"When I use a word," Humpty Dumpty said, in rather a scornful tone, "it means just what I choose it to mean -- neither more nor less."
"The question is," said Alice, "whether you can make words mean so many different things."
"The question is," said Humpty Dumpty, "which is to be master - that's all."
Through the Looking Glass by Lewis Carroll
iBlame Steve Jobs. He started the “pronounageddon”.
First it was the iMac and the iPod, then came the iPhone and the iPad. The iWatch was a step too far, however. Marketing said no.
Language is constantly changing and pronouns have come in for a battering in recent years. Latin scholars will know the declensions as nominative, vocative, accusative, genitive, dative and ablative and come either as singular or plural and words take a male or female or neuter form largely depending on the declension.
In English we mostly stick with just two cases, subjective and objective, and apart from third person singular don’t worry about gender so it is pretty straightforward. Most children grasp the concept of pronouns by the age of four.
However, gender fluidity has muddied the waters in recent times. If you are neither a he or she you might be a “xe” or a “ze” but the more common usage is “they”. This is confusing to the untrained ear and it will take some time to adapt if using the plural for the singular persists. One suspects that Queen Victoria would not be amused.
Pronoun concatenations are beloved by advertisers. The YOUI insurance company prides itself on its customer relations (yournamehere.insured) and it has emphasised this through its in-house advertising campaign for several years. Once again for the uninitiated it sounds a little intrusive, as if the Borg had taken over the marketing campaign.
The melding of the words “medical” and “care“ started with the Canadians in the early sixties. Medicare arrived in the United States a few years later. “Medical care” was provided through a state based health insurance scheme. In the seventies Australia had a similar program called Medibank but this was eventually superseded by Medicare in 1984. The term Medicare had greater “cut through” with the general public than its predecessor the Health Insurance Commission although the latter more aptly describes the program’s function.
Electronic systems have transformed society over the last 30 years. In combination with the almost universal availability of mobile phones as authentication devices, the internet has enabled businesses to increase efficiencies in the provision of their goods and services. While email and newsletters are good for disseminating information, secure apps are preferred for financial transactions and the exchange of personal information.
Businesses promote this new ecommerce as a boon to their customers. You don’t need to come into the branch office or the store; it can all be handled over the internet. This alleged customer focus can, however, pall when repeated calls are made to the helpline where the issue might have been resolved by a single in person visit.
Ten years behind business the Australian Federal government is getting into the eCommerce / eServices act. The myGov digital service started in 2013 and now allows individuals to access their data in government departments like the Australian Taxation Office, Centrelink and Medicare. The Covid-19 pandemic accelerated the trend to digital and today over 20 million Australians have a myGov account.
In the May 2023 Federal Budget the Treasurer, Jim Chalmers, announced the myMedicare program. This scheme that has been in development for several years and is largely informed by the government’s 10 year plan for primary care that was released 18 months ago. The program’s working title was initially “myGP” but Labor governments love sticking the word “Medicare” in wherever they can, as various GP networks can attest.
myMedicare aims to improve the care for older and sicker patients who benefit from a stronger relationship with their GP and her associated practice. Initially the program will be limited to better subsidies for longer telehealth consultations for enrolled patients but further services and incentives will become available over the next 18 months. More extensive changes are planned for the medium and longer terms.
The gradual roll out of the program shows the government’s caution in tampering with Australia’s health financing. The Medical Home trial that started prior to the pandemic and finished in 2021 was a failure. It showed that it is not easy to move from our current funding arrangements to a blended model that would increase block payments and add outcome payments to existing fee-for-service item numbers.
While the current medical system is far from perfect it has provided a reasonable quality of care at an affordable price for most Australians. Medical standards have improved through training programs, vocational registration, accreditation and continuing professional development while at the same time Medicare has progressively reduced the income of Australian doctors.
The government recognises that it is getting “better value care” by squeezing the denominator. When compared to other OECD countries Australian GPs are near the bottom of the table; on a par with Israel but remain ahead of Estonia and the Czech Republic.
Not to be left behind in this digital age myRACGP went digital seven years ago and has been offering its programs electronically even prior to that. With a rejigging of professional development requirements for the current triennium myCPD is your new medical CPD home. There’s even an app for that.
My, my, my … it’s all very confusing. You can’t help thinking it's all about them, not us. Methinks these neologisms are designed to confuse. Thank goodness humpty dumpty can tell us where to find the right answer.