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Friday, 3 April 1998
Page: 1970


Senator HERRON (Aboriginal and Torres Strait Islander Affairs) (11:00 AM) —That was all very interesting, but it had nothing to do with the Health Legislation Amendment (Health Care Agreements) Bill 1998 before the chamber. But I can understand Senator Crowley. It was the first time I had heard her speak in two years. She has had a blow of the pipes this morning and feels good about it. I welcome that, because it demonstrates yet again that she is locked in the past. As a matter of fact, my spirit soared when I heard Senator Forshaw because I thought at last, as the current phrase goes, that the tectonic plates might have shifted in the Labor Party in relation to health care. Then I heard Senator Crowley, and I regret to say that we are back where we were before.

I would suggest that Senator Crowley contact Mr Mark Latham and Mr Lindsay Tanner, who at least have some idea of shifting from the past. We have heard that terrible diatribe which I heard from Senator Crowley for the last eight years. She is locked in the past. It is time she started reading and, more importantly, started going out into the industry to see what is going on in the hospital system of this country, because it has changed. Senator Forshaw is aware of that. I am aware of that because of what he had to say. At least he stuck to the bill.

I hope Graham Richardson, the former Minister for Health in the Labor government, hears this debate. I well recall him when he was health minister trying to persuade then Prime Minister Keating of the essence of what Senator Forshaw was saying that there is a place for private health insurance. It is well on the record that Prime Minister Keating did not have private health insurance because he said that he had paid his Medicate levy and that he was entitled to go into the public hospitals. Of course he never did that. He went to private hospitals.

He did what is occurring out there in the real market, and that is that about 14 per cent of people in the leading private hospital in Brisbane pay for their own care. They are self-insured. They actually go privately. So to equate the level of private health insurance to what is actually occurring out in the marketplace in private hospitals is irrelevant. It has been static for about 13 years in Queensland. Between 29 per cent and 30 per cent of people have retained private insurance, and that includes a lot of pensioners because they want freedom of choice of doctor and freedom of choice of hospital.

Poor old Senator Crowley is locked in the past. Talk about being palely eolithic or concerned about the ideology of the last hundred years of the Labor Party. She has not shifted. She is still on about the necessity of maintaining the public hospital system. We agree with that in the sense that there is a desperate need to get it back to where it was when the Labor Party came into power and intentionally set out to destroy private health insurance, particularly by removing the bed day subsidy. It is on the record, no matter how much she talks about it, that when the Labor Party came to power 68 per cent of the population were insured. When they went out it was down to about 36 per cent because of their deliberate policy to try to destroy it.

Before getting off the subject of Senator Crowley, I should mention that she asked why these things were happening under this government. For heaven's sake, we have been in government for two years. The Labor government was there for 13 years. It is going to take us more than two years to fix things up, as we have had to do in so many areas.

Senator Crowley talked about private cover for childbirth. This bill does cover that aspect. What we are trying to do is stop the hit-and-run people. One of the problems with rising health insurance is that a lot of people, which is reasonable under their circumstances, come in for a short time and then get out. They are taking more money out of the system than they are putting into it. One of the other problems is that the majority of people who are insured are in the older age group and they are taking more out of the system than they are putting into it.

Young people are leaving it in droves because, as they can see, it is probably better not to privately insure. In fact, for childbirth, if you are fit and well and want to have your baby—and the number of babies being delivered has diminished—it is probably financially better to be privately insured, to go and have your baby, pay for it and then get out, because you are not likely to have to access the private hospital after that.

The problem, I explain to Senator Crowley, is community rating. Both parties and everybody agree that community rating should continue: that all the money goes into a bucket irrespective of age and then you take it out of the bucket. If money is not being put in the bucket by young people, of course the money in the bucket is going to run out. That is why private health insurance rates have increased: the rates had to go up because they are non-profit.

In relation to the bill, the 35-day rule—and that is the only bone of contention because I know the Labor Party supports this legislation—in practical terms just does not work. What happens in real life is that when a person is over 35 days the doctor has a form shoved under his nose which says, `Can you justify this patient staying in an acute hospital?' and the doctor says yes. So it is just removing an unnecessary bureaucratic requirement for the patient to continue. It does affect a handful of people who are in private hospitals when they are really nursing home patients.

We have recognised that Senator Lees—I yet again note this on the record; I have done so on previous occasions—does have a good knowledge of health care. All the time that I have been in the Senate she has taken a keen interest in it and is across the issues. I want to thank her for that. But, to answer the Australian Democrats' concerns, if people may be affected by this, and we believe only a handful would be, then we are happy to have that looked at as a disallowable instrument. The Democrats should note that the course of action the government is pursuing is supported by the Council of the Aged, the relevant consumer group, the Australian Health Insurance Association and the Australian Private Hospitals Association. We think that should satisfy the concern of the Democrats.

We are not supporting Senator Forshaw's amendment because of that. As I say, it is an unnecessary bureaucratic intrusion. It did not work anyway, because ultimately the people that are in health care—the nurses and the doctors—are more concerned about the patients than they are about the bureaucrats. It was an ineffective mechanism in any case.

Question resolved in the affirmative.

Bill read a second time.