by a Modest Member of Parliament [Bert Kelly],
“The fruit of specialist sideboards,”
The Australian Financial Review, March 30, 1972, p. 3.

We are all concerned about the almost inevitable escalation of the cost of government schemes. Let me take as an example the Commonwealth Government’s expenditure on health services. In 1961-62 these were costing $165m. By 1970-71 the cost had risen to $427m. The population had increased in the meantime, from 10.6m to 12.6m. But the cost had risen from $15.50 in 1961-62 to $33.81 in 1970-71.

Of course, the value of money has deteriorated in the meantime, but using 1961-62 prices to deflate the figures, the cost per head rose from $15.50 in 1961-62 to $26.44 in 1970-71, a 75 per cent increase.

There are many reasons to explain these increased costs, such as more services rendered, more complicated services, profiteering by doctors and so on. I have always blamed it all on these factors, but now I have an uneasy feeling that at least part of the problem rests with me and people like me.

If I get services for nothing, or close to nothing, I tend to use them unnecessarily, so the cost of these services to the taxpayer who supplies them rises alarmingly. Let me recount how this unpleasant fact was brought home to me.

A few months ago I thought I was going to be ill. I became very sorry for myself. I drew poignant pictures of me dropping in my tracks in the course of duty. The word “dedicated” frequently appeared in the epitaph that I fondled in my mind.

I used to imagine the scene in Parliament, with the House standing in hushed silence, after the leader had, with broken voices, extolled my many virtues.

Mavis complained that if I had been a Minister even for a few months, I would have been given a State funeral. She would have liked that.

After extracting the maximum pathos from my condition, I went with faltering steps to see my GP. I steeled myself to hear the sentence that I knew would come, that I had a very bad heart caused by dedicated devotion to my constituents. He would tell me that my only hope was to take things easy for what was left of my life.

He was very thorough; he kneaded me all over, listened to me in a most intimate way through his stethoscope, and then questioned me closely about the life I lived.

I seized the opportunity to tell him how hard I worked, how Eccles made me sit up all night reading Tariff Board reports, and so on. I was just about in tears by the time I had finished the saga of my suffering.

Then the wretched man said that my trouble was the result of not taking enough exercise, eating too much and drinking too often. I received this information with such obvious incredulity that the doctor said perhaps I ought to go and see a specialist.

So he took some blood and sent that along to a pathologist. He sent me to a heart specialist. I was glad to get these expert opinions, particularly as I knew I would not have to pay much money for the service.

The pathologist cost me $18.50 and I got back $18.50 in medical benefits.

The heart specialist cost $34 and I recovered $30.50.

The total cost of visits to the GP and the two heart specialists cost $66.10 of which I recovered $53.80.

Now all these doctors charged the common fee, no one deviated one inch from the highest ethical standards. But the specialist report only confirmed what the GP had said in the first place.

I only went to the specialist because I knew it wouldn’t cost me much. I am sure that the GP only sent me there because he knew I would get advice for next to nothing.

I know that specialists are necessary. But I know now, from my own experience, that many visits to specialists are only made because their cost to the patient is minimal.

The specialists have an expanded clientele, with an assurance of being paid, such as they never had before. The system suits them fine. It also gives, in some cases, good medical results. I am not denying that.

All I say is that supplying services at a great deal less than cost is a certain way of leading to their over-use. The things you get for nothing you value as such.

So every time the taxpayer, represented by the government, supplies something for nothing, or next to nothing, you always find the cost goes up and up.

The sad thing is that we think we are milking the government. We are really milking each other, and there is really not much profit in that exercise except for the specialists who get the cream.