There is no need for a Chicken Little response - Medicare reform is needed

What they ignore is that removal of the rebate would drive millions of people out of the health insurance system, forcing up prices and driving even more onto the public sector.

This would, of course, strengthen the role of public-sector unions representing doctors, nurses and everyone else in the health-care system and make it easier for them to squeeze future governments (and their taxpayers).

Is it too cynical to ask whether that's what all the fuss is really about?

Subject to any analysis, the federal government's package is a sensible and constructive one that deals in an equitable way with current and foreseeable future health system problems.

Australia, like the rest of the world, faces problems funding the health care needs not just of an ageing population but a world in which technology makes it possible to offer treatments hitherto unimaginable - but at continually escalating prices. As the recent SARS scare showed, nature is also capable of throwing up hitherto unimagined illnesses which will, of themselves, stretch the capacity of the health care system AND taxpayers to fund it.

In these circumstances a rational and compassionate society will ensure that its resources are directed to those most in need, while mobilising the capacity of the more fortunate to take some of the financial responsibility for their own care. Importantly, too, it will ensure that those on lower incomes are offered an opportunity, if they wish to use it, to access private treatment options as well as public ones. The 30 per cent rebate performs this task admirably.

The alternative is rationing public-sector treatments. We all know who will lose out then. And it won't be those who can afford to buy their way around the system. A black market in health-care services is the worst possible solution to our society's problems, and the sooner the opponents of sensible reform realise that the better.