THE NATION THE AUSTRALIAN,FRIDAY, DECEMBER 7, 2018

theaustralian.com.au 5V1 - AUSE01Z01MA

The long wait for hip and kneereplacements and cataract surgeryin the public hospital system isbeing used to justify those proce-dures being available only in top-level insurance policies, givenpatients already have a strongincentive to go private.

Long waits push surgeries onto private listUnder planned gold, silver,

bronze and basic categories ofinsurance, to be introduced fromApril, tens of thousands of policieswill be reorganised into compar-able tiers, promising membersgreater transparency and the abil-ity to shop around.

However, assigning clinicalservices to categories proved diffi-cult and took longer than the fed-eral government expected. Withhospital coverage falling, and con-cerns over rising premiums, stake-

holders have also had to predicthow members and prospectivemembers will react to the changes.

Documents obtained by TheAustralian under freedom-of-in-formation laws show waitingtimes for elective surgery in publichospitals have been factored intocategory design.

The Australian Institute ofHealth and Welfare this weekrevealed the average overallmedian waiting time for admissionfor elective surgery in 2017-18 was

40 days and increasing at a rate oftwo days a year.

Consultants engaged to modelvarious category options told theDepartment of Health they hadfactored in “demand shifting fromthe public to private setting” butmay have underestimated thepotential in elective surgery.

Where people faced waitingmore than a year in the public sys-tem, or an uninsured bill thatwould be higher than premiumsover the same period, there was

greater incentive to take outinsurance.

“Such consumers may warm tothe option of purchasing a productfor a particular service to avoid thepublic hospital waiting list,” theconsultants said, giving as exam-ples hip and knee replacementsand cataract surgery, which will bemandated only for gold-categorypolicies.

With an ageing population,demand for cataract surgery isincreasing and it is the most com-

mon elective procedure in thepublic system. So, too, is demandfor hip and joint replacements.

According to the institute data,1.9 per cent of people on the publiclist for cataract surgery wait morethan 365 days, with 6 per cent ofthose on the list for hip replace-ments and 8.4 per cent of those onthe list for knee replacements, alsoa consequence of rising obesityrates.

The consultants said that in2016-17 the average charge for a

hip replacement was $27,070 andfor a knee replacement $24,599.

“Both hip and knee replace-ments are good examples of treat-ments which have both long publicwaiting lists and treatment char-ges that are multiple times thetypical cost of a single year’s pre-mium,” the consultants said.

“Both of these effects will makeprivate health insurance particu-larly appealing, and there may even be people who adversely select against the industry by dropping

their cover again once they have re-ceived their treatment. The finan-cial sustainability of the private health insurance system is best managed by minimising such op-portunities for gaming the system.”

Health Minister Greg Huntsaid the biggest driver of waitingtimes in the public sector wasgovernments pursuing insuredpatients for the revenue, forcingthose who cannot afford insuranceand are “generally doing a lottougher” to wait longer.

EXCLUSIVE

SEAN PARNELLHEALTH EDITOR

Namatjira has mastered art of not taking things too seriously

It would be easy to place a crookedlens over Vincent Namatjira’s artand cast him as another progress-ive or “minority” person angry atDonald Trump. But that’s notwhat he wants.

“When I put a black person onthe canvas with Trump I want toput a question mark in people’sheads,” Namatjira says.

“I use humour to take awaysome of their power, to showpeople my side.”

The Arrente man and risingRed Centre artist, who has justbecome the first Aboriginal per-son to have a solo show at Florida’sArt Basel Miami Beach, thinks“positively” of leaders such asNorth Korea’s Kim Jong-un,although he also views him asdangerous.

“Putin reminds me of tjilpis(old men) back on the commun-ity,” he says. “Most of them werecowboys.”

Namatjira’s latest collection,on show in association with Mel-bourne’s This Is No Fantasy gal-lery, depicts Vladimir Putinshirtless on horseback, Trump of-

fering the Queen McDonald’s,himself and Trump, with a pro-vocative “Make APY GreatAgain” carving-up a cake decorat-ed with a map of the world.

Namatjira often places his sub-jects next to himself or out in the

Anangu, Pitjantjatjara and Yan-kunytjatjara Lands community ofIndulkana where he lives.

“I’m holding the Aboriginalflag: these two presidents havecome to Indulkana, but I’m here,and I’ve got the Aboriginal flag,

which is number one,” he says of awork showing himself, Putin andTrump. “I just want people toknow that indigenous people alsolook at world leaders … I want tobe recognised like my great-grandfather, Albert Namatjira.”

In Namatjira’s mind, Trumpmay be “trying to change theworld or whatever” but is still just“a funny bloke”.

“When he talks, he does thisstrange thing with his lips, like he’sgoing to kiss,” Namatjira says.

“Trump is doing things his ownway, sort of like I’m doing thingsmy own way.”

He sees Trump as someonewho’s too quickly judged, much asAboriginal people are, in his view.

“They are world leaders, butI’m an indigenous leader for theyounger generation. I do not wantto judge them, and I do not wantothers judging me,” he says.

“World leaders aren’t just an-gels or devils; they’re just men onan equal scale with the rest of theworld. To me, we’re all equal, and Ijust want to see people have fun.”

Namatjira, who was taken intoan institution at a young age, saysthe experience (including that oflosing connection to his ancestralculture) shaped his outlook.

An Archibald Prize finalist, hehas previously done reverent por-traits of indigenous figureheadsand seemingly mocking ones ofmodern Australian politicians. Hehas also tackled colonial person-alities and Aboriginal admirers ofthe Sydney Opera House.

News of Kim Jong-un’s nuclearwarhead-testing scared manypeople on the APY lands becauseof memories of British nucleartesting at Maralinga.

“I want American people andAustralian people to see that artcan change things, can changelives. It has changed my life andtaken me to places I’ve never beenbefore,” Namatjira says.

“I want people to see my paint-ings, smile and chuckle. Lookingat my work, laughing about it, goahead, because it makes me proudof who I am. I paint to have fun.”

ARTS P17

EXCLUSIVE

AMOS AIKMANNORTHERN CORRESPONDENT

JACKSON LEE

Vincent Namatjira in his Iwantja Arts studio

Namatjira gives Kim Jong-un a trim Donald Trump and the Queen

Bali drug muleLawrence willface chargesBali Nine drug smuggler RenaeLawrence will face court in Janu-ary on historical charges datingback to 2005, which are allegedto have occurred a month beforeshe was arrested in Bali for drugsmuggling.

The charges include stealinga car, driving unlicensed, speed-ing and failing to comply withpolice direction. Shortly after,Ms Lawrence was allegedly in-volved in a police chase on theNSW central coast.

Ms Lawrence, 41, handed her-self in to Waratah Police Station last month after spending 13 years behind bars in a Bali. She was granted conditional bail. She did not appear in court yesterday.

Her lawyer, Drew Hamilton,told magistrate Andrew Eckholdhe had earlier contacted thecourt to have Ms Lawrenceexcused from attending. MrHamilton said there had been“meaningful discussions” withpolice and he asked for a four- tosix-week adjournment untilafter the Christmas break. NSWPolice Commissioner Mick Full-er indicated that he would giveMs Lawrence time to settle backhome.

JESSICA CORTIS

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