How the care economy turned into a market meltdown

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OPINION: Health, aged care and disability care add up to some of the fastest growing parts of the economy. But they exist in a limbo of failed private contracting that has to be fixed.

One of the truly perplexing things about this election campaign is that, of all the things that we are talking about, or shouting about, few relate to the issues that have most reflected our suddenly intimate relationship with government amid a global pandemic: issues like the state of the health and hospital system;These were all found to be wanting during the pandemic. Two royal commissions are either completed or under way.

The care economy is now one of the fastest growing parts of the economy, it is the sector which is forecast to generate really seriously large numbers of new jobs, yet we know very little about how it is structured or who actually runs it.That is, actual government services to people is one of the fastest growing sectors of the economy. But we don’t talk about it because it lives in some limbo land between “the government” and “the private sector”.

Anecdotally, people in those sectors, and in the public service which now largely exists to run the contracts, will admit that governments increasingly want to just have a few large operators running things for them. Having thousands of small operators who you have to deal with and regulate is a drag.That creates a sultry swamp for the gradual build-up of oligopolistic, or at least not very competitive, markets. It provides the breeding ground for corruption and conflict of interest.

Almost three years ago to the day, this column documented how the Morrison government had announced a $320 million “investment” in aged care when it was under pressure from shocking revelations about the sector that had appeared on the ABC’sThe way the funding was announced implied it was going to add “$1800 per permanent resident” to the subsidy provided to each resident “to deliver quality aged care services”.

It is hard to work out from those numbers exactly how concentrated the service delivery markets are across the country. Well, announced is a bit strong. The details of the tenders were released on the departmental website. Bedlam has largely reigned ever since.It is estimated that 80 per cent of existing arrangements were overturned.

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