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Wednesday, 27 May 1987
Page: 3428


Mr PORTER(4.49) —As the snow on the hills in Canberra today indicates, the chill is setting in. The economic outlook for this country is grim. We are facing an economic recession. Inflation is out of hand. As a result of four years of a Labor government there are now 55,000 more families in receipt of incomes below the poverty line than there were when this Government came to office. There are more families without housing than there were when this Government came to office. There are now 160,000 families waiting for public housing. There are more families having difficulty getting the health care that they need. One hundred thousand members of families are waiting in public hospital queues for badly needed surgery. The community is despairing. The Government is terrified of the future. It does not want to face up to the August Budget and it knows that as a result of its grossly incompetent economic management the future is grim. The Government is running scared. I understand that the Prime Minister (Mr Hawke) is about to call an early election in what will go down in history as Australia's winter of discontent. Let me tell honourable members that the electors will show their discontent. This will be the last time that the Minister at the table, the Minister for Science (Mr Barry Jones), will sit in the chair on the Government side of the House.

This legislation is part of the Government's thrust to force people out of private insurance and into Medicare. In the place of the efficient, competitive private health insurance industry we have a bloated, inefficient and wasteful government Medicare bureaucracy. In just three years the Australian Labor Party Government has increased the annual tax take by some $4,400m to pay for Medicare. In just three years Labor has increased by 3,000 the number of public servants required to administer Medicare. In just three years Labor has increased personal health costs by 35 per cent. In just three short years Labor has forced 10 million health fund members to give up their private medical cover and join Medicare, and in just three years Labor has pushed up the cost of private hospital insurance, forcing 1.8 million people to give up their hospital cover.

We are now paying over $8,800m for Commonwealth health care. That is twice as much as we were paying three years ago. What is worse, the standard of service has declined. Queues for public hospitals have trebled. One hundred thousands Australians are waiting for a public hospital bed while more than four out of 10 private hospital beds remain empty. Every day there are on average over 9,000 private hospital beds vacant in this country. Under Medicare the community is paying more for health cover. Patients are unable to gain access to a hospital bed when they need it. Health care providers are fed up and the level of industrial disputation in the health care industry is the highest ever. The level of waste and rip-offs has exploded. The only beneficiaries of the Hawke Labor Government's Medicare program have been the 3,000 new public servants employed to administer it. Medicare has been a disaster which has wreaked havoc on our health system.

The Opposition will reverse this Government's failed Medicare policy. There is absolutely no reason why the Government should be involved in the provision of every medical service in this country. Some 12 million people will be encouraged to return to private health insurance under the Opposition's health policy-that is, the 2.8 million families and 2.3 million people who are currently paying the Medicare levy-and of course that will have a significant impact on the Commonwealth Budget. In addition to the savings from reductions in Federal expenditure there will also be a reduction in total heath costs through the elimination of waste and overutilisation fostered by Medicare. Together these will contribute to funding overall tax cuts.

The Government's encouragement of bulk billing has resulted in significant waste. People are led to believe that medical services are free-and the provision of almost anything free leads to waste and overuse. Initially under Medicare the enrolled population was using an average of 5.8 services a years. Last year the average was 7.5 services, a 28 per cent increase in the volume of services in just two years. If this growth in the average number of services per patient had been contained, instead of encouraged with bulk billing, savings of around $600m a year would have been achieved.

The Minister for Health (Dr Blewett) has said on many occasions that my figures are incorrect. I tell the House that those figures are taken from the Health Insurance Commission's annual report of services. What the Minister does, of course, is compare services before Medicare, when private insurance covered a much larger range of medical services provided, with Medicare cover. These are not comparable. The fact is that there has been an explosion in the number of services per patient per year under Medicare, and that is costing an extra $600m a year alone. We will end bulk billing for all bar health care card holders. Of course we will obtain Medicare cover for the 3.6 million pensioners and social security health card holders and their dependants. These changes will enable us to make more savings by streamlining administration under the Commonwealth Department of Health.

The Health Legislation Amendment Bill implements the May mini-Budget cuts. Basically the amendments do two things. Firstly, they reduce the Medicare rebate for doctors' services provided to private in-patients of hospitals from 85 per cent of the Medicare schedule to 75 per cent. At the same time they remove the $20 maximum gap in the hospital in-patient contribution for medical services. Secondly, they redefine the basic private table of benefits for private health funds. The private health funds will now be required to extend the coverage of gap benefits on the basic table so that all privately insured patients will continue to receive the full schedule fee for all in-patient hospital medical services.

In the second reading speech the Minister for Health scrambled for justification for these hopeless amendments. He said, among other things, that significant increases in out of pocket expenses to individuals will be avoided. What absolute nonsense. Take the example of a family whose aging mother, who has no private insurance, suffers from crippling arthritis and requires a hip replacement. The family has two choices. The first is to allow mum to remain on the waiting list for a public hospital bed. In New South Wales, for example, because of the Medicare program, she would have to wait three years on a public hospital waiting list to have her hip replaced. For most families that just is not on. They are not prepared to make their parents suffer as a result of this Medicare program. The second choice is for the family to have the mother admitted to a private hospital where there are beds available, and to pay for the hospitalisation themselves. Currently the surgeon's and the anaesthetist's bills will be covered by Medicare except for the $20 gap for each of those two specialists. Of course the family will have to foot the bill for the hospital costs.

Prior to the amendments being introduced in this legislation, the family's medical costs would have been $40-$20 for the surgeon and $20 for the anaesthetist. Following the changes in this legislation, the family's new liability will be $30 for the anaesthetist and $150 for the orthopaedic surgeon. In other words, the family will now have to pay not only mum's private hospital bill but also $180 towards the cost of the medical services provided-a cool 450 per cent increase in health costs. The Minister has the gall to say that significant increases in out of pocket expenses will be avoided. What absolute rubbish. First of all he lured people out of private insurance with his blatant lies about Medicare being the fairest health system that this country has ever seen.


Madam SPEAKER —Order! The honourable member will withdraw that comment.


Mr PORTER —Withdraw which comment, Madam Speaker?


Madam SPEAKER —The comment about the blatant lies.


Mr PORTER —I beg your pardon.


Madam SPEAKER —The honourable member will withdraw the unparliamentary comment he made about the Minister.


Mr PORTER —I said that the Minister had told a blatant lie.


Madam SPEAKER —That is right.


Mr PORTER —That is not about the Minister; it is about what he said.


Madam SPEAKER —The honourable member will withdraw the comment.


Mr PORTER —I withdraw. He obviously grossly misrepresented the Medicare program to the Australian public. He claimed that there would be free Medicare for all. Instead, he has provided a system which has jammed up the public hospital system. Now when people need hospital care they cannot get it. In desperation people are returning at their own expense to the private hospital system. They now find that this Minister and this Government have dumped another $100m on to the bills that they as private patients will have to pay for the privilege of saving the Government money by undertaking hospital care in the private system rather than in the public system. That is not all that this Minister has dumped on to the private hospital system. I get the feeling that there is some sort of expectation rising in the House. I am delighted that at long last so many honourable members have seen the concern that the Opposition has had for so long about the corrupt Medicare system that this Government has introduced.

The Labor Government over the last three years has been intent on increasing the cost of private insurance and driving people out of private insurance into the Medicare system. This legislation will increase the cost of private cover by $100m. Since the Hawke Government came to office this Minister has eliminated the Commonwealth subsidy for patients to private hospitals-$140m a year. He has reduced the hospital reinsurance fund by $99m a year. In justifying these actions and the amendments that we are considering today, the Minister, using his typical Medicare mentality, says: `We do not have to worry about all these increased costs that have been added to the costs of the privately insured'. He says: `It is all right because private insurance will cover the extra cost that the individual will have to carry'. That is precisely the sort of attitude that has helped bring the health system of this nation to its knees. He says: `Do not worry about the doctors bills; Medicare will pay for everything. Under Medicare the bulk billing doctors visits are free'.


Madam SPEAKER —Order! I recognise that everybody is a little excited, but I ask the House to come to order. The honourable member for Barker has the floor and the level of conversation is ridiculous.


Mr PORTER —Perhaps the Prime Minister (Mr Hawke) has changed his mind. I could understand him doing so, considering the discontent in the community with this Labor Government's policies. It is indeed the Australian winter of discontent.


Mr Ronald Edwards —Let's hear what you have to say after the election.


Mr PORTER —I would not worry about that; it is the last speech I will be making on this side of the House. Every time this Government looks for savings to protect its precious Medicare program, it seeks to shift more of the burden for health costs on to the privately insured. My question to the Minister and the question of private hospitals, of the patients of private hospitals and of the private health funds is: Where will it all end? The answer is that it will not end under this Government. It will not end until this Government and its compulsory Medicare program are driven from office by a justifiably outraged electorate.

The Minister has claimed that the action to be taken through this amendment will protect the main principles of Medicare. He claims that all Australians should receive protection against the high cost of medical treatment on a fair and equitable basis. Where is the fairness, where is the equity in forcing the privately insured population to shoulder the burden of $100m of the Commonwealth Government's commitment to pay reasonable fees for medical services simply because these people believe that the Medicare system has totally failed them and they have elected to purchase their own private health cover? Privately insured people pay the Medicare levy like anyone else. They do not participate in Medicare grants provided to States for public hospital services. These people contribute hundreds of millions of dollars to Australia's health system through their private health premiums.

I understand that the Prime Minister has panicked and wishes to make an announcement to the House. Of course, it is not the first time we have seen him crack. We had the MX missile crisis and the Fiji crisis.


Madam SPEAKER —Order! Does the honourable member for Barker wish to make a statement?


Mr PORTER —Not really, but I will. I seek leave to continue my remarks later this day.

Leave granted; debate adjourned.