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Wednesday, 14 September 1983
Page: 785

Mr ANTHONY (Leader of the National Party of Australia)(5.33) —The legislation before the House is bad legislation. It is repugnant legislation. It is legislation designed to destroy what has developed into one of the best health schemes in the world. It is legislation which will force on Australians a massive weight of officialdom and bureaucracy. It is legislation which offers the gravest possible threat to the right of all Australians to the best health care. For these reasons the National Party totally opposes this legislation and fully supports the amendment moved by the honourable member for Mackellar (Mr Carlton).

The Minister for Health (Dr Blewett) no doubt believes that he will be remembered as the architect of Medicare. I can assure him that he will be! But if this legislation becomes law he will not be remembered fondly. As the nightmare he has produced takes shape, consuming more and more of the nation's resources and steadily eroding the integrity and efficiency of the nation's health services, his role in this sham operation will be remembered with bitterness, anger and shame. I say that this is a sham operation because that is what it is. The Minister for Health and the Australian Labor Party generally have paraded Medicare as a badge of their concern for the sick. It is nothing of the sort. Like its father, Medibank, Medicare is nothing more than a device for foisting on Australians the big government, anti-free-enterprise philosophies of a socialist government. Those philosophies were exposed as the failures they are by the Medibank experiment. Even in the relatively short period of its operation one would have thought that a Labor government would have taken note of its effect. Health costs mushroomed, fraud exploded and government interference spread throughout the health system. The Labor Party, which has learned nothing and forgotten nothing, now wants to do it all again.

This legislation has one aim and one aim alone. It does not improve the health care available to Australians. The aim of this legislation is to bring the entire medical system-the medical profession, the hospital system and the ancillary services-under the control of the Government. It is the aim of this Government to ensure that it controls, directs and funds every facet of this nation's health care system. The standards of that system and the care it offers Australians are very much a secondary matter. To achieve this aim the Labor Party has maintained for many years a campaign of denigration against the medical profession. It has tried to arouse envy in people by attacking the earnings of doctors. It has tried to attack the integrity of doctors by smearing the profession as a whole for the regrettable failures of a few. It has tried to stifle their self-respect and the respect in which they are held within the community by putting the blame for rising health costs on the shoulders of the medical profession alone.

In this campaign of denigration the Labor Party has been able to gather a number of allies. The envious and the dissatisfied have rallied to its flag, along with others within the health care system who have seen personal advantage from pulling down the position of doctors. Of course, there have been the front groups such as the so-called Doctors Reform Society which has suffered a savage blow to its credibilty since its chief mouthpiece gained preselection as a left wing Labor candidate in Sydney.

I just note in passing that, despite the general willingness of the media to accept Labor's claims in this area as gospel, the general public regards them as rubbish. In any survey of public regard for various occupations, doctors mostly rate first or second. Politicians are well down the list-usually just ahead of trade union leaders and journalists. As a former member for Riverina once said in this House: 'He who throws muck, loses ground'. However, the medical profession has not been Labor's only target. It has also gone after the two other vital components of an effective, efficient health system-private health insurance companies and private hospitals. It has done so because the continued existence of private health insurance and private hospitals alongside the cumbersome, inefficient and costly government-run system demonstrates the failure of the government system only too clearly. Of course, it is too much to expect that a Labor government and a Labor Minister for Health would regard this situation as a stimulus for improving the Government's side of health care. They do not. Instead they see it as a good reason for destroying private health care because, for as long as it exists, people can see how the Government's systems are failing them.

The Government's decision to give Medicare a virtual monopoly in health insurance is clear evidence of its commitment to destroy private health care-as is its insistence on discriminating against private hospitals for the payment of benefits and its determination to force bulk billing on as many doctors as possible. This Labor Government, so proud of its commitment to reversing unemployment, is quite prepared to throw 5,000 employees in the private health insurance firms out on to the street, knowing that only a fraction of them will get jobs in Medicare. The Government is doing this in order to create a virtual monopoly for Medicare. It is happy to put enormous financial pressure on hospitals knowing that many of them will fold and, with them, the essential services they provide, especially in country areas, in order to create a virtual monopoly for government-run hospitals.

I can illustrate that problem clearly by referring to the Victorian Bush Nursing Association which has 38 hospitals spread throughout the State, 15 of them, incidentally, in Labor electorates. Because of the discrimination on insurance proposed by the Minister for Health, 34 of those hospitals will be in severe financial difficulties within a matter of months after Medicare is introduced unless their patients are prepared to pay up to $50 a day-a cost which, under Medicare, they will insure against. The lack of concern by the Minister for Health for this potentially disastrous situation for country people is shown by the fact that he has refused to see representatives of their Association. A copy of their submission on Medicare to the Minister was misplaced by his Department. There could be no clearer indictment of the shallowness of this Government's claim of concern for the health of Australians.

The problems facing Victorian country hospitals because of Medicare will flow on to many people in many regions. There will be similar pressures on private hospitals in country areas in all States. There will also be pressures on individual doctors who have had the enterprise to provide specialised medical services for their patients in country areas. In many cases, discrimination in insurance available to these patients will means that these specialised services will no longer be available. Patients will then have to travel long distances to central public hospitals. Does this mean better health care for country people? Of course it does not.

The third of the three elements of the Government's attack on private health care, to which I referred, is the attempts to force doctors to bulk bill. This is a key element in its strategy. It will have two effects: The first is to steadily reduce the independence of private medical practitioners to a stage where the Government is able to bring them under its control; the second is to open the floodgates to cost increases and fraud. If the Government succeeds in its efforts to promote bulk billing it will eventually be providing the total income of all but a few private medical practitioners. When this occurs, the Government will be able to argue that as it is paying the doctors it has become the doctors' employer. When it has become the doctors' employer the doctors will come under the total control of the Government. It will set their salaries and tell them where to work and how to work.

This will not happen immediately, but it will eventuate with socialist administration. The renegade doctors will be left out in the cold. If they do not work for the Government their patients will have to pay to consult them while Government doctors will be free. The Government can argue that its system still does provide for private medical care, but the fact is that it will destroy a system which is respected and understood by all Australians and replace it with one that has been discredited in countries around the world where it has been tried, all for the sake of imposing its socialist philosophies on the Australian people.

Bulk billing under Medibank Private corrupted some doctors and made possible the fraud that we saw begin in those days. This fraud has been rightly and properly condemned. These doctors who took part in it deserve no sympathy. But even with limited bulk billing that does exist now for pensioners there is the possibility for this abuse to take place. But fraud and abuse of medical services is obvious particularly when it is going to become universal. A bank that puts the contents of its safe out into the street for every passer-by to sample cannot escape blame if its money is stolen, nor can the Australian Labor Party escape blame for making possible fraud on the scale which I have been suggesting.

As well as making fraud more easy, bulk billing will mean that every brake is taken off financial restraint both by doctors and patients. Patients, knowing that whatever happens they will not have to pay, will have no reason not to demand and receive unnecessary services. Doctors will have no reason for denying them that service. This will only be magnified by the so-called free hospital care. The Government tells us that everything will be free under Medicare. Of course it will not. Nothing is free. We may not have to pay the doctor or the hospital, but we will have to pay the tax man and we will have to dig pretty deep.

The Government is proposing a one per cent levy on incomes to meet its costs. But this levy, like the whole Medibank scheme, is a deception. The total cost of health care in Australia is about $8 billion a year and will increase substantially under Medicare. The proposed levy will raise about $1 billion. So it will bear no relationship to the real costs of health care. Those costs, as always, will have to be paid, and they will be paid by the taxpayer. He will be paying much more than the one per cent levy, which is only just the beginning.

Many aspects of Medicare proposals deserve censure. They have been amply dealt with by speakers on this side of the House and by other speakers who come forward and feel so strongly about the grossness of the scheme that is being presented. Today I am trying to warn Australians about the path down which this Government is leading them with this legislation. It all sounds so very easy to say that it is a simplified means of paying for medicine, but it has great ramifications. It is a backward step which all Australians will live to regret because it takes away part of their freedom and erodes health services and standards. With greater demand on public hospitals, long delays and waiting times for admittance and operations will become the order of the day. I will quote from a speech to the Joint Sitting of Parliament on 7 August 1974 by Senator Dame Margaret Guilfoyle which I believe is very timely today. She said:

It has been stressed in a cliche that health care is a right. Surely health care is a responsibility. Surely it is a personal responsibility, and it is for each and every one of us for ourselves and our families to accept that resonsibility; but surely it is also a responsibility that should be shared by Government. We do not want a Government takeover but a sharing of responsibility between Government and community.

Senator Dame Margaret Guilfoyle also said:

The public interest is the interest of every individual in Australia. It is not a collective thing. We are not a collective mass. Each and every one of us is an individual with personal responsibilities to assert. When they are usurped by Government, we have no public interest, we have no private interest; we simply have a government which takes all.

Those words are as true in their warning today as they were in 1974. It will be only a matter of time before it becomes obvious to Australians that they have made a great mistake in accepting so calmly the consequences of this legislation . It will lead to poorer health services in this country. As one who represents the great rural areas of Australia, I feel very sad that rural people will suffer the consequences, probably more than most, because the standard of services will decline. These people will be obliged to travel much greater distances to get a service at a public hospital. They may have to wait in a queue for a long time before they are seen to. The National Party rejects this legislation for all it stands for. I hope many people in Australia will stand up and express their abhorrence as they analyse the legislation more closely.