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Wednesday, 28 May 2003
Page: 15262


Mr LATHAM (6:55 PM) —The Health Care (Appropriation) Amendment Bill 2003 is part of the government's attack on Medicare, part of the winding back of universal health care in Australia and, as the member for Perth points out in his amendment, part of a government plan to wind back bulk-billing. We consistently see a double standard from the Howard government. For working families in an electorate like my electorate of Werriwa, there is an attack on Medicare, the defunding of public hospitals and the winding back of bulk-billing. People in my electorate rely on universal health care. This has been a community standard for close to 20 years, and why shouldn't it be? If you are a young working family living in Liverpool or Campbelltown with young children, you need universal health care provision to make your family function. You need universal health care provision to look after your children and to lead a decent life in a civilised society.

The double standard of the Howard government is that at the same time as working families are copping it in the neck—they are losing their universal health care and they are having to pay more for the basics of life—the Prime Minister can afford a $43,000 hotel bill for just four nights accommodation in Rome. This has been the most extravagant trip to Rome since Caligula was in town. I have heard of Roman orgies, but this is a Roman orgy of spending and extravagance by the Australian Prime Minister. While he is living it up in Rome, families in my electorate, unhappily, are petrified about the health care agenda of his government. We have one rule for the outsiders, the working families in the great suburbs and regions of Australia, and a different rule for the insiders, the pampered elites of the Howard government. The insiders have the expensive hotel bills and the high life. Unhappily for the outsiders, the working families, they just have the loss of universal health care and the winding back of bulk-billing.

This is a very bad change indeed. In my electorate we are particularly affected. Liverpool and Campbelltown are very much the children's capital of Australia. A very high proportion of our population are young people who are part of young families moving into the new suburbs and release areas. We have also been known as the bulk-billing capital of Australia, with some 95 per cent of doctors in the electorate of Werriwa bulk-billing. So we have the most to lose from these changes. We have the biggest number of children and the highest number of bulk-billing doctors and, quite frankly, people in my electorate instinctively know that any change is bad.

With 95 per cent of doctors bulk-billing, the opportunity to go to a free local GP has been part of universal health care provision. It is almost the same as the public hospitals: free and available. This has been a community standard, a community entitlement, for close to 20 years. So people in my electorate are asking: `Why change a system which has been working so well for 20 years? Why make a change?' People instinctively know that any change in the seat of Werriwa must be bad. We are the children's capital of Australia and we are the bulk-billing capital of Australia and, under these changes, we have the most to lose. We have the biggest number of children and the most bulk-billing doctors and therefore we can only lose out through the changes proposed by the Howard government and through legislation such as this.

That is what people are worried about. I have never seen community concern of this kind in my constituency. I have been running a petition against the changes. The petition to this parliament identifies the need to keep bulk-billing for the young families and communities of south-west Sydney. People are praying that the House will oppose the introduction of an up-front fee for GP visits. I have been handing out this petition in my electorate as part of a card that I will be bringing to the parliament, and I have never seen a community reaction like it. Women in particular are petrified about this government's health reform agenda. They have a look at the petition and very often they come back to the shopping centres and the railway stations and ask for a few dozen of the petitions to hand out to their friends, take to their workplaces and put in letterboxes in their street. They will do anything to keep bulk-billing in Liverpool and Campbelltown. People are genuinely petrified of this government's changes.

Why shouldn't they be? Young families with three or four kids—with the winter months coming up and the possibility of the kids getting a sniffle, a cold or any of those sorts of problems—very often use a GP once a week. Now they will have to pay $20 or $25 up front just to get basic health care for their children. No wonder they are worried. No wonder they are responding so effectively to the campaign I am running in my electorate and signing the petition to save bulk-billing and save our universal health care entitlements in Liverpool and Campbelltown.

We know this government is hell-bent on the destruction of Medicare. Medicare over the years has had three basic principles. The first principle is that, if a doctor charges a fee up front, part of that fee can be recovered from a Medicare office. That principle will be gone under the Howard government's proposals; you will not be able to recover any of the up-front fee from a Medicare office. The second principle underpinning first Medibank and now Medicare is that the availability of bulk-billing means that people do not need private health insurance just to visit their local GP. People in my constituency have never thought they would need private health insurance to visit GPs. Why would they? GPs have provided 95 per cent bulk-billing; it has been a free, universal entitlement. Under this government that principle will be gone. The government actually wants people to take out private health insurance for their GP costs and is going to make that possible under legislation. It is going to encourage working families to take out private health insurance just to visit their GP.

Recently I was visiting the suburb of Greenway Park, which is one of the new, double-storey housing estates. It is a beautiful area and the people have lovely homes, and they are moving into my electorate of Werriwa. I ran into a fellow who asked: `How can the Howard government be making changes to bulk-billing? How can they be winding back the community standard that we have had for close to 20 years?' He said he will have to pay five times just to visit the GP. He did not believe that it could be this bad. First of all, he will be paying his taxes in general. Then he will have to pay his Medicare levy to the government. He already has private health insurance, so he is paying for health care through the insurance arrangements. Then he will have to pay an up-front fee to visit the local doctor, and then he will need more private health insurance to cover the cost of visiting the GP. A system that has worked so well for 20 years is being turned into a system where you pay five times just to visit the local GP.

I explained the Howard government's reforms to my constituent in Greenway Park and finally he accepted that this is the system the government is going to introduce. Quite frankly, he was dumbfounded—flabbergasted—as to why a government would want people to pay five times for a basic service such as visiting the local GP. They will have to pay the taxes, pay the Medicare levy, pay for private health insurance and, under the government's changes, pay the up-front fee for the GP. Then there is the government's plan to force families into further private health insurance to cover those GP costs. People will be paying five times for a service that, until now, has been a decent community standard.

The third principle underpinning Medicare is that we have quality public hospitals that are fully resourced, free and accessible to the Australian people. We know that under this government that principle is going. The first funding priority of this government is private hospitals and private health insurance, not the public hospital system. That priority is reflected in the legislation before the parliament. The cuts to public hospitals are quite extraordinary. Through to the year 2006-07 they total $918 million. Have a look at Budget Paper No. 2 at page 179. It is spelt out in black and white that the government is withdrawing funding for public hospitals in its forward estimates to the tune of $918 million. The government is trying to say to the Australian people that it has a Medicare package that is going to increase funding for health care and that that package is worth $917 million. This is a pea and thimble trick. The $917 million in the so-called Medicare package is in fact the equivalent of the $918 million that has been cut out of public hospitals.

There are three principles underpinning Medicare and they are gone, gone, gone under the Howard government. We will not be able to recover any of our GP fees at a Medicare office; that principle has gone. The winding back of bulk-billing means that working families will need private health insurance to cover the cost of visiting their local doctor. And we are seeing a further cut to public hospital funding. The principle of well-resourced, accessible, quality public hospitals has been lost in this country, because the first priority of the Howard government is to put health care resources into the private system and to underfund and underresource the public system. There is an ideological preference for private health insurance.

This is a very bad plan indeed for the constituents of Werriwa. They are very worried about this. When the Howard government was elected in 1996, people thought we had a quality health care system. If they needed a GP, the bulk-billing was available; 95 per cent of doctors in Liverpool and Campbelltown were bulk-billing. Now we are being told that the government is winding back that approach and that people will need private health insurance just to cover their local doctor expenses. In 1996 when the Howard government was elected, we had well-resourced public hospitals in the south-west of Sydney. Now they are quite underresourced and underfunded because of the transfer of resources through to the private health insurance system.

The paucity of private hospital beds in south-west Sydney illustrates a very important point. If you live in my electorate, you need good public hospitals to be available in Liverpool and Campbelltown because we do not have a significant number of private hospital beds. In Sydney the large number of private hospital beds are in the eastern and northern suburbs—over there in Liberal Party electorates—and that is where the government is putting its resources. It is taking money out of the outer suburbs and sending it to the insiders of Australian politics. This is a great shame, and it is a great disadvantage that an electorate like mine now suffers under the Howard government.

We know these intentions all too well. The Liberal Party has always been hell-bent on the destruction of Medicare. The Prime Minister said it himself in a press release on 5 November 1986, when he said:

Medicare has been an unmitigated disaster.

He followed up with a doorstop interview on 1 June 1987, when he said:

Everyone knows that one of the great disasters of the Hawke government has been Medicare. It's raped the poor in this country. Medicare has been a total disaster.

Fancy a political leader saying that Medicare has raped the poor in this country. The truth is that poor people have had the benefits of Medicare: free public hospitals and bulk-billing GPs. Medicare is one of the cornerstones of decency in a civilised society. It is one of the things that poor Australians have relied on for 20 years, and it is being taken away by the Howard government in a deliberate plan that was set out as early as 1986 and 1987. In an interview on radio 2GB on 1 June 1987 John Howard said:

We will be proposing changes to Medicare which amount to its de facto dismantling ... we'll pull it right apart.

That is what he said when he was honest with the Australian people: he wanted to dismantle Medicare and pull it right apart. He also said:

The second thing we'll do is get rid of the bulk-billing system. It's an absolute rort.

That is what he said on radio 2GB in 1987. He wanted to get rid of the bulk-billing system, saying, `It's an absolute rort.' Now, of course, the Howard government is planning to get rid of the bulk-billing system—because if a GP charges up front you will not be able to recover that from the Medicare office—and they want to push people into private health insurance just for their GP costs. This is the dismantling of bulk-billing. It is the destruction of the Medicare system.

The government's own so-called incentive plan makes the point perfectly. This is a government that is actually going to give more money to doctors who do not bulk-bill other than for people with a health care card. That is the Howard government plan: doctors will get more money if they do not bulk-bill for working Australians. Under the Howard government plan, they get the money if they do the bulk-billing for health care card holders but, for everyone else, if they do not bulk-bill they get more money from the federal government. That is where the $917 million is going, in bulk: to a plan to dismantle bulk-billing.

It is a silly plan. Fancy giving doctors an incentive to not bulk-bill people other than those who hold a health care card. Labor's plan is the sensible approach: give the money to doctors who do bulk-bill; the doctors who do the bulk-billing right across the community, as we have always had in my electorate. The incentives and the bonuses are there from a Crean Labor government. That is the way to save Medicare and the way to save bulk-billing: give the money to the doctors who are doing the right thing; doing the bulk-billing service for their patients.

The Australian people have a very clear choice. You have the Liberal-National Party coalition in government, who want to give more money to doctors who do not bulk-bill; and you have the Labor Party, who want to give the money to the doctors who are doing the bulk-billing right across the community. The Labor Party recognise the need for universal health care provision for working families. I return to John Howard's comments about Medicare. He described Medicare as `an administrative quagmire', `a financial monster' and `a human nightmare'. He said that, not surprisingly, to the Australian Private Hospitals Association on 5 November 1987. So that was the Prime Minister in honesty mode, back in the mid-1980s when he was the leader of the Liberal Party. He set out an agenda, an intention, to dismantle Medicare and wind back bulk-billing.

What we have seen since then is a series of promises made only to be broken. The John Howard who tried to reinvent himself in 1996 made a whole series of promises—made only to be broken. He said that he guaranteed the retention of Medicare and he guaranteed the retention of bulk-billing. In an interview on the Sunday program on 4 June 1995 he said:

... I'm giving a guarantee that it is not going to be changed. I'm giving a guarantee about bulk billing.

In the Age on 8 November 1995, he said, `We are going to keep Medicare lock, stock and barrel.' These were promises made only to be broken. The real John Howard was the politician who had that agenda in 1986 and 1987 for the destruction of Medicare.

So the Prime Minister, unhappily, has not been honest with the Australian people. He made those promises in 1995-96, knowing that his agenda was the same as it had been in the eighties, knowing that those political promises would be broken once in government. In fact, the only honest person we can now find in the Howard government is sitting opposite. The only honest, open politician in the Howard government is the member for Parramatta. He had the honesty last week to talk about the Howard government's real agenda in health care. He said that `some Australians would pay more under changes to Medicare and higher education'. He said that the baby boomers who expect free medical care and education made him `want to throw up'. I have been told that the member for Parramatta uses a bulk-billing doctor himself. I rather suspect that he might be described as a baby boomer. If the baby boomers who expect free medical care and education make him want to throw up, I would caution him about throwing up on himself. As a baby boomer who uses a bulk-billing doctor, if he wants to throw up about this ideal of universality of social provision, he is in serious danger of throwing up on himself. I caution him about that. I warn him not to do that. He should take a different point of view and support Labor's plan to save Medicare and save bulk-billing. It will save him a dry cleaning bill. It will save him a very dirty situation all over himself. But I do applaud his honesty for unveiling the true agenda of the Howard government when it comes to the Medicare system. It makes the member for Parramatta want to throw up. He went on to say:

... people turn around and have this massive collective whinge; they make me want to throw up.

He outlined that the changes to Medicare will lead to working Australians paying more. The member for Parramatta tried to dress this up in the media as an attack on so-called welfare bludgers, but in fact he was attacking the entitlements of hardworking, middle Australian families: people who work hard, pay their taxes and ask no more of government than decent health care for their children.

Is this an unreasonable demand in a civilised society? I think not. I would have thought, at the bare minimum, a government should say to people who work hard, pay their taxes and raise the revenue for the Commonwealth that in return they will receive the basics of a decent life—they will receive protection and security from their government, educational opportunities for their children and decent health care for their family. Young families living in my electorate would say, as the young families in Parramatta would say, `We work hard, we pay our taxes; all we ask for in return is a government to back us when we need it. When the kids are sick and wake up at night in the middle of winter with bad flu, bad coughs and other problems, we expect a well resourced, well funded public hospital system where we can take them in moments of emergency. We also expect bulk-billing doctors where we can take our sick children to receive care in daytime hours.' This is just a basic demand. It is not an unreasonable demand. It is not something we should be critical of; it is something we should be supporting the working families on—backing their instincts to look after their children. There is no more basic instinct in our society than a parent who has concern about the health care of a child. When the child is sick, you want to do everything you can to make the child better. I know myself, as a new parent, that when my boy is sick, I feel sick; I feel bad. I want to do everything I can to make him better. And Medicare has been there in an electorate like mine, doing that for 20 years. Why change that? Why change the circumstances? Why wind back bulk-billing, when all we are trying to do in Medicare is back the basic instinct of parents. It is not an unreasonable ask.

People work very hard. People work long hours in my electorate. People in double-income families work to try to make ends meet. It is not easy. I have the luxury of being on a politician's salary, as has the member for Parramatta, and quite frankly I do not know how families on $30,000, $40,000 or $50,000 with several children make ends meet. Looking at my family budget, I just do not know how they manage, but somehow they do. One of the ways they have managed historically is with the government on their side through Medicare. They have had a system that provides some decent entitlements and support when their children are sick. They have had a system that gives educational opportunities for smart kids who work hard. So let us not say that the system makes us want to throw up; let us say that we support that system, we honour that system and we give it every single resource we can as a parliament that wants to back the decent needs of decent people in a civilised society.