I expect that the association was so quick on the ball in demonstrating its endorsement because Daube is, by coincidence, deputy chairman of the taskforce.

The confected publicity also served the useful purpose of reminding us that cigarettes, junk food and binge-drinking are very very bad. So bad that, according to Roxon, they cost the economy $31billion a year in crime, health-care costs and lost productivity. The Commonwealth spends $872million a year, mostly through COAG, countering this.

Actually, Roxon welcomes the appearance of pressure from the public, or the public health lobby, to do something about public health objectives (or to raise taxes on the pretence that they meet social as well as fiscal ends). It helps counter the rather more crude lobbying of representatives of the merchants of death as they seek to obstruct and delay measures to blunt the effectiveness of their products.

Also issued yesterday was what was described as a draft of Australia's ''first'' National Primary Health Care Strategy.

With the Commonwealth and the states spending hundreds of millions on primary health care for 100 years, the news angle ought to have been the revelation that we have been doing it, until now, without any strategy or sense of direction.

But no one need get alarmed, let alone imagine that some new sense of purpose is galvanising frontline health care. All that is being injected is adjectives, adverbs and abstract nouns, statements of the bleedin' obvious dressed up as insights, and a vague but not novel idea that the more we spend on primary care the less we will spend later on expensive hospital and specialist care.

In the modern PowerPoint and flow-chart manner we are told that the efficient organisation of future primary care involves five ''key building blocks'', drawn from which are ''four priority directions for change''.

Though apparently there has been deep consultation involved in the preparation of this discussion paper, with 260 submissions received, and 600 hits a day on the program's website, very little is said which could not have been written about the system 50, or even 10 years ago, or, I expect, could be written 10 years from now.

Boiled down, the report says that services work best when they are planned locally and apply all the resources available, when they use modern technology, skilled workers with support, and are well run. We can always do better in getting services to the people who most need them, generally the obvious suspects such as Aborigines, people from the bush, and those who are too fat, have cancer, chronic conditions or are getting old. As ever, the middle class is hogging most of the resources available. We must do more about prevention or is that preventation? Quality, safety, performance and accountability needs improvement.

I can hardly think of a sentiment in the report with which a member of the public would disagree. It sincerely wants to maximise services to the public; it says nothing about rationing them.

The lobbyists, particularly doctors, will be more cautious, reading into some of the phrases vague menaces to a system mostly managed, now, by general practitioners. Managed well for most, especially the middle class, but badly, in results (or ''outputs'') for the obvious suspects.

Even then, however, all words used are open to interpretation indeed could mean almost anything.

The strategy, for example, says that in future ''access to core services supplemented by universal access to a Medicare rebate will be retained but will be supplemented by targeted local programs and collaborations across the service system. Through this combination of core services and targeted programs, accompanied by new funding and governance structures, primary health care services will be better integrated, will take responsibility for individual and population needs, and will address current variability in access and outcomes, including for after-hours access, traditionally under-serviced groups, and for patients in transition across the service system.''

In the bitter debate about health care in the United States now, such phrases could be are being read as a plot for socialism, death squads and euthanasia by bureaucratic committee and the insertion of a pen-pusher into every patient consultation. It's hard to imagine that Roxon, or those who draft her strategies, have any such things in mind. All she wants is to signal every day some dissatisfaction about the maldistribution of medical resources and some openness to different models of health-care delivery, and to make, with every appearance of courage, minor incremental changes in (what to her is) the broadly right direction. And, each day, to coat health care with a new layer of blancmange so that it is not seen, over at the Prime Minister's office as a problem to panic about over the next 12 hours (the usual PMO attention span). At the other end of town, of course, the hospitals are burning down, a process also being obscured by the mountains of reports, the media occasions, the spin and the non-events.

Jack Waterford is Editor-at-Large.