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Wednesday, 9 June 1999
Page: 6448


Mr EMERSON (12:19 PM) —Labor will not be opposing this National Health Amendment (Lifetime Health Cover) Bill 1999 , but it is yet another attempt to increase private health insurance coverage—the fourth health policy in four years of the coalition government. In this respect the coalition is remarkably consistent. It had seven different health schemes in seven years of the Fraser government and now it has had four different health schemes in four years of the Howard government. Coalition governments are maintaining their average of a new variation on the health scheme every year.

We have seen a means tested private health insurance rebate introduced by this government. That did not achieve the stated objectives of increasing private health insurance coverage. It was followed by a non-means tested private health insurance rebate of a massive $1.5 billion a year. That second non-means tested rebate had more to do with disguising tax cuts for high income earners under the government's tax package than with good health policy. Under the package, the tax cuts were already extremely high and the government needed to figure out a way to put a little more icing on the cake. It came up with this scheme of giving $1.5 billion to private health insurance policyholders on a non-means tested basis.

The Minister for Health and Aged Care would have to be very disappointed with the response to this massive new rebate. He is grasping at straws if he thinks that the take-up figures that have been released to date are good. They are very disappointing indeed. We find a situation where the Minister for Health and Aged Care has to look at yet further changes to the government's health policy to try to increase private health insurance coverage. They sought to do so under the $1.5 billion scheme through a large advertising program which has been judged, independently, as highly misleading because it told all Australians that they were entitled to a 30 per cent rebate whereas in fact those who already had access to the means tested rebate would not be getting anything like 30 per cent. This is yet another example, unfortunately, of the government spending taxpayers' money on highly misleading and false advertising.

The coalition's track record on health was not lost on the then shadow minister for health, the Hon. Peter Shack, when, in July 1989, he told a private medical seminar:

We went through Medibank Marks 1 to 4, or 4½ or 5, when we were last in government. Since we have been in opposition we have had four health spokespersons and we have produced four health policies—two of which were never made public. I think the last one in the 1987 election probably lost us votes instead of winning us votes.

The shadow minister made those candid comments in a private seminar because he felt confident that he would not be reported. He was in fact reported. There have been seven health policies in seven years in government from the coalition. In opposition, there were four health policies by four health spokespersons up to 1989, followed now in government by four health policies in four years.

The reason we are contemplating the bill before us today, the National Health Amendment (Lifetime Health Cover) Bill 1999 , is that the Prime Minister has never been com fortable with Medicare. He told the John Laws program on 1 June 1987, just before the 1987 election campaign:

There will be many major reductions in health, the Medicare system is a total disaster, we will be proposing changes to Medicare that amount to its de facto dismantling. We will pull it right apart.

Three days earlier, on 27 May 1987, the current Prime Minister told the Alan Jones program:

What I'm going to do is take a scalpel, without punning too much, to Medicare. I'm going to say to people if you want to get out of Medicare and make your own private health insurance arrangements you can do so. They will be given an incentive to do it. They will not have to pay the levy. I'll get rid of bulk billing completely for people rather than pensioners. I'll free up the whole private health insurance market so that health funds can in competition with each other offer a variety of packages to help consumers.

Those are the words of the current Prime Minister of Australia. Don't they give us a sense of deja vu?

The bill before the House today has precisely the effect of freeing-up the private health insurance market. That is the first part of the Prime Minister's long-held and long-cherished agenda. The second part is taking a scalpel to Medicare—his dear ambition, thwarted only by the huge public popularity of Medicare. That is why the Prime Minister's strategy has moved from a public commitment to `take a scalpel' to Medicare—to `pull it right apart', to use his words—to a new strategy of dismantling Medicare by stealth. This dismantling of Medicare by stealth by the Prime Minister is a reluctant acknowledgment of the revelation by the then opposition health spokesman, in July 1989, to the same private seminar to which I referred a moment ago, where the opposition spokesman said:

The political strategy is to recognise, regrettably, that the constituents whom we have to win are wider than this room and Medicare does have substantial support.

The dismantling of Medicare by stealth by the Prime Minister involves three stages. The first stage is to starve the public hospital system of funding, and this government is doing that. In its first two budgets the government cut $800 million from the public hospital system. The second stage is to increase subsidies for private health insurance. As I indicated earlier, the first was means tested. The second, enacted late last year, was a $1.5 billion annual subsidy with no means test at all. The third stage is to refuse to inject extra funds into the public hospital system so that it becomes at best a safety net for struggling Australian families. But the Prime Minister hopes the cash starved public hospital system will eventually fall into disrepair and disrepute and then he can realise his dream of taking a scalpel to Medicare.

The Prime Minister should heed the immortal words of the shadow minister for health on 25 January 1990 in a famous press conference on the eve of the 1990 election campaign. The shadow health minister held that press conference to announce that the coalition did not have a health policy at all going into the 1990 election, after promising for more than two years that they would have one. At that famous press conference, the shadow minister uttered these immortal words that the Prime Minister should heed:

You might accuse us of a lot of things but one of the things I don't think we're guilty of is learning from our past mistakes.

How true that is. This government has never learnt from its past mistakes on health. In a great moment of candour, that point was readily conceded by the shadow health minister in 1990 when, rattled at a press conference where he had to announce that after two years of working on a policy to take a scalpel to Medicare, to dismantle Medicare, to pull it right apart, they had no health policy at all. The reason for that is the overwhelming popularity of Medicare. They knew that they could not go to the 1990 election with a stated policy of destroying Medicare, so they went quiet; they abandoned completely any pretence at a health policy. In that same famous press conference, the shadow health minister said a few minutes beforehand:

Now I want to say to you, with all the frankness that I can muster, the Liberal and National Parties do not have a particularly good track record in health and you don't need me to remind you of our last period in government.

The Prime Minister should learn from his past mistakes, but he will not. He advocated a goods and services tax way back in the early 1980s and, 20 years later, he is prosecuting it. The Prime Minister advocated the dismantling of Medicare 13 years ago, and he intends to achieve it—this time by stealth.

But that does not mean Labor opposes the legislation before the House. What we do oppose is the denial of adequate funding for the nation's public hospital system. As my colleagues on this side of the House have pointed out, the states made representations to the government that for $750 million—half the amount that is being splurged on a non-means tested private health insurance rebate—they could fix up the problems in the public hospital system. But the Prime Minister said no, because that would not be consistent with his agenda of dismantling Medicare by stealth.

This bill introduces Lifetime Health Cover. It encourages people to join a private health fund earlier and to stay in it. In virtually all Western countries, private health insurance is risk rated, not community rated, and I have no difficulty with private health insurance, as a concept, being risk rated rather than community rated. But Labor's objective is to strengthen Medicare as the best route to controlling medical costs and avoiding the disasters of, for example, the American system, which costs a much higher proportion of gross domestic product than the Australian system.

The role of private health insurance should be to complement Medicare, not to replace it, as the Prime Minister wishes. Labor is able to support this legislation because the measures it contains can lead to complementarity between private health insurance and the Medicare system—hopefully, an improved private health insurance system and improved coverage of private health insurance but as a complement to a strong, viable Medicare system. That is not a third-rate Medicare system which falls into disrepair and disrepute, as the Prime Minister wishes, so that over time it loses community support and he can then move on Medicare, not by stealth but by a stated public policy. That is what he would love to do. He would love to reannounce his 1987 commitments to tear Medicare apart, to pull it right apart—to take a scalpel to Medicare.

I hope and trust that the Minister for Health and Aged Care does not share the Prime Minister's view that the way forward on health policy is to dismantle Medicare. I hope and trust the Minister for Health and Aged Care is committed to private health insurance complementing a strong, viable public health insurance system. For us on the Labor side, a strong health insurance system in Australia would involve a combination of a competitive private health insurance system and a publicly funded Medicare system, but it does not involve realising the Prime Minister's dream of taking the scalpel to Medicare and pulling it right apart.

We are able to support this legislation and we hope it achieves its stated objectives, but we say to the government: do not try to take any further measures to dismantle Medicare—to make it a third-rate system that falls into disrepair and disrepute—because I can provide the assurance that Labor will always support the Medicare system. We would, in government, ensure that it is adequately funded and we do not want to see any further instalments on the Prime Minister's agenda of pulling Medicare right apart. With those words, I say once again that we support this legislation and we trust that it will be put in place to complement a strong public health insurance system in the form of Medicare.