Australians will find out this week whether or not the world-reknowned Medicare system will be hit with a co-payment fee for doctor visits.

If Australians are willing to accept this latest user pays phenomenon, then it is worth looking at just how they have been conditioned to this logic. At the root of the problem is a decision made by the Labor government in 1989 to introduce co-payments for education, the infamous HECS scheme. Over 25 years, a whole generation of Australians has been ingrained with the concept of having to pay for simply being who they are.

Even in Labor circles today, many people seem to discuss their HECS debts in a matter-of-fact way, as if it is perfectly logical that they have been a burden on society.

There are plenty of other examples of this user pays philosophy smeared across our national identity and all of them have a common theme, they target some sub-group of the population and insinuate that group has somehow acted selfishly or recklessly. HECS targets people who have been born with an intellectual talent and attended university. The immigration department extorts obscene fees from any Australian who marries a person born abroad, way in excess of the comparable fees in other modern nations (The EU guarantees its citizens and their spouses, regardless of birthplace, a right to move between countries without any fees at all).

The Medicare co-payment, then, targets another sub-group: those who need some kind of medical assistance, the sick, the elderly and the disabled. Like those who go to university and those born abroad, we are to believe that anybody with an illness is irresponsible with public resources.

It has been widely noted that the real reason for Australia's budget problems is not expenditure, rather, it is falling tax revenues. If anybody really believes such a serious revenue problem will be addressed by a $6 doctor fee then they are kidding themselves.

The reality is that the Medicare co-payment is not solving any real problem, it is just another step towards unpicking the fabric of Australian society. British Labour appears to understand this and has been outspoken about differentiating themselves from the economic rationalism of the Tories. Will Australian Labor be willing to differentiate themselves from the coalition and stamp out user-pays practices, with the hope that such visionary leadership will help Labor return to office? Or will they let the rot continue and even take Australia to new lows, just as they did in the realm of asylum seeker policy?