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Thursday, 15 March 2012
Page: 1922


Senator HUMPHRIES (Australian Capital Territory) (17:28): When I was young, I recall playing a game that my parents bought me one Christmas. I forget what the game was called, but there was a vertical column and there were marbles in the top of this column. There were sticks that went horizontally into this column and the idea was that each player in turn withdrew a stick from the column and hoped that they were not the one that released all the marbles into the bottom of the column. The name will come to me at some point—probably later in the speech, so I will leave members in suspense until I can think of it. Obviously, nobody else in the Senate at the moment played that game and they cannot refresh my memory.

The ACTING DEPUTY PRESIDENT ( Senator Cameron ): Senator Humphries, I have been advised that it was called Ker Plunk!

Senator HUMPHRIES: Thank you very much Mr Acting Deputy President. You obviously were not playing it yourself—it was not a popular game in Scotland, no doubt. Or you were too young—or possibly too old? I would not venture which that might be—but thank you. The game springs to mind in the course of this debate because it rather seems to me that the federal Labor government is playing a game of pulling out a stick from this structure of public and private hospital and health infrastructure in Australia—a stick worth $2.8 billion over the forward estimates. It is hoping—it is not necessarily very sure, but it is hoping—as it pulls this stick out that somehow the marbles do not fall and that the people in the private health system who have private health insurance and who are taking a load off the public hospital system at the bottom of the column do not cascade down into the bottom of that column. That gamble is—

Senator Polley: What about the effect of the $1 billion Tony Abbott ripped out of health?

Senator HUMPHRIES: I am happy to defend against that fallacious argument. There was no $1 billion ever taken out of the public hospital system or the public health system of Australia by Mr Abbott or anybody else in the coalition government. But, to stay with my point, we have a situation where the federal government have determined that they can withdraw that amount of money and they are hoping that it will not have serious consequences for the quality of the public hospital system in our country.

They have conceded, I suppose, that at least one marble will fall. The government say as a result of their own modelling that 27,000 people will drop their cover as a result of this measure. Let us call that one marble dropping to the bottom of the column. If that were the case, the gamble might have paid off at least partly. But we have among the range of estimates of what will happen if the federal government withdraw that $2.8 billion other much less rosy scenarios or predictions of what will happen. I note that the government's own medical insurer, Medibank Private, estimates that 37,000 of its members alone are likely to drop their cover and a further 92,500 will downgrade their health coverage, most likely by dropping out of hospital cover. Deloitte have done their own work. Their estimate is very sobering. They estimate that in the first year alone of this new scheme 175,000 people would be expected to withdraw from private hospital cover and a further 583,000 will downgrade their cover. Over five years, Deloitte estimate that 1.6 million people will drop cover and 4.3 million will downgrade. As a result, they estimate that private health insurance premiums will rise by 10 per cent above what they would otherwise have risen by. If that turns out to be the case, a lot of marbles are dropping and a lot of serious consequences are flowing down to the public hospital system and the public health system of Australia.

Senator Mason: Labor's lost their marbles!

Senator HUMPHRIES: You could say they have lost their marbles, Senator Mason. I think that it is clear, however, that the government just do not know what is going to happen with this measure. We have a national economy which is good in parts, like the curate's egg, but which leaves a large number of Australians who are struggling and where living standards generally across Australia are falling. Yet the government believe that when people face these sorts of cost pressures—higher cost of government charges, higher taxes, higher cost of local services, higher cost of petrol and these other cost of living pressures—somehow in the midst of all of that pressure they will not drop their private health insurance. It is a big gamble.

We have a situation where clearly our public hospital systems are struggling to cope with the level of demand on them, and that level of demand is likely to increase significantly as a result of people dropping their private health insurance, particularly with respect to hospital coverage, as people decide that they simply cannot afford to sustain that coverage and they can go to a public hospital system. They probably factor in a certain loss of quality as a result of that, but nonetheless in tough economic times they may well decide that that is a rational decision to make to help sustain their family's standard of living.

Twelve million Australians—over half of the population—have private health insurance, and 10.4 million of them have hospital treatment cover. It is very hard to imagine that Australians will sustain that level of investment in their own health when they have such enormous pressures on them overall and when the government is signalling that it no longer wishes to support them in the choice to sustain a proportion of the cost of their health care—because that is what this step is doing. It is saying to people, 'Don't worry about providing for your own coverage and covering the cost of your health care by taking out private measures; our government system will cover you.' Indeed, it might, but at what cost to the public purse and at what cost in loss of quality in the process?

This measure, I think, will lead to a very large number of Australian families deciding not to continue with coverage, at least to the same extent that they have today. I imagine that would be a decision made by a large number of people in my own community, the Australian Capital Territory, where at this stage we have, and have had for some time, the highest level of private health insurance in the country—56.4 per cent of people in the ACT are insured. That is over 200,000 people. Clearly it is citizens of the ACT who will lose very significantly out of these arrangements, because the government has classed people earning more than $83,000 as—to use a phrase employed in debate earlier today—'super-rich' or 'super-wealthy'. I think that greatly mischaracterises the sorts of people who are noticing a loss of living standards and who are struggling to make ends meet. The fact is that this change will affect many people at many levels, because if people who can afford at the moment to take out private health insurance withdraw in significant numbers it must have implications in a number of areas. It must lead to higher premiums, not just for people on higher incomes but across the board. So those millions of Australians on low incomes, those 3.4 million people with a household income of less than $35,000 per year, who presently have private health insurance will have to consider their position as their insurance premiums rise. It will also affect the suppliers of private health services. I am thinking particularly of smaller private hospitals in regional Australia which may not be a vastly profitable proposition at the present time but who will find that as a significant proportion of their communities withdraws from private health insurance the viability of their enterprises will diminish. When we see a few of those sorts of hospitals or health centres close—and bear in mind that most elective surgery in Australia today is done in private hospital settings or private clinical settings—in many communities the withdrawal of that kind of service will drive more people into already very pressured public hospital systems.

All of that adds up to a loss of quality and capacity in Australia's healthcare system. Where does the $2.8 billion come from? It comes directly from the pockets of Australians that the government chooses to characterise as super-wealthy or super-rich. I do not think that that characterisation is fair. I think that, in recent years, we have seen tremendous pressure on Australians at all levels. Some of the safety net for those people has been enhanced in some ways with compensation arrangements, particularly for lower incomes, but it is very much middle Australia that this measure is targeted at. I make no apologies for advocating for middle Australia in this place, because I do not think we need to be picking off sections of the community and saying that they can afford a hit here, that they can afford to have their standard of living sliced on the edge because they are wealthy enough to sustain that sort of decision.

We are still a wealthy country, and if it were not for the profligate decisions made by this government with respect to the way it has spent the taxpayer's dollar in recent years we would not need to make these sorts of decisions. We have to take $2.8 billion out of the pockets of Australians in order to sustain the government's vision of a surplus budget into the future. We need not be in this position and we on this side of the chamber reject the idea that we have to create this kind of paradigm: to cut the living standards of Australians in order to meet the government's budgetary requirements.

I fear for the effectiveness of Australia's public hospital system. As a former health minister in the ACT, I know that, as people come through the reception areas of in-patient departments, the system is incredibly sensitive to the number of decisions about where people will go. Will they go to a private bed or to a public bed? When more people take the turn on the left side to go to the public beds, it puts huge pressure on the rest of the system. We can expect more of that because of this government's somewhat perverse vision of how to improve health care in Australia.

I remind members of this chamber, as others have done, that the decision to remove that stick worth $2.8 billion was a broken promise. I recall very well the words used by the then shadow minister for health before the 2007 election that this was Liberal hysteria—that the Liberals were being hysterical in suggesting that there would be any tampering with the private health insurance rebate. It is interesting because the other time in Australian politics that I recall the phrase 'Liberal hysteria' being used was with respect to claims made by the opposition in 2010 that the Gillard government was going to impose a carbon tax. According to Treasurer Swan that was Liberal hysteria as well. I suspect that we should be very sensitive to the words 'Liberal hysteria' in the future and assume that, when we hear that phrase, it means that they are on to us, that we have been caught out, that they know what we are up to.

I simply indicate that I think Australians will be poorer and the health system will be weaker as a result of the measures which the Senate is being asked to approve today. The Greens have long advocated for pulling out of this particular measure. In fact, they say the whole of the private health insurance rebate should go. They have no compunction about imagining that they can find the extra dollars necessary to sustain a hospital system where nobody uses private health insurance or private hospitals. But that is the bizarre world of the Greens. I for one will not stand by and support a situation where—

Senator Di Natale interjecting

Senator HUMPHRIES: A lot fewer people were using private hospitals and private health before the rebate, and today we have a strong private health and hospital system in this country because the Howard government had the vision to sustain people's decisions to take out private health insurance and invest in their own health care. That is the way the system was improved. Enormous pressure was taken off the shoulders of public hospitals in this country by virtue of that decision, and you guys are going to put that pressure right back there when you support this measure today. I urge the Senate to reject this legislation. It amounts to a cut in the quality of health care in this country and a reduction in the living standards of millions of Australians.