Does Australia have a healthy democracy?

For some, the story of this election has been that overt anti-immigration sentiment lost, and expanding healthcare and women’s health won. It’s a heartening sign that Australian voters want real solutions, and that the scapegoating of migrants might no longer be a surefire path to election victory. But the story of this election is just as much about what was off the agenda, as what was on it. Issues such as establishing a Treaty with First Nations and action to stop the genocide in Gaza were off the government’s election agenda, which caused frustration and distress among many voters. When it comes to the winning election promises for expanded health access, particularly for women, many migrant and refugee women are still left out and excluded.  

Among these promises is Labor’s $793 million package for women’s health. For those who hold a Medicare card, the package is a big win, allowing many women and gender diverse people to access cheaper contraception and medications for endometriosis, longer appointments for complex women’s health concerns such as menopause, IUD insertion, and pelvic pain and more government funded endometriosis and pelvic pain clinics. But for many migrant and refugee women and gender diverse people on temporary visas, these services and medications will remain expensive, inaccessible and out of reach. 

Over 700,000 women in Australia are on temporary visas, most of whom have no access to Medicare. This means no access to the promise of expanded bulk-billed GP visits and PBS subsidised medications, while the cost of government-funded endometriosis and pelvic pain clinics still varies confusingly from clinic to clinic for those without a Medicare card. When it comes to the government’s promised 50 additional Medicare Urgent Care Clinics, it is still unclear if those on temporary visas will have access to these vital 24/7 clinics that hope to increase access to urgent health advice and reduce hospital wait times.  

For migrant and refugee women and gender diverse people who already face significant barriers to accessing healthcare, this confusing and inconsistent terrain makes access more difficult. Not being able to access the treatment and care to get better and prevent serious illness affects migrant and refugee women’s ability to rest, play, work, study and care for themselves and others. It also puts pressure on the emergency and acute end of the health system. In Australia, 26% of endometriosis-related hospitalisations were of females born outside of Australia – a statistic that reflects in part the barriers migrant and refugee women face in accessing primary and preventative health care.  

The primacy of healthcare this election indicates that Australian politicians know that accessible, affordable primary healthcare is vital for a healthy society and a strong healthcare system. But to reap the benefits of primary health, it must be universal. As our CEO Dr Adele Murdolo told SBS, “All of those types of healthcare, which is more at that preventative and early intervention end, save us money at the other end. So, I’d really like to see a government putting some kind of thorough investigation into separating out healthcare from visas.” 

More than 90,000 migrant women on temporary visas work in health and healthcare, many of whom have no access to Medicare. Among these is Elnaz, a cancer researcher who has no pathway to permanent residency due to the government’s ‘Fast Track’ visa program, which traps many asylum seekers in visa limbo with no chance of permanent residency or citizenship, with some living continuously in Australia for over 10 years. Her case, among many others, highlights an unfortunate truth: perhaps it is unsurprising temporary migrants aren’t included in democratic promises – they aren’t allowed to vote, and some never will be, raising serious concerns about the quality of Australia’s democracy. 

While temporary migrants may be excluded from formal democracy and representation in government, they aren’t silent. Migrant and refugee women are among the loudest voices in the movement for visa and health justice, advocating for their right to dignity, security, health and wellbeing. It’s up to us to join them.