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Thursday, 19 February 1987
Page: 376


Dr BLEWETT (Minister for Health)(3.52) —Having listened to the usual tirade, it is clear that we will not get from this Opposition new ideas, worthwhile policies or the kinds of health developments that this country needs. Once again we have heard an almost totally negative speech from the Opposition. There was scarcely a single idea on how it would meet the very real health problems that face this society. I must say that the honourable member for Barker (Mr Porter) did at least broaden his attack on the Government by discussing a few issues that he has not previously dealt with. I think that simply reveals the lack of credibility he has throughout the health community in this country.

In relation to the acquired immune deficiency syndrome, the work of this Government in very difficult circumstances and in difficult economic times has been recognised internationally. We are considered to have taken some of the most effective responses to this disease of any country. Such comments have been made by independent observers at the United Nations, including within the World Health Organisation. As to the shortage of funds for AIDS research, of course we will need more money for that; but let me say that this Government has met every worthwhile proposal for AIDS research and we have indicated to the AIDS Task Force that it merely needs to come forward with properly evaluated and worthwhile research proposals and we will find the money, and we will do so as part of what has been, until today, a very effective bipartisan effort to deal with this problem. It has been a bipartisan approach not only by the Government and the Opposition here in the Federal centre but also around the country. We cannot fight the scourge of AIDS without the active co-operation of the State governments.

The honourable member for Barker also raised the national Government's drug offensive. This came, oddly and ironically, from the member of a party which did nothing at the national level to develop policies to deal with the drug problems in this country. Never before 1985 was there a national effort to tackle the total problem of drugs. One of the great pleasures I have when going around the country these days is travelling from local community to local community to see the expansion at the grass roots level of services. The honourable member does not realise that in the last 12 to 15 months there has been a quiet revolution in support, rehabilitation and treatment services right around this country. That is exemplified in every State. Insofar as some criticisms have been made of the choice of projects, in nearly every case that choice has been made by the State governments, because we believe in a co-operative health policy and as part of our drugs campaign we said that we would share the costs of this expansion. The State governments and the local people know the situation on the ground; they have to make the decisions. Again, I have not the slightest doubt that history will record that 1985 marked a major step forward by this nation in tackling the problem of drug abuse.

The third new element of the honourable member's contribution concerned the issues of generic drugs. I will not deal with that at length today; I merely say that this Government has continued with the Fraser Government's policies on generic drugs. In no way have those policies been altered, although increasingly, as is the case with every other segment of the health sphere, one has to look at the mess the previous Government left behind. As I announced today, an independent inquiry by the Public Service Board, outside of the Department of Health, will look into the whole evaluation process as it has developed over time. That will give us a new start in this area, just as we have made a new start in regard to Medicare, pharmaceutical benefits and drug abuse.

I now turn to the usual material that fills every one of the honourable member's speeches on health policies. There is nothing new, nothing creative; we have the same old set of cliches. All around the country everybody, even our critics, believes that this Opposition has no credibility in regard to health policy-for one reason: It has no health policy. It has spent four years in opposition but it has not been able to produce a credible health policy. What we get-we got it again from the honourable member today-are mealy-mouthings about how the Opposition would pander to the well-off. Members of the Opposition sometimes disguise that, they sometimes hide it; but in essence they are saying that they will pander to the well-off and pander to the vested interests in the health field-the private doctors, the private hospitals and the private insurers. There is no doubt that the sort of vague health schemes that they talk about, or which they allow their think tanks to leak or suggest to the papers under pressure, would reduce the cost of health cover to the wealthy. But they would considerably increase costs for middle income earners and would involve very heavy payments for low income earners. Today a low income family can have complete and adequate health cover for approximately $6 a week-around $2.50 less than the cost three years ago, despite all the problems of inflation this society has faced.

Of course, those sorts of people do not concern the members of the Opposition. They are not concerned with the fact that as a result of Medicare two million more people were able to gain health cover. Those people had no health cover at all before we came to power. So all they would do is alter the way people pay for their health cover, and that would mean that middle income earners and the less well-off would have to pay more while no doubt the better-off would pay less.

Insofar as one can detect anything at all in the Opposition's three years or ramblings about health policies, it appears to promise us a return to the chaos of the Fraser years-that is, five health schemes in seven years. One of the difficulties in comparing our scheme with any of the previous schemes is that none of the five schemes of the previous Government had a life beyond 20 months. That is the same as the situation we are now promised. Indeed, when the final change was made-that is, in 1981 when cost sharing with the States was ended-there was such an explosion in health costs that we saw the biggest increase in charges for private hospital beds that we had seen in this country in the last 15 years. In 1981 they went through the roof. As a result of those five policies in seven years, the Fraser Government finished up with two million people totally without cover. They had no access to the provisions for the deprived and they had no health care cover. That is what the Opposition is proposing again, the same sort of instability. When the honourable member for Barker does say something positive, it is usually: `We will allow people to opt out of Medicare'. That is what the Opposition did in 1976, and that scheme lasted for a bare two years. Indeed, all the Opposition's talk about saving on Medicare I think was dealt with quite succinctly yesterday in the Sydney Morning Herald. I quote the article by Mr Ross Gittins:

Mr Howard-

and, I would add, our friend from Barker-

has developed a new line: Why, we could save $2 billion just by abolishing Medicare. Perhaps we could, but we could do it only by reverting to the old position where everyone had to take out private hospital and medical insurance. We could wipe $2 billion off the Commonwealth Budget by adding $2 billion to the budget of the nation's households.

Not only would it be added; it would be added in a totally unfair way. The basis of Medicare is that people make their contribution to that $2 billion through an income related levy. The private insurance system involves flat rate insurance. So not only would the consumers be saved nothing; a burden would be imposed on them in a most unfair way.

Not that anyone worries much any more what the honourable member for Barker says about health costs because in the last year he has proved himself almost completely innumerate on health costs. Last year, between February and May-I can supply the dates if anyone would like to check-he had no fewer then seven guesstimates on health cost overruns. In one Press release, which was his best, he said that bulk billing would blow out the Budget by up to $300m. One has only to examine the seven widely ranging guesstimates to see how innumerate this man is. He tried the same practice this year. In the Budget debate he said:

The Government has consistently underestimated medical expenditure under Medicare, and this year's Budget is no exception.

He went on to suggest that we had cooked the books. He said:

. . . its all-out effort to present a low Budget deficit figure. Has the Government again cooked the books?

I am very pleased to say that the Medicare budget is running on target. It is in fact $2m or $3m below, but with the size of the total budget I will not claim that we are under budget. We are on budget, despite the allegations that somehow we have cooked the books. These allegations were made without any real basis. They were made from a lack of understanding of the health care system and the Medicare system. The latest effort of the honourable member for Barker is to try to claim that families are worse off under Medicare than under the previous health insurance arrangements. I have pointed out that the almost 50 per cent of Australian families who have only the Medicare levy are in fact $2.50 a week better off than they were three years ago.

Let us deal with just his more general claims about the impact of Medicare on the consumer price index. If we analyse the consumer price index from 1980-81 to the December quarter 1986, it gives us the great advantage of looking at the impact of the Opposition's schemes and the impact of our scheme. The analysis shows that costs in the CPI rose much more under the Fraser schemes than they have since the introduction of Medicare on 1 February 1984. To use 1980-81 as a base index of 100, the following figures show the true impact of the Opposition's health policy compared with Medicare. For the health services group, the index had increased to 184.1 by June 1983. A year later, in June 1984, the first full quarter of Medicare, the health services group had dropped to 102.7 and by December 1986 had increased to only 138.4. Even if we take the health and personal care index, which includes the cost of pharmaceuticals, the index had increased to 167.9 by December 1983, had dropped to 118.2 by June 1984 and still-taking them all in-had reached only 153.6 by December 1986.


Mr Porter —What happens if you add in the levy?


Dr BLEWETT —The Opposition talks about the levy. There is not a single criticism of the fact that the decisions we made in relation to the Medicare levy were major elements in wage restraint in this society in 1984. It is quite clear that the deliberate policy which the Opposition is now advocating again-that is, shifting costs back from the public on to the private sector-has a much more serious impact on the CPI than the policies produced since the introduction of Medicare. If health care is put back on the private sector and private insurance, once more we will see inflation in this country fuelled by the health policies of the Opposition as they were fuelled by the Fraser Government. In the six-year period I mentioned, the increase in the health area was still below the increase in the areas of food, clothing, housing, household equipment and transport. Other areas of expenditure increased more dramatically in that period.

I turn finally to the cost involved in the one policy which has been suggested-allowing people to opt out into private health insurance. Given the $2 billion saving which the Opposition talks about, the average cost of basic private insurance will be approximately $27 a week. If the Medicare element is taken off the Budget and people are allowed to opt out and to buy private insurance, it will cost something like $27 a week. Opposition members know that the only way they can sell that policy-it crept into the speech of the honourable member for Barker today-is by providing tax relief, which would eat up all the savings. I did such an analysis in the House for the Opposition last year. Once the Opposition moves in that direction and tries to reduce the cost of private insurance it loses all the savings and leaves us with an inequitable system whereby the poor have to pay as much for their health insurance as the well off.