Social

Key Points

• The budget does nothing to reduce health inequities.
• The people in most need receive the least in the 2019-20 Federal Budget.
• Tax cuts will remove vital revenue from the system well into the future. Our ability to pay for essential services such as health care and education will be at risk.
• Lack of action now on social determinants of health will have substantial costs on the health and wellbeing of Australians into the future.

Analysis

‘Investing in the conditions in which people are born, grow, live, work and play is good for society, for the economy 
and for people’s physical and mental health.’ Professor Sharon Friel

• Our health reflects the environments we live in – our physical, cultural, economic and environmental circumstances.This is the single most important determinant of health. 
• The relationship between income and health is clear – those with lowest incomes have the poorest health. 
• Reducing poverty, addressing racism, stigma and discrimination, ensuring secure and affordable housing for everyone, ensuring health care is accessible to everyone, acting on climate change and improving education and employment will create the environment that promotes good health and reduces health inequities.
• The 2019-20 Federal Budget fails to address any of these social determinants of health.
• Tax cuts reduce Australia’s revenue base well into the future. Funding for the essential services the community relies on – health care, schools, child care, age care and disability services – will suffer in the future. Health inequities will worsen.

Measures addressing the Social Determinants of Health

Measures that would improve health equity through addressing the social determinants of health were completely absent in the Budget:

• Reducing poverty
• No increase to the woefully inadequate level of Newstart Allowance, despite widespread. support for an urgent increase of $75 per week. 
• No increases to other pensions and benefits. 
• Housing
• Nothing to respond to or reduce homelessness. 
• Very little investment in social or affordable housing. 
• Tax cuts
• Biggest benefits flow to those on higher incomes – who have less need for them. People on the lowest incomes – who don’t earn enough income to pay tax – will receive no benefit from the tax cuts.
• People on $200,000 will get over $224 a week. 
• People on $50,000 will get $23 a week. 
• People on $25,000 (on pensions) get a one-off payment of $75 (equivalent to $1.40pw).
• People on $15,000 (on Newstart) get a one-off payment of $75 (post Budget announcement). 
• Energy Assistance Payment  
• The one-off payment of $75 will do little to offset rapidly increasing costs of living for those on the lowest incomes. 
• Employment
• No plans to reduce unemployment, particularly for long term unemployed. 
• Rural/remote
• Limited provisions aimed at the addressing the health disadvantages of living outside major cities. There is $62m to train doctors in rural general practice and money for specific programs in particular regional and rural areas.  
• Climate change
• Nothing to address the health impacts of climate change 
• Reactions to the Climate Solutions Package are skeptical that it won’t produce significant emissions reductions 
• No specific plans to respond to and reduce racism and discrimination  
• Education and early childhood 
• 15 hours of 4-year-old preschool extended for two years, including $1.4m to increase preschool attendance rates of disadvantaged and Indigenous children.  
• No changes to school education funding.  
• $525.3m over five years to improve the VET system, including up to 80,000 new apprenticeships. However, commentary indicates this is simply returning some investment into the sector that had been cut in recent years. 

Public health measures

There’s also little joy in public health measures that would improve the health of people on the lowest incomes.

• Lifting freeze on Medicare rebates for diagnostic imaging and GP services could reduce out of pocket costs.