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Monday, 25 June 2018
Page: 89


Senator WATT (Queensland) (18:06): I rise to support the motion that has been proposed here; that there is a need for Australia 'to have a more transparent and accountable health system that helps consumers make informed choices'. The need for greater transparency and accountability in our health system is something that the Labor opposition has supported for some time now. As I'll mention in the course of my contribution, there are a number of either policies or commitments that we've already made, and a number of other things that we have asked the government to act on, that would improve transparency and accountability, which, unfortunately, the government has yet to act on.

I think all of us understand that ensuring that Australians have good quality health care and are able to enjoy a decent standard of health themselves is one of the most important things that we can ask of our federal government. It's really good that over a number of years, due to improvements to the way health care has been provided in this country and to advances in medical technology, more and more Australians are living longer, healthier lives. Despite that, we know that there remain pockets of health disadvantage throughout our community, particularly if we're looking at preventable diseases. That is particularly where we need to see greater action on the part of governments.

In terms of transparency and accountability, though, I don't think anyone can deny that it's important for governments to ensure that health consumers, citizens of Australia, have access to as much information as possible about the availability of health care and the likely cost of that health care if they get problems fixed, whether in hospitals, by GPs or in other environments. Giving patients access to more information about the fees and out-of-pocket costs that they are likely to incur in the health system is absolutely critical for consumers to be able to make informed choices about the kind of health care that they need.

All of us who come to this place as political representatives have heard the horror stories from constituents of the cost of health care that they end up incurring which goes well beyond what they expected that they would incur when they made a decision to have a particular operation or procedure performed. Unfortunately, because health care is expensive to provide, it's not as if people get a bill for just another $20 or another $10—which, for many people, is still a lot of money. Too often, what we see in the health system is people agreeing to have procedures conducted, thinking they are going to be fully covered either by the public system or the private system—if they have private health insurance—only to find out, once they've had those procedures undertaken, that they are left with a bill of several hundred dollars or, even worse in some cases, several thousand dollars. That's not something that anyone should be faced with in this country with a universal health system of the kind that we have.

The need for greater transparency was highlighted by an ABC investigation into out-of-pocket costs last month. I think it aired on Four Corners. That was a very revealing investigation. It showed there are still too many instances where Australians face the dilemma of having to make a decision about whether they are going to have a health procedure undertaken on the basis of what the costs are going to be—and sometimes those costs are going to be higher than they should be because of cutbacks to the health system that we've seen by this government. But, even having weighed up the costs and benefits and decided to go and have a procedure performed, the ABC investigation revealed that there are a number of Australians who are facing huge bills when they come out of hospital, or wherever they've had a procedure done, which they hadn't planned for and, had they known about them, may have resulted in them making different decisions. In some cases they would still have gone ahead and had a procedure done. Obviously if it's a life-threatening procedure then someone is much more likely to make that kind of decision and somehow come up with the money needed to do so. But if people are having procedures done in the belief that something is going to cost a certain amount, only to find out that it's going to cost several thousand dollars more, that is an outrage that we should be taking action to prevent.

The ABC report showed that, while we continue to have every confidence that most Australian surgeons are going to do the right thing by their patients and are going to properly inform people about the likely cost of a procedure, there are rogues out there, as there are in any industry, who don't have the best interests of their patients at heart and are doing the wrong thing by their patients by not fully informing them of the likely cost of a procedure. The Four Corners investigation made clear that, tragically, there are some unscrupulous profiteers in the medical profession who do need to be brought into line, and that's what the purpose of this motion is. It is to emphasise the need for action by the government.

One troubling aspect of the Four Corners report was that there are some surgeons in Australia who are charging patients unexpected out-of-pocket booking fees of up to $6,000. That's something that many citizens of our country aren't necessarily providing for or thinking they are going to incur when they're making decisions about the health care that they will receive. This sort of behaviour can add significant stress to patients at a very vulnerable time. If someone is trying to make a decision about whether to get a procedure performed or not, that's a stressful time for people. Obviously when someone has had a procedure performed and they're discharged from hospital, or whatever health environment they've had that procedure performed in, they're hardly in a good position to be making a decision about whether they'll pay some out-of-pocket costs. In some cases, they are under far too much pressure to pay up to be able to think through the consequences.

Labor has called for an urgent ACCC investigation to look into this predatory and unethical practice from what is hopefully a small percentage of the profession, and it's disappointing that the government has not heeded our request. Perhaps the debate today and putting this issue on the radar will be enough to convince the government that this is a very serious issue that is affecting too many Australians and that no Australian should be left in a position where they have a health procedure undertaken only to find out that they are left owing thousands of dollars that they didn't provide for.

An ACCC investigation is urgently needed to try and crackdown on this practice. Of course there are also instances where we have some specialists simply charging exorbitant fees for their services, which means that there are enormous gaps between the amount someone is insured for and what they end up having to pay in the form of out-of-pocket costs. That's also wrong, and that's why it is so urgent that we get better transparency of fees for people so they can make much more informed choices before undergoing procedures. There needs to be a lot more accountability built into the system for surgeons who do the wrong thing by their patients and overcharge people.

Labor are very concerned that, despite the number of times that we've called for action on out-of-pocket costs, in terms of transparency, accountability and just taking action to keep those out-of-pocket costs down—despite all of that—we've seen no action on the part of this government and the current Minister for Health, Mr Hunt.

Instead of tackling the issue as part of their private health insurance package last year, they simply shunted it off to a committee and that's the last that we've heard of it. I know that this is something that we've been exploring at Senate estimates hearings, and we'd really like to know more from the government about what they are doing to try to bring out-of-pocket costs under control.

One of the key factors that is driving this increase in out-of-pocket costs in the Australian health system is the refusal of this government to do anything about the Medicare rebate freeze. We've seen the Medicare rebate just kept at the same level for far too long, and we understand that—even though there are many doctors who want to do the right thing and aren't seeking to overcharge their clients and their patients—the reality is that the cost of providing medical treatment is going up. Despite that, the government has held the Medicare rebate at such a low level for so many years that that has increased out-of-pocket costs that Australians are facing.

Across the entire country, Australians are now paying up to nearly $47 out of their own pocket to see a GP because the Medicare rebate just has not kept pace with the increasing cost of health care. Out-of-pocket fees to see specialists have soared even higher, up to almost $88 for Australians; they are having to pay another $88 out of their own pocket to see a specialist because of this government's refusal to fund the health system properly. As we're going to see this week, in another debate about company tax cuts, the government is happy to ship lots of money off to big business to give them a tax cut that the country can't afford, but out-of-pocket costs is another area that the government should be putting proper funding into.

The DEPUTY PRESIDENT: Thank you, Senator Watt. The time for this debate has expired.