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Thursday, 26 November 1998
Page: 869

Mr ANDREN (1:02 PM) —As one of those members wishing to contribute to the Private Health Insurance Incentives Bill 1998 , but missing out as the government truncated debate, I want to make some comments on that legislation here. There is absolutely no doubt that our health system is in urgent need of more federal assistance, and the recent Medicare agreement between Canberra and the states falls way short of the kind of money required to keep the system in proper shape.

A major injection of funds is needed for country hospitals. In my own electorate the staff at Orange Base Hospital are in a state of despair at times over the lack of space and staff. Recently a heart patient was airlifted to Sydney for urgent treatment. He had relatively minor surgery during the week and then was forced to catch a train back to Orange. The reason? Only hospital to hospital transfers are available on the air ambulance. When there is no other form of transport is available, you catch the train or bus.

Another patient went to Sydney expecting a heart transplant. When that operation fell through because of unavailability of a donor organ he, too, had to catch the train home. He had an angina attack at Orange station and was immediately admitted to Orange hospital. To make way for such an admission, elderly patients have been moved sometimes as far as Cowra hospital because of a lack of nursing home beds in the district. So you see there is both a state and federal funding component at work—or, might I say, not at work—here. Doctors I have spoken to at Orange are at their wits' end, quite apart from the public on the end of waiting lists.

Many would argue that the almost $5 billion being injected into this incentives program is wasted and is only buying time. But I must say that I have supported, from the time of my first election and for years before that, the need for an incentive program such as this to attract people into private health insurance. Many say it will not work; it is a bandaid; it is only buying time. I can begin to appreciate that argument too. But we have to decide in this country if we want private health insurance to survive, and we will do that only if we make such insurance more attractive to those who are not attracted to it at the moment.

I would have preferred a rebate scheme targeted at the younger and less well-off in the community. I do not need the rebate myself, but the fact remains that those who choose private health insurance also pay the Medicare levy. There is an argument that the levy should be increased if we want to maintain the standard of hospital care we once had in this country, but there are other reforms that are desperately needed, too. The gap payment is one of the greatest disincentives to private health insurance and, unless the AMA can come to an agreement with the health funds on this issue, people will not regard health insurance as any insurance at all.

But it is not an either or situation. It is not either the $5 billion or nothing else. We should be looking at ways of sustaining both the private and public health systems and that means more funding for the public system as well and the restoration of proactive health programs like the scrapped dental scheme. The federal and state governments need to expand the multipurpose service model in smaller communities so the federal aged care and state hospital care functions are clearly defined and properly funded. Some communities will have to accept rationalisation of services so sufficient resources can be given to base hospitals. We should also regulate Medicare provider numbers to communities, not doctors, in need. I have always believed public health funding should be exclusively a federal matter, then we could have a truly federal health system without the constant bickering about cost shifting. We need a strong private and public health system in this country, not an ideological debate that gets us nowhere. We need to encourage private health cover as much as we need to provide more resources and staff to base hospitals like Orange.

In the few moments I have got left, I also want to place on record my hope that the Prime Minister will initiate a review of the parliamentary superannuation scheme. This issue is a running sore out there in the community, and until this scheme is brought into line with acceptable community standards, there is no way we can stand here and talk about youth wages, cut backs at Centrelink or rules that restrict access to superannuation when people are downsized in middle age and desperate for those funds.

We remain a bunch of hypocrites while ever this super scheme remains in its current form, where people can leave in their mid-30s and enjoy half a backbenchers' salary for life. It is absurd and unfair. How can we describe ourselves as leaders if we follow the leader to this trough? The Prime Minister must instruct his Minister for Finance and Administration to get cracking on this reform now.