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Wednesday, 28 May 2003
Page: 15233


Mr MURPHY (4:46 PM) —With respect to the Health Care (Appropriation) Amendment Bill 2003 when you examine the consequences of the changes the government has put to the parliament, you can be forgiven for thinking that the government wants to mirror the appalling public health administration record of the United States. I invite government backbenchers that want a US style health system in Australia—a system that caters only for those who can bear the astronomical costs of private health—to move to the United States and discover it for themselves.

This year's budget shows that the Howard government is withdrawing funding for public hospitals already in the forward estimates to fund its Medicare package. Instead of recognising the pressure that they are under—the pressure the government is contributing to—its only answer is to withdraw a further $918 million over four years from our public hospitals. Quite frankly, that is outrageous.

The government's Medicare reforms are a lifelong political ambition come true for the Prime Minister: that is, the destruction of Medicare and the end of bulk-billing for Australian families. They are an end to effective insurance for everyone visiting the doctor. That will be replaced by a two-tier system and user pays; there will be a safety net for pensioners and the poor, while most working Australians will pay, and pay more, for their health care.

We all remember that in the 1980s the member for Bennelong said Medicare was a `miserable, cruel fraud'. He also said it was `a total disaster' and he threatened to `pull Medicare right apart' and to `get rid of the bulk-billing system'. The member for Bennelong's 1987 formal election commitment stated:

Bulk-billing will not be permitted for anyone except pensioners and the disadvantaged. Doctors will be free to charge whatever fees they choose.

In 1996 the Prime Minister made a litany of infamous `never ever' speeches, including one where he said:

We're not going to contemplate altering the universality of Medicare. I mean, that is fundamental, and we're also going to keep bulk-billing ...We guarantee the retention of bulk-billing.

Now the Prime Minister is trying to implement his 1987 commitment to destroy Medicare, robbing most Australians of access to universal, affordable health care.

The Howard government has undermined Medicare from day one. Since 1996, the rate of bulk-billing by doctors has fallen by 11 per cent. Across Australia, only 69.6 per cent of doctor visits are bulk-billed, down from 80.6 per cent, and the average cost of seeing a doctor who does not bulk-bill has risen by almost 55 per cent. That is scandalous too.

The Liberal Party and the National Party now want families earning more than $32,000 a year to be denied access to a doctor that bulk-bills. That means Medicare will become an Americanised two-tier and user-pays health system where only pensioner concession card holders or health care card holders can be bulk-billed, forcing millions of Australian working families to pay more when they visit the doctor. This plan will not stop the alarming decline in the number of bulk-billing doctors in electorates where their levels are already low. Moreover, in electorates like my electorate of Lowe, where 93 per cent of doctors presently bulk-bill, it means most working Australian families will soon pay three times for their health care: once by paying a Medicare levy; twice by purchasing private health insurance; and then, for a third time, when they are slugged $20 or more every time they, their kids or a family member need a doctor.

Another damaging consequence, obvious to everyone except apparently the Prime Minister, is that many parents will have no choice but to take their sick children to our already stretched public hospital emergency rooms. Working families should not be forced to make decisions about the health of their children based on their ability to pay. Not content with hitting working families with the highest level of taxation in Australia's history, the government's plan will ensure families pay more and more for their health care as doctors' up-front fees inevitably rise.

Not satisfied with forcing Australians earning between $30,000 and $50,000 to pay $20 every time they go to the doctor, the government also wants Australians to pay an extra $5.50 every time they buy essential medicines in the form of the Pharmaceutical Benefits Scheme copayment. Australians understand that the principal objective of the PBS is to ensure equitable access to necessary and lifesaving medicines at an affordable price. Any change to the scheme should not compromise this objective. Copayments should not be used as a mechanism for containing demand on prescription medicines subsidised under the PBS or as a strategy for increasing revenue for the PBS. Shamefully, the government saves money on the PBS when the copayment is increased, because many low- and middle-income Australians and pensioners stop filling their prescriptions.

The government's own analysis indicates that over 5½ million prescriptions for pensioners and Australians under financial pressure will not be taken up. If people do not take up their scripts, they ultimately end up in the emergency rooms of public hospitals at far greater expense to the taxpayer. Australians are entitled to know how highly the government value their PBS and their access to essential medicines. The government value the PBS so highly that they are secretly trying to trade away this critical aspect of our public health system by keeping the PBS on the negotiating table for the US-Australia free trade agreement. Opponents of this outrageous development include the Pharmacy Guild. If the Howard government cave in to the big US pharmaceutical companies and negotiate away the PBS in the free trade agreement, prescription prices could rise by 90 per cent for hardworking Australian families. This is a plan for higher prescription prices by the back door.

I will continue my campaign in this House to fight for the patients and the families of my electorate of Lowe for one simple reason: basic health care should never be about someone's ability to pay. That is why Labor built Medicare. Only Labor believes in Medicare and only Labor will save Australia's world renowned universal health system from this disgraceful attack by this government. The people of Australia have had a gutful. (Time expired)