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Thursday, 17 October 2002
Page: 8038

Mr GAVAN O'CONNOR (12:15 PM) —The Health Care (Appropriation) Amendment Bill 2002 is designed to make two changes to the Health Care (Appropriation) Act 1998. It will allow the Minister for Health and Ageing to increase the maximum limit of funding provided to states and territories under the Australian health care agreements and will require the minister to table in parliament a statement of the total amounts granted under the amended maximum payment level. The current agreement between the Commonwealth and the states and territories is for the period 1998-2003, for an amount not exceeding $29.633 billion. With this amendment, that maximum amount is increased to $31.8 billion over that period. The opposition has already indicated it will be supporting this bill.

An important feature of the agreement is the capacity of the Commonwealth to adjust its funding commitment where private health insurance membership increases or decreases beyond certain thresholds. A central but flawed tenet of the government's position is that increases in private health insurance membership automatically over time lead to a reduced demand on public hospitals. This is a position that rests more in ideology or philosophical positioning than in fact. The fact is that, although people have been virtually dragooned into private health insurance by the government through its 30 per cent private health insurance rebate and other incentives, this has not led to a dramatic decline in public hospital waiting lists. There are reasons for this. Public hospitals have the resources and expertise to undertake complex medical procedures, and that is where people go for their treatment. Whether or not a person has private health insurance is quite irrelevant to the issue of seeking the best treatment for a complex medical condition; hence, people will gravitate to the waiting lists of public hospitals when such procedures are required.

A second important factor in this analysis is the nature of the government's private health insurance initiatives themselves. They are deliberately designed and focused to attract young people to the private funds. As young people are on average more healthy than others, they are not big users of the public health system anyway. So a significant increase in membership from certain age cohorts—particularly the young—does not by itself translate into a reduced demand for public health services.

This bill provides me with an opportunity to make some comment on Australia's health care system—an issue of critical importance to my electors in Corio. It is timely to make these comments, as our most recent experience in the wake of the deadly terrorist bombings in Bali has brought home to us all how fortunate we are to have a health care system of such quality and sophistication, with the capability to handle even the most dire of emergencies. I pay tribute today to those Australian health care professionals who have worked beyond the call of duty in Bali and in Australia to alleviate the pain and suffering of their fellow Australians. It is important to understand and acknowledge that this selfless contribution is being made daily, right across Australia, by these professionals in the health care system.

In my electorate of Corio, which encompasses the great regional and provincial city of Geelong, we are fortunate to boast one of regional Australia's best public hospitals, operated by Barwon Health and servicing the Barwon region from Geelong and the surf coast well into the Western District. That hard-won reputation is the result of the efforts of many people: the doctors and nurses who form the professional core of health providers in the facility; the Geelong Hospital Board, chaired by Lisa Neville; the work force, well represented by their unions; the ancillary volunteers, whose support is so vital to the operations of the hospital; and, of course, the Geelong community, which strongly supports this key institution in our local region through fundraising activities and various appeals.

Our public hospital is part of a public health system which ranks as one of the best in the world, despite the Prime Minister's incessant attacks upon it. Australia's Medicare is a great Labor initiative of which we are very proud and which provides universal health cover to all, regardless of race, religion, occupation or social status. It is strongly supported by the Australian people, yet we have a Liberal Prime Minister at the moment who is dedicated to its destruction. John Howard has made the dismantling of Medicare one of the central goals of his political career, one to be achieved by stealth and deceit. Who could ever forget his now infamous statement that he would stab Medicare in the stomach if the Liberals ever regained office? They did regain office but they have not been able to dismantle it because the Australian people will not let them—and, of course, this Labor opposition will not let them either.

The fact of the matter is that Australia's health care system is in crisis, and the mess has been created by this Liberal Prime Minister. The result of that has been increased health care costs for Geelong and for Australian families. Firstly, we have seen a dramatic decline in the provision of bulk-billing services, and that simply translates into increased costs for working families. The rate of bulk-billing has declined from over 80 per cent when the Howard government came to power to now only 73.9 per cent. Today the latest Medicare statistics show that the average copayment for someone seeing a GP has increased from $8.32 in 1996 to $11.98 today—an increase of 44 per cent. At the end of the day the financial impact of these trends is borne by working families.

The medical indemnity insurance crisis is also impacting on the rate of bulk-billing and on the costs to families. We have had the example of an indemnity levy being imposed by some rural and regional doctors. The example that has been brought to the attention of the parliament is the doctor in Parkes in the west of New South Wales who, it has been reported, has billed each of his patients with a levy, ranging from $2 to $6, each time they visit. That levy is assessed for each patient, based on considerations such as the length of the consultation, the financial status of the patient and the legal risks associated with the particular treatment. Here is a very concrete case where another failure of government policy is hitting the pockets of ordinary Australians. We now have the automatic increases in the costs of private health insurance, courtesy of this Prime Minister.

In 1996, John Howard said this about future premium increases:

What I can give is an absolute guarantee that any change—

that is, in private health insurance premiums—

in future will be the result of a decision taken at the political level in a way and in circumstances where we are satisfied that the rise is completely justified.

It is another broken promise on private health insurance by the Prime Minister. Australian taxpayers now contribute $2.3 billion each year to subsidise private health insurance. These particular increases, or the structures that are being put in place to allow these increases without scrutiny, will simply mean increased costs to Australian families who have private health insurance. Wherever you go in the health system today, this Liberal government has its hand in the pockets of Australian families, be it from the impact of the decline in bulk-billing, be it from the impact of medical indemnity insurance—or the lack of it—on medical practice, or be it in the area of rising health insurance premiums in the private sector. Australian families are bearing a terrible burden at the moment because of the incompetence of this government in health care.