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Wednesday, 12 February 2014
Page: 181


Mr CHAMPION (Wakefield) (11:31): Listening to the previous speaker in this debate on the Private Health Insurance Legislation Amendment Bill 2013, you would have thought that Labor was still in government. I do not think he has caught up. His conclusion did not seem to reflect the reality that the coalition are in government, they are making changes and they are responsible for these things now. I would point out a few facts for the benefit of the gallery, who were constantly addressed during the previous speaker's contribution. More than 105,000 people took out private health insurance between June and September last year. Those are the Private Health Insurance Administration Council's own figures. In the previous year, some 255,000 extra people had private health insurance in Australia. In percentage terms, that is the highest it has ever been. That would seem to indicate that there is not really a very strong linkage between the private health insurance rebate and the level of coverage in the community.

We saw that when the rebate was first introduced by the Howard government. They threw money at the private health insurers, and the rates of insurance held by Australians did not go up, just as they did not go down when we means-tested the private health insurance rebate. What drove those numbers higher was things like Lifetime Health Cover. That is, it was the penalties that were introduced by the Howard government—taxation penalties, penalties allowing private health insurers to, in effect, make different conditions for people dependent on when they joined, whether they joined when they were young or later in life. It was those changes—the penalties, the stick in the 'carrot and stick' arrangement—that drove up private health insurance rates.

I guess this reflects a conservative approach, which has traditionally been to throw money at the private sector in the vain hope that, if you provide some tax concession, people will take out a private product. We heard the phrase 'nickel-and-dime' before, but their modus operandi has been to starve the public system, to starve Medicare, to constantly cut back, to make massive cuts to the funding that goes to states for our public hospital system. That was what they did in the Howard government. That was reversed under the previous government, and we now await the audit commission. We know what the audit commission will recommend. It will recommend big cuts to health, and that is what we are waiting on now.

I do not know where all of this fits in with the famed line in the sand that the Treasurer apparently has drawn, or the end of the age of entitlement. We are told constantly, day after day, about how workers in several industries should not rely on public subsidies and should tighten their belts and should be prepared to give up wages and conditions that have been fought for and won over rounds of enterprise bargaining. That is what we have been told in other areas. If you are in the auto sector, apparently there cannot possibly be any investment of taxpayers' money to secure your jobs or your industry in a time of extreme economic conditions, in relation to our dollar and other things. But apparently the private health insurance rebate—which does not go directly to consumers; it is paid directly to the private health care funds; it bypasses the individual; it just gets taken off your premiums—the public money that is paid to private insurers, is somehow this sacrosanct part of a public-private partnership that cannot be touched.

I just wonder how the government is going to reconcile those two conflicting notions—on the one hand, the end of the age of entitlement and, on the other, this desire to extend the rebate to high-income earners and to all and sundry. They opposed every set of means-testing of the private health insurance rebate during our time in government. Every single time, they opposed it, despite apparently the end of the age of entitlement.

It appears to me—and it would appear, I think, to most fair-minded Australians—that the approach of the Abbott government is dual. Which rule will apply in relation to the spending of taxpayers' money depends on which industry you are in. If you are in automotive manufacturing then any industry assistance is bad and you should lose your jobs, lose your wages and conditions and face the dole queue, but if you happen to work in the private health insurance industry then you will be deserving. To suggest that private health insurance rebates should be in some way curtailed is un-Australian, according to the previous speaker.

So there is this duality, and behind that there is their standard modus operandi of cutting in the public sector and throwing money at the private sector. In the end, what they want to create is—and let's make no mistake about it—an American-style health insurance scheme. That is, you pay top notch—you pay a lot of money for insurance in America—and, if you do not pay, you fall out of coverage or the health insurer can squib out of covering you for some disease or health issue, then you fall back on a very basic set of conditions. I think that is wrong. Health should not be linked to your income; it should be linked to your health needs, and, as a nation, the fundamental thing that makes us fair in this country has been our commitment to universality of health coverage and Medicare. Most Australians know that, and they reward governments that take care of Medicare and they dispose of governments that do not, because they know that it is critical to a fair go, to the national character and to our sense of ourselves as Australians—not just in a historical context, but also going forward. We want fairness, and we know that, unfortunately, during conservative governments in this country—not all the time, but some of the time—they set out to smash the universality of the system and, with that, the equity that underpins the country.

The tragedy is that it is Liberal and coalition voters who have the most to lose in this situation. One of the things we found when we did healthcare reform in the previous parliament under the Rudd and Gillard governments was that, if you had cancer, the type of treatment you got and your survival rate for those cancers directly correlated with how far away you lived from the CBD. The further you lived from that, the worse chance you had of surviving cancer. In South Australia, that meant if you lived in Clare, Blyth or Burra—places in my electorate and northwards—then you had to travel a very long way to treatment. You were looking at driving in some weeks for chemo every day or every week. What that meant was that your survival rates were not very good and you were constantly admitted to hospital.

One of the things I am most proud of in relation to the previous government—and it is one of the things that we do not talk about, that will not be listed in any of the newspapers today or tomorrow and that will probably only get a mention in history books—is that we opened cancer centres around the country in regional areas. If you go to Clare Hospital today you will find people in a modern chemo unit getting treatment. Instead of driving three or four hours, they might be driving half an hour or an hour. They are being treated in a hospital in their local community by people they feel comfortable around and do not have to battle the big cities. It is the same in the metropolitan bit of my electorate in places like Elizabeth, the working class community based around Holden. There were no cancer facilities north of Gepps Cross, so you had to go into the centre of Adelaide to get those sorts of treatments. One of the best things the previous government ever did was to fund those things.

I think that underlines the point that people who live in regional and rural communities—who tend to vote conservative—actually have the most to lose when the government cuts from the public sector and gives to the private sector. The private sector is generally not interested in regional, rural or remote areas because there is not a dollar in it. Only the public sector can reach out to the bush, to the country and to regional communities. We hope that the government looks at the pragmatic and practical nature of these things and realises that we are a country that a) desires universality in our healthcare system and b) pragmatically needs it as a matter of course.

This bill, despite all the debates about it, is a simple bill. It changes the way that we index the cap on the private health insurance rebate. This is related to some $700 million in savings—$700 million in savings. We hear all this hoo-hah about SPC and the quibbling over giving $25 million to them to save some 5,000 jobs of farmers and factory workers in Shepparton, and yet here is a saving which they would not have and they are not the authors of—it is a previous government that is the author of these savings. They will the savings and they will talk about the importance of private healthcare rebates and say that they would not have touched it, but let's be clear about it. The effect of their ideology is to hand a tax concession to people on high incomes who can afford to pay the full tote.

This bill is important. It brings forward savings to the taxpayer. It allows us to spend that $700 million on things like cancer centres in rural communities—places like Clare, places like Gawler—and even in the outer suburbs, in places like the Lyell McEwin Hospital. When you make those savings, when you rigorously apply logic to the system, you can then afford to do other things. We know that healthcare inflation is rising. We know that that is because of the technology available now. It is running much faster than normal rates of inflation, and that means that we have to make more efficiencies in our healthcare system or we have to spend more.

The previous speaker would have you believe that, if only we spent more on private health insurance, that is an effective way of dealing with that problem. But in fact we are going to have to have serious discussions about what our hospitals do, when they do it and how to tackle that issue of ever-rising costs and do it efficiently. I do not think we can afford to be handing money through tax concessions, through rebates, to high-income earners. I think we should make those people pay their way. Let's be plain about it. That is what the previous government decided to do. We have saved the taxpayer an enormous amount of money over the course of the forward estimates. Despite all the rhetoric of those opposite, they will not reverse those changes, because they were sensible and prudent and they were made because they were the right thing to do, not because of any budgetary constraint.

The Labor Party, as always, supports the universality of health care. It is a fundamental thing, I think, to the character of this country, and we will continue to defend it against the actions of the government.