, the Commonwealth the remaining 60.
Hospital workforce planning will be jointly managed by the federal and state governments, which will make workplace relations for nurses and doctors a hell of a lot more complicated. Specialised services will also be jointly managed, as will the mix of medical services. Procuring equipment will be negotiated between states and local hospital networks. The federal government will set performance targets, state governments will measure targets, and local hospital networks will try to achieve those targets.
This plan won't cull bureaucracy. It'll add it. The federal government will have a stake about what happens in the hospitals. The states will have a stake, and the local hospital networks will have a stake. And regulators get a stake. A bit like the current system, except in triplicate.
More: if you believe a federal government takeover of funding will allow local communities to run hospitals, recall the insulation industry debacle. The government that coughs up the money is ultimately held responsible when it all falls apart. The next person to die in a waiting room will be seen as Kevin Rudd's personal responsibility. And then there'll be more direct federal intervention into hospital management.
Brumby's stand against this plan is great. But he doesn't focus on the real problem.
The states cannot avoid being the lapdog of the federal government while they're almost entirely reliant on the federal government for their money.
Rudd's health plan takes a third of the revenue from the GST back from the states.
If Brumby wants to assert Victoria's position as a health innovator, he'd push for something really radical: to get Canberra out of the income tax business and return the power to levy income taxes to the states.
Ask a nearby teenager. Earning your own money is the key to independence. Only with fiscal sovereignty will the states be able to reassert their policy autonomy.
Brumby's confrontation with Rudd will be hollow unless he tackles the states' master-servant relationship with the Commonwealth.
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