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Wednesday, 14 September 1983
Page: 788


Mr SAUNDERSON(5.50) —I support the Health Legislation Amendment Bill, the Medicare Levy Bill, the Income Tax Laws Amendment (Medicare Levy) Bill and the States (Tax Sharing and Health Grants) Amendment Bill (No. 2). I applaud the Minister for Health (Dr Blewett) for doing a fine job in putting together the Medicare proposal. For the first time in eight years Australia will have in February 1984 a national health scheme which will provide universal cover for all. We have seen a number of changes since members of the previous Government set about destroying Medibank within only about 10 months of its inception. They promised that they would maintain it and keep it. But what did they do? They were elected in December 1975 and in June 1976 they made their first announcement to change the way that Medibank operated.

The previous speaker for the Opposition, the Leader of the National Party of Australia (Mr Anthony), said that the health care system at the moment is the best in the world. Let us look at how it became, in his view, the best in the world. A number of changes were made by the Fraser Government during 1976 and I have a list of some of the changes in chronological order. I do not know whether I have been able to pick up all of them because there were quite a few. It announced some changes in June 1976 and in July 1976. In August 1976 more changes were announced. In June 1977 and May 1978 more changes to the health scheme were announced. I should have thought that that would have been enough, but there was more to come. More changes were announced in August 1978, November 1978 and May 1979. In June 1980 and April 1981, yet again, more changes were announced. One would have thought that by that stage members of the previous Government would have achieved a system that operated, but they instituted another government review in 1980, and in January 1981 a report was brought down .

I will refer to only two of the recommendations. There were 140 of them, indicating how wonderful the system was, even after the 11 changes I have been able to find had been introduced. The first recommendation was that the Commonwealth must set its objectives in the health field by clearly showing what it intended to do and on what conditions. That recommendation indicated that, with all the changes that had taken place, nobody knew where they stood. Obviously, the previous Government did not know. Another recommendation was that a working party be established by the Government-that is, another working party; one wonders what this one was supposed to be doing-to devise a new health insurance system which satisfied the principles of equity, freedom of access, and payment by those able to afford it and which promoted universal participation. The then Government must have looked at the proposition we had in opposition because that is exactly what we are proposing to do under the Medicare scheme.

Members of the Opposition-a bunch of mismanagers-set up a confusing, fragmented , expensive, disjointed health scheme during their eight years in government. They were able to drive people away from the health insurance scheme because they could not afford it. Under Medibank, during 1975 and the first part of 1976 we had developed a system whereby everybody in Australia was entitled to coverage and was receiving coverage. By 1979 over two and a half million Australians, or families in Australia, were not covered by private insurance. One can only assume that with the downturn in the economy since that time, that situation has grown worse.

The previous Government did make a change to the scheme to look after those people who could not afford private health cover. They could not afford it because it had become so expensive, because of the numbers of changes and because of the way the Government was pandering to the private health insurance companies and the doctors. The previous Government said: 'We understand that some people cannot afford to be covered, so we will look after the socially disadvantaged. We will not give everybody free treatment by right. We will be condescending and call them socially disadvantaged people'. Pamphlets which the previous Government sent to people stated: 'If you wish to talk to your doctor on your next visit about your personal circumstances, you may become entitled if the doctor thinks it is appropriate'. The doctor became the judge as to whether someone should be entitled to some form of treatment. That was the previous Government's consideration of how people should be treated. This legislation gives everybody the right to medical treatment without distinction with regard to status in life, income or whatever. Every Australian will be entitled to treatment. That is something which the previous Government thought was totally incorrect.

Members of the Opposition talk about the cost of Medibank. It is quite clear that when they were in government they did nothing really to contain the health costs. They had to be badgered by public pressure and by the Opposition of the day to do something about bottom of the harbour schemes and those who were ripping off the Government. The same situation applied to Medibank. Who was ripping off the system? Was it the patient, the worker? It was the doctor, the man who was already enjoying a fairly good life in Australia. I refer, for example, to three South Australian doctors who were convicted of charges relating to fraud. During a short period of time in 1977-they had had only two years or 18 months in which to achieve this-they were charged and convicted of fraud offences totalling $280,000. Another $210,000 which they had undertaken to repay was not taken into account. So three doctors in 18 months had been able fraudulently to rip off half a million dollars. Some 30 cases of fraud were prosecuted in other areas; twenty-one doctors were prosecuted. Other cases against doctors, not members of the public, who ripped off the system were dropped.

What answer is given by members of the Opposition? We must be fair and say that only a minority of doctors find that earning a good living is not enough, and that they want to make an excessive living and rip off the public. But members of the Opposition do not say: 'Let us really sort out these doctors and fix them up'. They simply say: 'Let us change the system so that we can no longer find whether they are ripping off the public because we really do not want to know about it'. That is their answer. We would then revert to their fragmented system .

They talk about the cost of Medibank. They want us to keep in operation the current system in which hundreds of agencies operate, all with bureaucracies and administrators. They want us to employ more and more people in Australia to look after health care. They decry the fact that Medicare will provide a national health service employing 2,000 people fewer than the private health funds now employ. Moreover, it will provide a unique Australia-wide service. At the moment , if it is left to the agencies, a person might be insured in Victoria but if he moves interstate he has to go to different agencies. Medicare will provide Australia-wide coverage. The Opposition knows that it is not true to say that 5, 000 jobs will disappear from private health funds. Those people will not be sacked. They know that arrangements have been made so that people will be employed in the other areas, and they know that there is a turnover of some 20 per cent in private health insurance agencies.

As I said before, these Bills will provide a proper coverage for all Australians-something which was not attempted by the previous Government. It attempted to ensure that it looked after those who could afford to pay, and those who could not afford to pay simply had to hope that they never fell sick. Honourable members opposite talk about the problems of bulk billing. Who is opposed to bulk billing? The Australian Medical Association has been opposed to it for a long time. The voluntary health insurance funds have been opposed to it ; they do not like it. The public like it. In surveys conducted by the previous Government there were statements such as 'bulk billing is the cheapest and administratively most efficient billing system'. That quite clearly is the case.

Today some members of the Opposition have said that those in the medical profession do not want Medicare. I suggest that is not the case. Many doctors out there, having gone through the at least 11 changes of the previous Government with several Ministers of Health, are saying: 'Enough is enough. We want to go back to what we had in 1975 because that was a simple system which we understood. We now realise the error of our ways when we opposed that change and we cannot wait to get back to it'. Not only will this Bill provide access to health insurance for all; it will also provide it more cheaply than the cost people are paying today. Someone who today is paying well in excess of $12 a week for private health cover with the health insurance funds could save as much as $7 or $8 a week when the levy is introduced and still take out private health cover. If that person decides not to take out private health cover and simply have the public cover, he or she will be saving up to $10 a week. These are the facts.

We have heard from the Opposition a lot of hysteria and discussion about socialism and that sort of garbage, hogwash and humbug. But the plain facts are that for the first time since 1975 Australia has been presented with a comprehensive program and plan for health cover and health insurance instead of the fragmented and disjointed programs which the previous Government introduced. When it came to power in 1975 all it knew was that it wanted to destroy Medibank . It set about doing that and it had no alternative. It simply set about taking it down brick by brick-with 11 amendments, as I have pointed out. Now we are presented once again with a comprehensive program which provides cover for all, irrespective of status in life and income without the taint of being socially disadvantaged and without the pressures that have been applied. We have maintained freedom of choice. The patient has the freedom of choice. He has the choice of doctor and he has the choice of whether he wishes to accept public hospital treatment. He has the choice of whether he wants to take out private insurance and go to private doctors and he has the choice of his own local doctors. That has maintained his freedom of choice. The doctors have the freedom of choice. They have the choice of billing patients direct or bulk billing.


Mr Connolly —But you want them to bulk bill. The Minister said so.


Mr SAUNDERSON —It is their choice. It is not being forced on them by the Government. It is not compulsory. It is their choice. Of course, we would like them to bulk bill because, as I pointed out, reviews under the previous Government showed quite clearly that bulk billing was the most efficient method of payment. In winding up, I think we really have to look at the facts. We have heard a lot of hysteria from the Opposition, but the plain facts are that we now have a comprehensive medical insurance program. Everybody who participates in the medical field and those who have to administrate it, both in the States and nationally, now fully understand what is going to take place. They have a program which will be clearly laid out. For the first time Australians can start to breathe easily-particularly the 2 1/2 million who have not had cover and have been in fear of becoming ill-knowing that they will have health cover as a right .