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Thursday, 4 December 2003
Page: 23779

Mr ABBOTT (Minister for Health and Ageing) (10:34 AM) —I move:

That this bill be now read a second time.

On 18 November 2003, the Prime Minister announced MedicarePlus, a comprehensive package of measures to protect and strengthen Medicare. Through MedicarePlus, the government is investing more than $2.4 billion in Medicare from now to 2006-07.

I want to make it clear that Australia has one of the best health systems in the world. For the past 20 years, Medicare has provided Australians with essential protection through affordable access to medical, pharmaceutical and hospital services. But the environment in which health care is delivered is changing. Consumer expectations, advancing technology and an ageing population bring new challenges for our health system.

Through MedicarePlus, the government has made a substantial investment in improving Medicare to meet these future challenges. There has been a significant level of consultation leading up to the introduction today of this legislation. MedicarePlus responds to the concerns raised and seeks to guarantee that Medicare remains a universal system of affordable access to high-quality health care.

MedicarePlus makes it easier for doctors to bulk-bill concession card holders and children, it provides more convenient Medicare claiming, it increases the supply of doctors and nurses in areas that need them most and, most importantly of all, it gives all Australians peace of mind with the introduction of a new safety net.

The government is committed to a high level of bulk-billing as a key element of Medicare. But I should point out that no government can force any particular level of bulk-billing, although governments certainly can take measures that support doctors and encourage them to bulk-bill, as this particular bill does.

MedicarePlus makes it easier for GPs to bulk-bill patients. It provides a new $5 payment for every bulk-billed service that a GP provides to a child under 16 or to a person covered by a Commonwealth concession card. As has been the case since the start of Medicare, GPs can choose to bulk-bill any patient.

Under MedicarePlus there will be more convenient claiming for patients who are not bulk-billed, through incentives to accelerate and extend the take up of HIC Online to all GP and specialist practices. Through HIC Online technology, patients who are not bulk-billed will be able to choose to have their claims lodged electronically and their rebates paid directly into their bank accounts. There will be no need to stand in line at a Medicare office.

A key factor in maintaining the affordability of medical services is having an adequate supply of doctors and nurses. MedicarePlus is Australia's most extensive effort ever to attract and retain a larger medical work force. It makes an immediate and sustained investment in supporting the equivalent of about 1,500 more doctors and 1,600 more practice nurses by 2007. More than $1 billion supports these initiatives to 2006-07.

More doctors will be trained, and more will be encouraged to work in areas of shortage. MedicarePlus also supports an increase in the availability of GP services to residents of aged care homes, supports rural GPs and helps doctors return to the work force after a break.

Finally, and central to this bill, MedicarePlus adds a new and comprehensive government funded safety net that gives all Australians peace of mind about their health costs.

Since Medicare was introduced in 1983, the complexity and cost of medical services have grown enormously. Many more tests and treatments are now available, and they can be done safely in the community rather than in hospital. With this has come an increase in the cost of medical services by specialists, diagnosticians and treating doctors.

For many Australians, it is difficult to plan for unforseen major health care costs that may arise due to an accident or major illness requiring hospitalisation. The government has recognised this and addressed it through a range of measures to support private health insurance. But private health insurance does not cover out-of-hospital medical expenses.

Each year, many individuals and families face an unexpected illness or need to manage a chronic health condition requiring large numbers of out-of-hospital services not covered by private health insurance. (Quorum formed) People in this position can face very significant costs.

This bill provides a new MedicarePlus safety net that protects all Australians from high out-of-pocket costs for medical services provided outside hospital. For Commonwealth concession card holders and families who receive family tax benefit A, the government will reimburse 80 per cent of out-of-pocket costs for medical services provided outside hospital once an annual threshold of $500 per individual or family is reached. This will cover 12 million people, including four out of five families with children.

For the remaining eight million Australians, the government will reimburse 80 per cent of out-of-pocket costs for medical services provided outside hospital once an annual threshold of $1,000 per individual or family is reached.

The MedicarePlus safety net will apply to all out-of-hospital services covered by the Medicare Benefits Schedule, including general practitioner consultations, specialist services, pathology, X-rays, CT scans and radiotherapy.

The Health Insurance Commission will keep track of costs. Families or individuals who reach the MedicarePlus threshold will automatically be eligible for the safety net. Through the MedicarePlus safety net, all Australians will have the peace of mind of knowing that they will never be out of pocket for more than 20 per cent of the cost of medical services provided outside hospital once the threshold is reached.

A world-class health system helps everyone stay healthy, provides support and treatment when people need it and is financially sustainable. The government is committed to ensuring that Australia has just such a system, now and into the future.

The MedicarePlus safety net is a structural improvement to the Medicare system. Through this $2.4 billion investment in MedicarePlus, the government is making a very substantial commitment to strengthening, improving and extending Medicare.

Medicare is too important, and health security is too important, for a legislative vacuum to persist over Christmas. That is why the government is putting this bill into the House now and passing it today. I commend the bill to the House and present the explanatory memorandum.