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Thursday, 19 March 1987
Page: 1176

Mr BRUMBY(6.06) —It is my pleasure also to rise to support this important legislation, the National Health Amendment Bill. We have had a large number of speakers in debate today and debate has ranged fairly widely and, I think, appropriately, over aspects of overall national health policy. It has been instructive, I think, to listen to this debate to see whether or not the Opposition parties have any coherent health policy which they can announce or describe for the Australian people. It is now more than four years since this Government was first elected in March 1983, and yet in that time we have not seen a formally released and instructive health policy from the Opposition parties. I would have thought that in that period the Australian people at least had a right to know what the alternative being offered by the Opposition parties was.

What we can glean from what has been said today and from newspaper reports of leaked Liberal Party of Australia meetings, such as those in this morning's paper, is that the Opposition seems to be promising a return to the health system which existed in the Fraser years. Honourable members opposite seem to have learned very little from the seven years that they had in Government and, of course, they seem to have learned very little from what is becoming an increasingly lengthy period that they are spending in Opposition. The Fraser Government gave Australia five health schemes in seven years. I think that is something which the Australian people will not forget for many years. It first dismantled Medibank. Then, as it tried to push more and more costs on to the individual, it made change after change. The final changes occurred in 1981 when cost sharing with the States was terminated. That was a decision which was to cause an explosion in health costs as public and private hospital bed-day charges went through the roof. It also led to substantial increases in private insurance costs.

In debate earlier today it was mentioned by the honourable member for Barker (Mr Porter), the Opposition spokesman on health matters, that health costs had increased under this Government. It is a claim which he makes consistently, although with little validity. If we look at the statistics and at the last effort of the Liberals when in Government we see that about two million people did not have health insurance. But, more importantly, on the cost aspect-this matter apparently of concern to the Opposition today-health costs increased by 93 per cent between 1981 and 1983. That is just a massive increase. It almost cannot be contemplated that within that two-year period of 1981 to 1983 there was such a massive blowout in health costs in Australia. It is simply not good enough. It is not good enough for the Opposition in this debate to offer no policies and no justification for saying that if it were ever elected to government it would not go back to that same shamed and chaotic scheme that occurred between 1975 and 1982.

It is important also in this debate to look at the credibility of the honourable member for Barker in relation to claims which he makes in this place. I have mentioned already the claim that he made today about costs. The facts show that it was during the period of the Fraser Liberal Government that health costs escalated dramatically. But the honourable member for Barker has also been running around the country over the last year or so suggesting that this Government's health policies would run grossly over budget and that this Government was incapable of balancing its health budget. In fact, over a year ago, in February 1986, he said that Medicare would be $250m over budget. In a Press release in March 1986 he said that bulk billing had blown out and that the health budget would be $300m over estimate. This went on throughout 1986. I have here a list of about eight Press releases and speeches that the Opposition spokesman on health made, in which he said that the health budget would blow out by hundreds of millions of dollars. The facts are--

Mr Porter —I was quite right, wasn't I?

Mr BRUMBY —I will tell the honourable member the facts because he seems to have an aversion to them. When he hears the facts, they are a bit slow to trickle in. It is sort of the trickle-down theory, is it not? The facts are that this year Medicare is right on budget.

Mr Porter —Last year. You are talking about 1986.

Mr BRUMBY —No, we are talking about this year because the honourable member's predictions have been made in the last 12 months. In the eight months to the end of February 1987, Medicare benefits paid out totalled $1.874 billion; that is $10.6m, or 0.6 per cent, under budget.

Mr Porter —How much were you over last year?

Mr DEPUTY SPEAKER (Mr Ruddock) —Order! This is not a matter of cross-examination.

Mr BRUMBY —The facts hurt because the honourable member knows that the Opposition's record was so dismal.

Mr Porter —What percentage increase is that for this year?

Mr BRUMBY —There is no percentage increase. The fact is, as I have just stated it. The honourable member is having trouble understanding it, so I will repeat it. For the eight months to the end of February this year, Medicare benefits totalled $1.874 billion which puts the figure under budget, not $200m or $300m over budget. The honourable member can go around Australia, getting cheap publicity from cheap jibes about inaccurate statistics, but the time will come when people will stop running the cheap publicity because they will finally want him to come up with the figures. They will finally want the Opposition to come up with a policy.

I mentioned an article in this morning's Melbourne Age. It was yet another leaked Liberal policy from a Liberal meeting. It suggests that the Liberals are getting close now, after four years, to finalising their policy on health. It is nice to see that that is occurring after four years. But from what we can glean from newspaper articles, it seems that two central aspects of the Opposition's health policy are, firstly, that it would like to scrap totally Commonwealth medical benefit subsidies for all except pensioners and the disadvantaged, and, secondly, it would like to increase public hospital charges to reflect full costs. I want to make a few points about that.

Under this Government costs for medical services and administration of Medicare totalled $2.8 billion for 1985-86-the last full financial year. Even if the Opposition under its policy covered the costs of approximately $1 billion for pensioners and the disadvantaged, medical costs of $1.8 billion would be shifted to the public. I hope there is no disagreement about that analysis, because it is fairly elementary. If one carries on that analysis, on the basis that health costs of $150m per annum represent an extra $1 a week for private insurance at the basic rate, $1.8 billion represents a medical insurance cost of $12 a week. It is simply a matter of multiplying 12 by 150, which is how one reaches the figure of $1.8 billion. So we are looking, just at that side, at an extra $12 a week. Of course, that is just the figure for medical insurance. To that must be added the cost of hospital insurance. Before Medicare, the cost of hospital accommodation was about $130 a day. Adjusting that amount for inflation, that figure would now be approximately $170 a day. Health fund hospital contributions to cover this level of charge would have to be set at approximately $15 a week. That seems to be the thrust of the Opposition's health policy. The cost of the transfer of all of that from the public sector to the private sector, making some concessions for pensioners and other needy people, in medical insurance terms is $12 a week. The cost in terms of hospital insurance is $15 a week. That means that under the Liberals yet to be announced health policy, total health insurance costs for the average Australian would be $27 a week. If one multiplies that figure by 52-which is how many weeks there are in a year-one gets an enormous figure. It is a four-figure number.

Mr Porter —It is over $1,400 on your calculations, and it is absolute rubbish.

Mr BRUMBY —Thank you. The honourable member for Barker suggests that what I have just described as the Liberal Party's probable policy on health would add up to private insurance costs of more than $1,400 per annum.

Let us see how that compares with the situation under this Government. A person in receipt of an income of $20,000-many people earn $20,000-who is currently paying only the one per cent Medicare levy would be $22 a week worse off if the Opposition ever came to government. Would that not be outrageous!

Mr Porter —It would be a popular policy, wouldn't it?

Mr BRUMBY —It would be very popular for the Liberal Party.

Mr Porter —Do you reckon we would do that?

Mr BRUMBY —Yes, I do, because it is all part of the Opposition's philosophy of shifting those taxes on to people so that the people in the community who are well off, those on incomes of $50,000 and $60,000 a year, would pay less-and I will come to that in a moment-but the large majority of ordinary people in our community would pay more. It is a sleight-of-hand tactic. The Opposition would try to bring down the Budget deficit by transferring that public expenditure to the private sector. So the ordinary person who is in receipt of $20,000 a year would be $22 a week worse off under the Opposition's policy. If they were taking basic private insurance as well, as many people do, they would be nearly $14 a week worse off. A person in receipt of average weekly earnings, which are about $23,500, who is still paying the Medicare levy and who has private insurance, would be more than $12 a week worse off. Of course, the key point in the Opposition's policy is that individuals on high incomes would be very much better off.

The alternative to the abolition of Medicare is the much-quoted opting-out system-something for which I believe the honourable member for Barker has a fair bit of sympathy. It is called the opting-out system and it would allow people to choose between Medicare--

Mr Porter —Mr Deputy Speaker, I take a point of order. Whilst the debate has obviously been very wide ranging, we have had hypothesis after hypothesis from the honourable member which do not relate in any way to the legislation. They relate to his fantastic ideas of a policy, which certainly has nothing to do with the coalition. I suggest that you draw his attention to the legislation and ask him to be relevant to the Bill.

Dr Blewett —On the point of order: It does seem to me that, given the extraordinary latitude that has been allowed to Opposition members, and even the remarkable tissue of nonsense produced by the honourable member for Barker which did not relate to the Bill whatsoever, there should be no restriction on members in this debate.

Mr DEPUTY SPEAKER (Mr Ruddock) —I believe the debate has been extraordinarily wide ranging, having regard to the title of the Bill. It is a Bill to amend the National Health Act. It covers a wide range of health-related issues. It seems to me, as well as government policy and the way in which government policy might go, it is appropriate to consider Opposition alternatives.

Mr BRUMBY —Thank you for your ruling, Mr Deputy Speaker. I was pointing out that the alternative to the abolition of Medicare which I have just described would be what is known as the opting-out system. Honourable members would certainly recall that that was what the Fraser Government used and tried in 1976. It lasted a mere 18 months or two years and it was scrapped in November 1978.

The problem with opting out arrangements is that only the healthy and the well-off opt out. That leaves people on low incomes and those with chronic illness as the only ones left in the insurance system. If opting out is allowed, why would fit young people of 18, 19 or 20 years of age bother to make any contribution to insurance? Of course, they do not. That is the problem with the opting out system. On the income side, if people earning above average weekly earnings were to opt out, as they did in 1976 under the Fraser scheme, they would take nearly 60 per cent of the Medicare levy collections with them. The result-this will come as no surprise to any honourable members who have carefully looked at the facts-is that those remaining in Medicare would face a doubling of the levy to 2.5 per cent. That was what occurred under Fraser in 1976. Judging from an article in the Age newspaper this morning, I suspect that that is on track with where the Opposition is going.

I wish to conclude by commenting on a few of the points made in the debate. I have briefly addressed the question of costs, which has come up again and again. The honourable member for Barker (Mr Porter) tried to claim that families are worse off under Medicare than they were under the previous health insurance arrangements. That is arrant nonsense. If he goes around the country making such absurd statements, as I warned the House earlier, eventually people will stop listening to this rubbish. They want to hear realistic alternatives, not the fantasy-land alternatives put forward by those opposite. They want to know the policy options, because in the next year there will be an important election and people will have an important choice to make. They really want to know what the Opposition's policies are.

If one looks at the cost aspect and analyses the consumer price index over the period 1980-81 to the December quarter of 1986, one sees that health costs rose more under a variety of Fraser schemes than they have since the introduction of Medicare on 1 February 1984. If one takes 1980-81 as the base index of 100, the figures show the true impact of the Opposition's health policies compared with Medicare. For the health services group, the index increased to 184.1 by June 1983; a year later in June 1984-under the first full quarter of Medicare-the health services group had dropped to 102.7. By December 1986, it had increased only to 138.4. In fact, if one compares health costs with the costs over the same period of food, clothing, housing, transport, tobacco, alcohol and so on, one sees that increases in health and personal care costs have been modest compared with those other areas.

The final point I wish to make touches the question of choice. The Opposition claims that it will offer choice at the next election. What it really offers is cliches, meaningless nonsense, in place of policies. Under the present health system all Australians-no matter where they live, no matter what their state of health or income-have complete freedom of choice. We are all covered for basic hospital and medical treatment through the payment of a fair and equitable Medicare levy. If we want to have a doctor of our choice and to be treated in a private hospital, all we have to do is to take out private insurance. There is no restriction on any individual anywhere in Australia on any income from taking out private insurance. Everyone in Australia has freedom of choice in the health area but, importantly, every Australian has basic hospital and medical cover. That is where the philosophies of this Government vary vastly from the philosophies of the Liberal and National parties which unquestionably, if ever returned to government, would place us back in the old horse and buggy days when two million Australians under the Fraser Government had no right or entitlement to health care. That was a disgraceful policy; it has been amended under this Government. All Australians now have basic hospital and medical entitlements and can have a freedom of choice by taking out additional private insurance. I commend the legislation to the House.