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Monday, 16 June 2003
Page: 16454

Mr GAVAN O'CONNOR (6:50 PM) —Thank you very much, Mr Deputy Speaker, for your indulgence. The Health Legislation Amendment (Medicare and Private Health Insurance) Bill 2003 we are debating in this chamber today was cunningly conceived by the government to, over time, give effect to the Prime Minister's stated intention to destroy Medicare. Labor will be opposing it with every means available, both within the parliament and outside it.

A leopard never changes its spots. The Prime Minister's past statements on Medicare are an indication of his true position with regard to this great Labor initiative. He has in the past stated that he wanted to destroy Medicare and, in his own words, `stab Medicare in the stomach'. The Prime Minister has also called one of the world's great health systems `a cruel hoax' and `a fraud on the Australian people', and he now expects the Australian people to believe that his government does not have plans to dismantle it.

The Prime Minister knows that to retain Medicare as the universal system of health cover for all Australians universal bulk-billing has to be retained, yet his government has deliberately let bulk-billing rates fall to such low levels that it will, under his package of measures, be available only to concession card holders. The Prime Minister knows that if he can run down bulk-billing rates under Medicare he can effectively destroy it and create the two-tiered Americanised health care system that has always been close to his heart and that he has always desired.

We on this side of the House are very proud of Medicare. It has provided all Australians with a quality standard of health care. Despite the system's imperfections, it now ranks as one of the best four health care systems in the world and is the envy of many countries. Medicare was introduced by Labor in 1984 and is based on the fundamental principle that need, not one's capacity to pay, determines one's access to quality health care. It is this principle which has fundamental appeal to Australians and is the reason that the scheme has been so strongly supported by the Australian public over the past two decades. Medicare appeals to their basic egalitarian instinct. They have on successive political occasions endorsed the scheme and forced the Prime Minister into a political position of grudgingly accepting the scheme's existence.

We on this side of the House know the Liberal and National Party's past attempts to destroy Medicare, and we do not intend to have it dismantled by stealth on this occasion. We are used to members of the government getting up in this place and telling Australians that they really do support Medicare and accusing members of the Labor Party of attempting to scare people about the future of Medicare. I put this simple series of questions to the Australian people, and they can make up their own minds. Who do you believe on this issue? Do you believe the Prime Minister, who, in the past, has threatened to destroy Medicare and who has called it a fraud and a cruel hoax on the Australian people and their families? Or do you believe the Leader of the Opposition, the member for Hotham, whose public life has been dedicated to the retention and enhancement of Medicare? Do you believe a Prime Minister who believes in non-core promises, who promised never, ever to introduce a GST; whose government lied to the Australian people on the `children overboard' affair and is now defending itself against charges of doctoring the intelligence used to justify Australia's involvement in the Iraq war? Or do you believe the Leader of the Opposition, who, before he entered the parliament and after, has on every occasion—not one occasion, not several occasions; not half-heartedly expressed support for Medicare—expressed support for this universal health care scheme. I simply rest my case.

We on this side of the House believe that health care is something that Australians, regardless of their economic position, race, colour or creed, are entitled to access. Indeed, they are entitled to access it, regardless of how much they earn. Australians in the past have emphatically stated at election after election that they do not want a health care system where the first thing they are asked for when they get sick is their credit card and not their Medicare card. The government can expect from us on this side of the House a vigorous defence of Medicare, and our opposition to this awful piece of legislation in this House is just the beginning.

We have serious objections to key elements in the government's legislative package, which is enshrined in the Health Legislation Amendment (Medicare and Private Health Insurance) Bill 2003. There will be several inevitable consequences to what the government is proposing. Firstly, the government's measures will create a two-tiered health care system in Australia, with bulk-billing only accessible to concession card holders at the end of the day. The government has provided a $22,000 incentive for doctors to do this. The second consequence of what the government is proposing is that doctors' fees will rise, and so will the overall cost of our health system. One of the great advantages of Australia's health care system is that it provides universal coverage to every Australian, and it does it at a percentage of the GDP that is significantly lower than the cost of the system which the Prime Minister is attempting to drive Australia to. In the United States, almost 20 per cent of their GDP is consumed in health care costs yet there are some 40 million Americans who receive substandard health care.

Doctors will be able to bill Medicare, as well as charging patients directly for the same service—something which was unlawful under previous legislative arrangements. It was made unlawful simply as a measure to put a brake on excessive costs in our health care system. There are other measures in this bill that are of concern to the opposition—for example, it is currently unlawful for private health funds to offer cover for out-of-hospital medical expenses. Medicare has always been the sole insurer in this area; that is why we all pay through the Medicare levy. What the government is proposing to do will ramp up the cost of medical services; it is inherently inflationary and it will give impetus to the creation of the two-tiered system that will at the end of the day destroy the universality of Medicare.

The government ought not to be under any illusions about the commitment of working people in my electorate to the defence of Medicare. Last week in the Corio electorate I held a public meeting—a Save Medicare campaign—which was very well attended, given it was a cold Wednesday night in Geelong with many other meetings taking place. I thank here the speakers at that particular rally. Councillor Heather Wellington of the City of Greater Geelong, who is also a doctor and who, I might add, is also a director on a private health fund, spoke passionately in defence of Medicare. The meeting acknowledged that we do have a dual health care system in this country. That is a reality that we do not deny, but of course at the core of our health system—and that which must be protected and enhanced—is the universality of the Medicare system. Councillor Wellington spoke quite passionately about the need for us to retain it and to defend it.

Speaking also was Barbara Fletcher of the Australian Nursing Federation, who spoke from a nurse's perspective on the health care system. Nurses are at the front line of health care in our hospital system. When the public hospital system is denied funds, it is the nurses who bear the brunt. Ms Fletcher spoke eloquently and quite passionately about the role of nurses in our great public health care system in Australia.

Also speaking was Leigh Hubbard, Secretary of the Victorian Trades Hall Council. He spoke about the past support of the trade union movement for Medicare as a universal health care scheme. Leigh Hubbard made this very important point: when Medicare was introduced, wages were forgone so that the trade union movement and working people could have a universal health care scheme that their members could access. So they earnt this scheme; they paid for it through their wage packets. It is incumbent on the government of the day to acknowledge that particular fact and ensure that the critical elements of that scheme, which was introduced and which was agreed to by millions of workers around this country, are retained. Also speaking was Dr Tim Woodford of the Victorian Medicare Action Group.

That meeting unanimously passed a resolution in support of Medicare and its retention and enhancement—not its destruction, as contained in this pernicious piece of legislation. I thank those people who attended that public meeting in Geelong. A Save Medicare campaign committee was formed which will become a part of the network of the Victorian Medicare Action Group, and it has been tasked with elevating within my electorate awareness of the importance of this scheme and rallying political support for its protection.

We on this side of the House are quite used to the Prime Minister being out there in the political arena accusing the Labor opposition of having no policies, of being a policy-free zone, and stating that the Australian people do not know what Labor stand for. Once again, unfortunately, the Prime Minister is attempting to sidetrack Australians on this issue. There is no doubt about our opposition to the full sale of Telstra. There is no doubt about our position on the pursuit of an Australian republic and a genuinely elected Australian head of state—something that the Prime Minister cannot even countenance. There is no question about our commitment to reconciliation and the fact that one of the first acts of an Australian Labor prime minister will be to say sorry to our Indigenous communities—something that this Prime Minister cannot do. On the environment, Labor will sign the Kyoto protocol—a point of significant difference between Labor and the government.

So let us put aside the hoary myth the Prime Minister is attempting to perpetrate that there is no real difference or that the Labor Party does not have firm policy positions on these matters. On one particular issue we are like chalk and cheese—that is, on the issue of the protection of Medicare and its enhancement. Labor announced a plan in the budget reply speech which was warmly received by the Australian people: a $1.9 billion package over four years to save Medicare and arrest the decline in bulk-billing. That plan provided for immediately increasing the patient rebate for all bulk-billed consultations to 95 per cent of the schedule fee, which means an increase of $3.35 per consultation, with plans to subsequently lift it to 100 per cent—an increase of some $5. There is also a provision to doctors of up to $22,500 as an incentive to them to bulk-bill and to retain and improve the central pillar of Medicare. These are elements, fully costed, of a Labor plan to save this great health care system.

In my concluding remarks, let me reiterate once again my commitment to Medicare. Since I came to this parliament in 1993 I have articulated, on every occasion, very strong support for Medicare as a universal health care scheme for all my electors in Corio, and indeed for all Australians. There can be no doubt about my commitment to this particular health care scheme. It is a commitment that stands in contrast to that of the Prime Minister—who, in the past, indicated that he wanted to destroy Medicare. He regards it as a cruel hoax and a fraud on the Australian people. The Australian people are not stupid. They can see through a Prime Minister and a government which continually speak with a forked tongue on these key policy issues. The Prime Minister is on the public record as desiring to destroy one of the great health care systems of the world. Now, with a package of measures that he has the temerity to describe as the Fairer Medicare package, he expects the Australian people to believe that his ultimate intent is not to destroy what he has vowed in the past to destroy.

The Australian people are not fooled. They know very well that the Prime Minister has always been lukewarm about Medicare, and what they are coming to really detest and reject is a Prime Minister who cannot countenance the great Australian things in our society and defend the great Australian innovations and initiatives in public policy. He wants an Americanised health care system. He wants an Americanised foreign policy. He wants an Americanised industrial relations system. We saw the awful spectacle of an Australian Prime Minister grovelling at the feet of an American president on the recent issue of Iraq. Australians do not want that. They want a health care system that is uniquely Australian, and they want it to be defended—and Labor intends to do it. (Time expired)