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Monday, 13 February 2012
Page: 918


Mr WYATT (Hasluck) (19:43): I rise to oppose the Fairer Private Health Insurance Incentives Bill 2011 and the suite of related bills. I do so on the basis that what is proposed means that there is a reduction—and I will not cite all the figures because they have been evident in all the speeches that I have been listening to during the course of the day—and it will impact on the health system. When I first entered parliament during the reform period under the Rudd government—and later in its continuation with the Gillard government—I saw incredible hope and opportunity for the reforms to be effective and for the private sector, through private sector funding, to be a key player in all of this and I saw that the 30 per cent levy would allow people the opportunity of moving between the health services provided within both public hospitals and the private sector. I give an example of St John of God in Perth that has robotic surgery for men who have prostate cancer. The cost of that is significantly high and the difference in price is covered by the private health insurance that is provided through membership and underpinned by the 30 per cent element that assists people to continue with their private health insurance.

The other thing that disappoints me is that A healthier future for all Australians talked about a continuity of care, access to specialist services and the ability to be part of making a choice about the type of healthcare service delivery you would access and the point at which you would access it. The National Partnerships Agreements that have been negotiated make reference to the fact that all Australians should have the opportunity of moving between the choices that exist for them, but they do not always have the capacity to pay. There are private and government hospitals that have differing services and certainly a significant number of the specialists tend to operate within the private health sector. If you are covered by private health insurance, your movement through the elective surgery waiting lists and surgery is enhanced because you are sometimes advised to take the opportunity to book into a private hospital in order to expedite that service. It means that you do not remain on a waiting list for a substantial period of time.

But the articles that have been appearing in the papers in recent times have made some very interesting points for this debate. The headline in the Australian today was 'Both sides failing the test on health'. It states:

Labor's policy lacks coherence but this should not let the opposition off the hook.

The article says:

First, as the public and private systems compete for health professionals, it would increase costs and reduce quality in the public system. Second, it will make the PHI even less affordable for low-income consumers, ensuring that we truly do end up with two healthcare systems: one for the better off, who will be forced to have private cover, and one for those with lower incomes, who will have to rely on the public hospitals.

Again, 'Gillard confident on health rebate' was a headline in the Australian Financial Review on Tuesday, 7 February:

Prime Minister Julia Gillard said yesterday taxpayers should not have to subsidise private health insurance for wealthy people and the government would continue discussions to get the changes passed.

…   …   …

Greens leader Bob Brown yesterday softened his party's resistance …

"We don't believe people should be penalised because they make the choice to go the public health system," he said. We are continuing to talk with the government.

I have been dismayed also by the fact that there have been a number of speakers on that side of the House who referred to a welfare or class system when it comes to the subsidisation of the health rebate, because to me it is not that. I think we have to be serious in considering that we want to encourage people to access the opportunities to reduce the burden on the public hospital system.

One of the continued debates I had when I worked in health, when we used to meet as an executive, concerned the choking of public hospitals with people who could not access the private health sector or access specialists whose time was principally involved with the private health sector. What worries me with this one is that, if these figures about the 1.6 million consumers dropping their health insurance or the number that fall in under each of the tiers are correct, we will see an increase in the number of people accessing the public hospital system. That in itself will increase the requirement for funding to meet those health needs when it could be covered within the private health sector.

In reading through the National Partnership Agreements, there are some provisions for increased funding where there are pressure points within the public health sector under each state and territory's jurisdiction and to negotiate a variation to those actual costs. I suspect that we will see an increase in requests for additional funding by states and territories. With that in mind, today's Hobart Mercury had the headline 'Private insurance bypass—Doctors warn rebate changes will up pressure on public hospitals'. The article states:

Tasmania's public hospitals will be hit with more patients under plans to means test the private health rebate, the Australian Medical Association says. Premiums are tipped to rise by up to $1000 a year for families from 1 July with Gillard government legislation to be voted on in coming days.

…   …   …

AMA Tasmanian president John Davis said …

"What we're already seeing is the Royal Hobart Hospital working at capacity at what should be a quiet time of the year."

If that is the case at a quiet time, then those proposed changes will have a significant impact on hospitals. I was down in Tasmania recently and I was speaking with a senior official from health who indicated that the quantum of money received to provide for their hospitals and for the types of services required for the public of Tasmania is not sufficient. On that basis, I suspect that we will see health ministers coming back to the discussions with the federal minister seeking to increase their share of the Commonwealth funding that would assist in the provision of the health care that we expect and take for granted in this country.

I know that the Minister for Health believes these changes will ensure that those with a greater capacity to pay will make a larger contribution towards the cost of their private health insurance. The government says it will ensure that government support for private health insurance remains fair and sustainable in the future. This is simply not the case. In my electorate of Hasluck, which is geographically and economically diverse, there are many people who are feeling the pressure points of increased costs of living. Those increased costs of living are impacting on their capability and capacity to pay their private health insurance premiums. I have had constituents say to me that they will be dropping the level of contribution they make to private health funds. To me this is a pity because when there is an illness of some magnitude which requires coverage of the full fee, or at least the gap, they will be deprived of that and their out-of-pocket expenses will certainly increase. The extra costs will hit families hard and drive more towards the public system. The public health system is already under strain and this could be the straw that breaks the camel's back. Increased living costs will be created not only by hospital costs and the payments needed for anaesthetists and some of the surgical procedures but also by the medications that will be required. Over 1½ million Australians, including thousands in Hasluck, will face significant increases in private health insurance costs. $1,000 might not sound a great deal to many in this chamber, but there will be people who will struggle to find that within their tight economic circumstances, particularly with the other added pressure from the banking sector where there is an increase in home interest rates.

Private hospitals treat 40 per cent of all patients in Australia and perform over 60 per cent of elective surgeries. What happens to the public system when these patients scrap their health insurance? The government owned insurer, Medibank Private, has predicted that 37,000 of its members alone will drop their cover and 92,500 will downgrade. This is considerably more than the 27,000 the minister has claimed will drop their cover throughout the entire sector. To me, this is another example of the Labor Party playing the politics of envy and punishing those who are able to take financial responsibility for their health care instead of having the Liberal Party economic philosophy of reward for effort and providing people with choice and financial opportunity.

Many of the people who have taken out private health insurance in Hasluck are not super-rich as those opposite would have you believe. In the near future, you will hear more political-speak coming out of the Labor Party--things like, 'They are the rich; why should they get subsidies for private health?' This is social engineering coming to the fore yet again. These people are already paying for the services of private health insurance and this takes a significant load off our public health system. We will all have seen articles over a period of time in which health systems and jurisdictions talk about the burden of cost in the delivery of health services. I have had firsthand experience of actually working in the health sector at a senior level and I know the strain many in this system are under. These changes will just make things worse.

The phasing down of the healthcare rebate to nil would see the need for nearly 200,000 hospital bed days to be created. One million extra patients are expected to flood the public health system. The Gillard government is acting out of desperation to balance its books and is doing so at the expense of many hardworking Australians and people in my electorate of Hasluck. Instead of creating hope for the people of Australia that if they work hard and pay their way they will be rewarded, it penalises the people who are paying their way.

Cost of living, as I have said, is a serious issue in my electorate. The so-called luxuries will be jettisoned, and I fear that private health insurance will be one of them. The cost-of-living pressures will only get worse under the carbon tax regime. This wasteful government is introducing another burden. The deceit shown by this government knows no bounds. Every new tax or levy that is introduced chips away at the household budget. People in Hasluck are struggling and this typical tax-and-spend approach to economics is damaging to the social fabric of this country. I would ask the Minister for Health to come to Hasluck and talk in a forum directly to families that will be hit by the amendments to the legislation. Previous governments have rejected these changes, and I call on this government not to dig its heels in and to stop this lunacy.

What makes this worse is that the Prime Minister previously stated in opposition that she would not seek to remove the rebate, yet when it is politically convenient she once again goes back on her word. The former Prime Minister, the Hon. Kevin Rudd, and the former Minister for Health and Ageing, the Hon. Nicola Roxon, have both gone to great pains previously to say they would never support this move. What has changed? This is the third time the parliament has considered this legislation. It was introduced in the last parliament despite explicit promises at the 2007 election that:

… Federal Labor has made it crystal clear that we are committed to retaining all the existing Private Health Insurance rebates.

That was said in a media release by Nicola Roxon on 26 September 2007.

I call on the Independents to actually stick up for the people in their electorates and vote down these amendments, which will hurt everyday Australians. I think we have the basis of an incredible health reform agenda that is providing a wide range of health outcomes and improvements for Australians, consistent with the objectives of the national partnership agreement and the National Health Reform Agreement. I would rather see the strengthening of those and not their diminution through the impact of this legislation in reducing the rebate that is currently given to all Australians. I oppose this legislation.

The SPEAKER: Order! It being almost 8 pm, the debate is interrupted.