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Tuesday, 4 June 2013
Page: 5154


Mr LAMING (Bowman) (20:30): This has been a government that has been engaged in a debate with private health cover ever since they came to power. They were quite happy to make promises before an election. Now they have steadily, progressively nickel and dimed the 10.7 million Australians who take control and fund some of their own health cover. The 30 per cent health rebate, the lifetime health cover and the community rating are the three legs upon which private health cover now covers more than half of Australia's population but one side of politics does not have the foresight and the vision to allow the public health system to be sustained.

Many parts of the world have moved on from this puerile and petty debate, this class warfare and this hatred of anyone looking after their own health care. Go through most parts of Europe: they acknowledge that there are two sectors that working together can look after the health of the citizenry. But that is not the case here in Australia. We are engaged in a multi-decade fatwa against private health cover, on the one hand building up 12 new bureaucracies costing a billion dollars over the forward estimates to run and on the other hand ripping money out of the MYEFO retrospectively. What a curious act from a Labor government that since the mid-2000s has engaged in criticising this opposition about ripping money out of health care because they did not increase it as fast as they had in the previous government agreement.

Now the government have the duplicity and the hypocrisy to come in and rip money out of state hospital budgets to the tune of $1.6 billion when that money is already committed and promised. It has already been transferred to state governments. It is already paying the wages of doctors and nurses. Then they tell you in this futile and desperate struggle to come up with a budget surplus—that ephemeral and ultimately futile and impossible budget surplus that they had to rip money out of public hospitals. What foolish and short-sighted conduct these health ministers have engaged in. Let us run it through just one more time. We are not talking about forward estimates. We are talking about money already transferred—ching, ching—already in the bank account, already paying the salaries of nurses and doctors and that money has been removed.

Ms Plibersek: Mr Deputy Speaker, on a point of order: the member is both wrong and irrelevant. I ask you to call him back to the legislation being discussed.

The DEPUTY SPEAKER ( Mr Lyons ): Order! I ask the member for Bowman to return to the legislation at hand.

Mr LAMING: Mr Deputy Speaker, I have made my point. On the one hand, there has been nickel and dining of the 10.7 million Australians. For every $2.60 they put into private health cover to take responsibility for their own health care, the government puts in an additional dollar and says, 'Thank you.'

We are in a nation where if we want to redistribute income, we use a tax system—progressive income and company tax. But when it comes to social services, we deliver to those in need. We deliver health services to the sick, educational services to those who need education and childcare services to those who have children but not to this government. This is about an attack on everyday Australians who pay their way in the tax system and then want to fund their own health care. It is a simple proposal that most nations have moved on with but the fatwa continues on the other side of the chamber.

This is a government that has sought to downgrade the value proposition for caring for your own health care. I can understand there is one story and one narrative in the cities, but let us also remember there are regional Australians who are far away often from healthcare providers and private hospitals. They do not have the same value proposition to keep their private health cover, do they? Instead, we have seen relentless attack that is hitting regional Australians first because they are the ones most likely to drop or downgrade their cover or seek out exclusions so that it remains affordable.

Let us look at the detail of the bill. The one that concerns me greatest is the removal of the 30 per cent rebate from the lifetime health cover component. This is the extra amount one pays for one's private health cover if you do not take it out from the age of 30. That premium is increased by two per cent for every year of life after 30 years of age that you fail to take out private cover—a maximum of a 70 per cent loading—and that can continue for 10 years after you take out the cover.

Let me hypothetically paint a picture for you of a couple that did take it out late in life—five years too late perhaps. They have paid 10 per cent for nine years and now we have the nickel and diming from a government that has never ever trusted someone to fend for themselves and pay for their own private health cover. They are at risk of dropping and downgrading when they are only a few years away from actually having that whole lifetime health cover removed and the premiums becoming more affordable. Let us take another instance: living in a small country town where there are perhaps one or two private providers, no private hospital. So you are paying these large amounts of private health cover but effectively not being able to access as many of the services.

Every time a family makes a tough decision around the kitchen table, the father speaking with the mother about whether to cover the family for another year or so, looking at the increasing private health insurance costs, they are now being slugged by a government that has found every tricky way in the book to make it harder for those families. Those 10.7 million Australians will not forget this. Many of them are low income earners, they are not all the high-flyers. I guess this other side of politics tends to forget that. The first thing that they will do in a conversation across the kitchen table is say, 'How can we keep our private cover to know that we will always have some access to hospital if something calamitous occurs?' The first thing that will drop will be the extras—and that just sounds fine to this government, doesn't it.

That is until you remember that the local private physiotherapist, the local OT and the local pharmacist in town are in many cases supported by people who pay the extra, who have a much higher Medicare safety net and in many cases will only use those private covers if they are insured. Up to 50 to 60 per cent of the work of the local physiotherapist in town is private. They do an amazing service and they reduce the need for country Australians to travel down to the big cities. Once you erode the value proposition for private health that whole exquisite balance that has been achieved over two decades of hard work by governments prior to this one is eroded. People ultimately lose a general practitioner. Let us not forget that. It is the very presence of a general practitioner in town that supports all of the allied health workers around that GP and that is being undermined. Right across this country, the impact of this legislation is for Australians to say, desperately, in an eye-to-eye conversation: 'How can we keep our cover? We've been in it for this long.' The punishment is significant, the uncertainty is incomprehensible if we do not keep our private cover, and you have a government that is doing everything it can to undermine that.

To put it in the simplest possible terms: what we have is a government that came to power in 2007 but in that time has really fixed no problem in the health system. I can make a list of all the challenges the Australian health system faces and, after all these reforms, we still have them today. And that may well be the long-forgotten epitaph that is written when we consider the health performance of this government. Sure it was good at the back-end financial dealings in restructuring our health system, but it never got to the front line to work out what it takes to keep practitioners and providers supported and to keep Australians with private health cover.

I concede that so far the numbers pulling out have not been as high as they could have been—the reason for that is simple: there are significant penalties to pulling out—but watch for the downgrading. The downgrading of cover is something where we cannot trust the modelling that has being done. We do not accept the modelling that has been put together, and I think that even with these changes they are yet to feel them because $1.2 billion was prepaid and none of these people have faced increases in their premiums yet.

But this is a government that does not see more than five minutes into the political future. It is quite happy to make financial commitments for the year 2017, when it is unlikely any of its members will be around, but it does not govern for today. It does not look after today's families, and it is becoming increasingly obvious that it completely forgot health reform through the GFC period. It did not invest a single cent of the stimulus package in health. And now, with its private health cover, in a futile and late attempt to fund a government surplus—

The DEPUTY SPEAKER: The member for Bowman will resume his seat.

Mr Dutton: How can this not be relevant?

Ms Plibersek: He is talking about the GFC and the Health and Hospitals Fund. It is so way off private health insurance. If he has got nothing else to say, he should sit down.

Mr Dutton: That's not a point of order.

The DEPUTY SPEAKER: Order! Please be silent. Minister?

Ms Plibersek: Deputy Speaker, I just made the point that if the member has run out of things to say about private health insurance, he can sit down and we can all go home a bit earlier.

The DEPUTY SPEAKER: The member for Bowman has the call.

Mr LAMING: Thank you. We are moving into the inane here. There is a significant history here of a tax on private health cover, and there is a complete record of commitments that have been made by that side of politics never to touch the private health rebate. Why are we here today if we could believe a single word that came out of the mouths of the leaders of that side of politics? The truth is we cannot. The truth is it has always had a vendetta against people who care for and fund their health cover, and we think that is highly regrettable.

I can appreciate if those over there fundamentally do not like people who want to pay for their own health cover. That is okay; that is something for their caucus and their policy. But there are 10 million Australians quietly taking notes on what is happening tonight, and they will not forget. They will not forget that at every opportunity those opposite took a chance to reduce private health cover and to make it way less affordable. I know that premiums go up every year, and that is simply a reflection of increasing health costs. But you need to be able to look your own government in the eye and say, 'If you won't touch private health cover, give me the confidence that you won't do a double deal on us.' But in fact that is not what has occurred. What has occurred is an attack on a 30 per cent rebate with means-testing. We have now seen an attack on Lifetime Health Cover, all of this in the spurious and ultimately futile attempt to run a budget surplus.

The great question is: now that you have waved the white flag on a budget surplus, why are we persisting with these minute changes to try to save a little bit of money off the people who pay for their own private health cover? I would be happy to contemplate some of these propositions if those opposite were running the public health system better, but the great fear of most Australians now is that is not the case. The COAG Reform Council has clearly said that there have been no improvements in waiting times for operations over the period of this government. And the government will tell you that is because some other party removed some of their funding. Isn't it possible to write up an agreement that locks in those jurisdictions? No, these agreements were not sophisticated enough, and this is a federal government that has basically been seeing additional money being committed with no difference for Australians.

The great concern here when you are taking private health cover is this: I am hoping not to have to leave my footprints in the public system; I hope to fend for myself, pay my own way and be more self-reliant. That is something that needs to be supported. It always will be by this side of politics. There are 10.7 million Australians who look to us to fight for those who fend for themselves. And of course we support a decent public hospital system. Of course we support workers on the front line. But the latest extraordinary proposition is that we have 3,000 people now working in Medicare Locals around the country, of which apparently 80 per cent of them are front line. What is the definition of 'front line'? This is money that is being devoted to Medicare Locals that potentially is meant to be improving primary health care. I would like to see evidence of where the money that is being collected here, in this attempt by the government to steal from the pockets of those who are privately covered, is going to be invested, because there is no cogent and convincing explanation that that money is leading to either better public health or hospitals.

In conclusion, this is a government that tends to mess up everything it tinkers with. It is a government that promises not to do something and then does it. And it is a government that, fundamentally, inherited a series of challenges that all health systems have. In the end we may well see by 14 September, in a retrospective look at what has changed in our health system, plenty of administrative changes, plenty of health reform by press release, but ultimately this health system will carry on. The same challenges it had in 2007 it is still vexed with in 2013. The only difference will be life will be far tougher for those who have attempted to pay their own way and fund their own private health cover.

The DEPUTY SPEAKER ( Mr Lyons ): I call the member for New England.