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Tuesday, 30 November 2004
Page: 79


Ms PANOPOULOS (7:54 PM) —I rise to speak on the Health Insurance Amendment (100% Medicare Rebate and Other Measures) Bill 2004, and to speak against the proposed amendment. I am delighted to be speaking on this bill because it implements one of the government's major election policy announcements made in early September during the election campaign: to increase the Medicare rebate for GP services from 85 per cent to 100 per cent of the schedule fee. In dollar terms, this means that there will be an almost $5 increase in the rebate for a standard GP consultation. The bill supports the government's commitment to delivering high-quality, affordable health care.

This bill represents one of the most important improvements to Medicare in 20 years. It assists both GPs and their patients. Through the measures in this bill, which are complemented by the government's previously announced Strengthening Medicare initiatives, the government is providing real incentive for GPs to bulk-bill. But, importantly, GPs are not forced to bulk-bill. Where a GP does bulk-bill, they will receive the higher rebate; where they do not and the patient is charged for a visit to the doctor, the patient receives the increased rebate. During the election campaign the Leader of the Opposition proclaimed:

When it comes down to it, on the ninth of October it's a referendum about the future of Medicare. It's a referendum about the future of health care this country.

If this statement is anything to go by, I am pleased to note that the people of Australia—and indeed the people in my electorate of Indi—think that their health care system is in pretty safe hands under the Howard government.

Bulk-billing is important and it should be available to those who need it. But in the end, as we all know, bulk-billing is a matter between doctors and patients. This was the case in 1984 and it remains the case 20 years later, despite the sometimes hysterical ranting of the member for Lalor. She supports coercive measures to transform the GP profession into an enclave of government-controlled, bureaucratic public servants offering a new style of socialist medicine. Perhaps the member for Lalor should not be so peremptory. It is a little-known but curious fact that if the proposals that the Labor Party took to the election were implemented, the actual incidence of bulk-billing would have declined. For months, the Labor Party trumpeted its bulk-billing proposals, which, according to the policy document, would have meant that `GPs on average will receive an extra $3.35 per consultation'. They later raised it to about $5 per consultation, but did it not occur to the Labor Party that GPs in my electorate were already receiving an extra $7.50 loading when they bulk-billed a goodly number of their patients?

This point opens up a number of interesting scenarios. Let us say that a person is charged $40 for a visit to their GP. Under this legislation they will be rebated at a higher rate of $30.20. If the Labor Party's approach were followed the patient would receive only $25.70. Taking this point even further, in conjunction with the Strengthening Medicare initiatives, when the measures contained in this bill come into force on 1 January 2005, if a child or a Commonwealth concession cardholder in my electorate is bulk-billed, the GP rebate will be $37.70, whereas under the Labor Party's proposals the rebate would still only have been $30.20.

Labor only had a plan to offer higher rebates to GPs who bulk-billed. This flies in the face of the longstanding principle of universal access to the Medicare rebate that underpins a patient's contact with their GP. Once again we have winners and losers, discrimination and division and insiders and outsiders. These are the binding philosophies behind the modern Labor Party's approach in 2004 that were so clearly illustrated in the recent federal election. The Labor Party believes in division and strife. Its leader is obsessed with class warfare and envy. The Leader of the Opposition sees us as a dog-eat-dog society infested with categories of irreconcilable interests.

With the current Leader of the Opposition it is always the parts, never the whole. He remains an angry class warfare warrior who sees the world through the eyes of his roots. The tiresome repetition of the Green Valley story is in no way born out of empathy with those he left behind; it is driven by envy and anger towards those who never lived there. Not only did we see a manifestation of this in the Labor Party's schools policy—which even the Catholic and Anglican archbishops of Melbourne and Sydney saw as `potentially divisive' and `regrettable', and `which would have benefited schools of one faith background largely at the expense of another'—but we see it in the approach to the legislation we are debating today.

The reality is that, for a whole host of reasons, some GPs will not bulk-bill all of their patients all of the time. In fact, some patients would resent it if they did. Doctors and patients understand this, but the modern Australian Labor Party does not. Then the Labor Party goes to an election with a policy that penalises patients who are not bulk-billed. The government's views on this are broadly similar to those espoused by the creative architect of Medicare, Neal Blewett, when he said of bulk-billing that government `has not the power to compel them to do so nor does it desire to compel them to do so'.

For a political party that arrogantly prides itself on being the true arbiter of good health policy, the Labor Party's announcements on health during this election period were a great and severe disappointment. The centrepiece announcement of the campaign for Labor—the promise to give free first-class hospital cover to over-75s—must surely rank as one of the most appalling pieces of health and social policy ever advocated by a political party in the Western world. It was unsustainable, it was irresponsible, it was eminently unachievable and it also happened to be underfunded by around $700 million, according to Treasury. Medicare Gold became `Medicare Copper' in a matter of days. Medicare Gold was a farce from the very beginning, as nonsensical a piece of public policy as heroin-injecting rooms. But what has the Labor Party done to the architect of Medicare Gold? Kept her, promoted her and held her up as a beacon of what a perfect Labor member of parliament should be, instead of relegating her to beyond the back benches for this disgraceful, irresponsible and amateurish piece of policy.

The Howard government remains proud of its achievements in the health portfolio in recent times. At a local level, as the federal member for Indi I am pleased with many of the exciting developments which improve primary health care in north-east Victoria. For instance, we have the $1.6 million announcement of a rural medical school in Wangaratta, we have a new bulk-billing clinic in Wodonga, we have the $7.50 bulk-billing incentive for our local GPs and we have the Mount Beauty medical student accommodation block, which I opened last year and which was funded by the Commonwealth. Local doctors will tell you of the success of the Bogong Regional Training Network scheme, which has grown in GP training numbers from 10 to 43 since its inception. We have the measure we debate today where, from 1 January 2005, there is an increase in the Medicare benefit from 85 per cent to 100 per cent of the schedule fee, and we also have more than 5,340 people in Indi benefiting from the Medicare safety net. It is timely to mention the Medicare safety net and to recount the comments of the member for Werriwa, who in 1995 said:

The methodology of good health reform is to get effective public safety net provisions in place.

This is apparently now not the case, because Labor went to the last election promising to ditch the single biggest improvement to the architecture of Medicare seen in recent history—that is, the Medicare safety net.

I also wish to comment on another feature of this bill: the assurance that all families eligible for family tax benefit part A are automatically eligible for the lower $300 threshold. This particular issue was raised with my electorate office prior to the election by a constituent who received her family tax benefit in one lump sum and, due to a drafting error in the original legislation, was not immediately recognised as being eligible for the lower safety net threshold. She is now eligible, and I am pleased this legislation has rectified this matter to enable even more of my constituents to go on receiving immediately the significant benefits that come with the Medicare safety net.

On another local initiative in my electorate related to bulk-billing, I have spoken in this place before on the success of a new bulk-billing clinic operating adjacent to the Wodonga hospital. This clinic is offering an important service to border patients and is clearly paying dividends to the Albury-Wodonga community, mainly through the initiatives contained in `Strengthening Medicare' and MedicarePlus. Minister Abbott came to this clinic in March this year and met with GPs and patients. I refer to a representation made to me by the CEO of the Wodonga Regional Health Service, where this clinic is situated. The CEO said: `I am pleased to inform you that the clinic has been successful to date, largely due to the MedicarePlus initiative'. He also notes the `significant returns to the community of Indi that arise from a clinic committed to bulk-billing under the MedicarePlus initiative'. What all this confirms is that this government is not interested in playing politics with people's health. It is interested in getting runs on the board for the benefit of patients and the Australian community.

This bill commits an extra $1.7 billion to make Medicare fairer and stronger. Few governments in the world can claim to oversee a world-class health system as Australia's government does. The Australian people like Medicare and, as the Minister for Health and Ageing has said, believe that Medicare is a fundamental part of our health system: `Medicare remains an article of faith for this government.' The measures in this bill continue the good work of the government in making our world-class health system even better and able to deal with the challenges of the changing demographics of this nation over the decades ahead. I look forward to seeing the benefits of this legislation being delivered to the people of my electorate and to the broader Australian community from 1 January 2005, and therefore I have great pleasure in commending the bill to the House.