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Wednesday, 22 August 2012
Page: 6023


Senator LUDWIG (QueenslandMinister for Agriculture, Fisheries and Forestry and Minister Assisting on Queensland Floods Recovery) (09:52): I thank senators for their contributions to the debate on this bill. I also thank Senator Fierravanti-Wells for her contribution. Although I am not sure it stayed relevantly close to the bill, we do have wide-ranging second reading debate speeches on this topic.

More than ever before, we are making the most of every precious health dollar. We are guided by the evidence and have invested wisely. We are finding efficiencies and returning the benefits to patients. Where the evidence said things were not working, the Gillard government have done things differently. The bill before this Senate is part of this. We have looked at the evidence on how the extended Medicare safety net works, and it says we need to close the loophole to protect the integrity of the system.

The EMSN provides individuals and families with an additional rebate for their out-of-hospital Medicare services once an annual threshold of out-of-pocket costs is reached. Once the relevant annual threshold has been met, Medicare will pay for 80 per cent of any future out-of-pocket costs for out-of-hospital services for the remainder of the calendar year, except for a number of services where an upper limit of the EMSN benefit cap applies. The government introduced benefit caps for certain services following an independent review that found some providers have used the EMSN to increase their fees to excessive levels. The EMSN was designed to help patients with out-of-pocket costs, not to subsidise excessive charging by some doctors.

Under the current legislation, in certain circumstances where more than one Medicare item is claimed by the same patient on the same occasion and the items are deemed to constitute one professional service, EMSN benefit caps are unable to apply as originally intended. An example of this is where patients have more than one operation performed at the same time. Some doctors are performing multiple operations to avoid the EMSN benefit caps. The bill amends the Health Insurance Act 1973 and allows the EMSN benefit cap to apply even when multiple services are performed. This means that the Medicare benefit goes towards helping patients with out-of-pocket costs, not on subsidising excessive charging by doctors. Importantly, it helps to protect the integrity and sustainability of the EMSN, and for those reasons this bill is supported.

I note the opposition are also supporting the bill. In reply to some of the issues raised in the second reading debate speeches raised by the coalition, one of the areas where there is really a stark contrast between the views taken by those opposite and this government is if you look at one area in GP bulk-billing rates.

We think bulk-billing rates do provide an indication of the difference between this government and those opposite. In 2003, under the coalition, bulk-billing plunged to a low of around 67 per cent. This government has spent a record $17.64 billion in Medicare benefits, excluding dental benefits. That is an average of about $784 in Medicare benefits for every Australian. So GP bulk-billing rates are now at a record 81.2 per cent. The coalition could never claim to have improved bulk-billing rates. This government has set out to improve the bulk-billing rate and has improved it significantly. Why? Because we have an unprecedented investment in health and hospitals across Australia, unlike those opposite, who took a billion dollars out of the health system.

If you look at bulk-billing rates since 2008, you will see that we have invested a record $2 billion to drive them up, with incentives for general practice, pathology, diagnostic imaging and telehealth services. If you look at the record of the coalition, you can see that it has only ever stood for cuts to health, which means cuts to bulk-billing and higher fees for Australians when they go to the doctor. The opposition have characterised this debate as a health debate. Our record stands for itself, while the coalition failed to deliver during their 10 years in government. But we are not talking about that; we are talking about a health legislation insurance amendment to ensure that it continues to deliver for Australians. So, with those short words, I commend the bill to the Senate.

Question agreed to.

Bill read a second time.