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Tuesday, 10 February 2015
Page: 287

Senator DI NATALE (Victoria) (15:29): I move:

That the Senate take note of the answer given by the Assistant Minister for Health (Senator Nash) to a question without notice asked by Senator Di Natale today relating to proposed changes to Medicare.

I rise today to talk about the debacle that is the changes proposed by this government to Medicare. It represents everything that is wrong with this government. It represents, firstly, a complete lack of integrity. It represents a triumph of ideology over evidence. And it represents breathtaking incompetence from a government that promised that the adults were back in charge.

On that first point on lack of integrity, this is a government that promised no cuts to health care. In its first budget it introduced a freeze to Medicare indexation, representing a real cut to the income of GPs to the tune of hundreds of millions of dollars. There was an increase in the Medicare co-payment representing a $5 out-of-pocket cost for ordinary people seeking to access Medicare services at a time when out-of-pocket costs are higher than they have ever been.

This is a triumph of ideology over evidence because we have a policy based on a lie. These changes are premised on the notion that Medicare is unsustainable despite the evidence saying the exact opposite. The rise in health spend is lower than it has ever been. Our total spend on health care is lower than the OECD average. Over the last decade we have seen a decline in Commonwealth spending in health care. The evidence is telling us that our system is good and strong. That is not to say it cannot be better, but we do have a strong health system that is sustainable and that will provide health care to Australians over the long term.

Why has the government done this? It is because this is a party that, contrary to what people think about it lacking vision, has a clear vision that says, 'Government needs to get out of the way. If you cannot afford access to health care it is your fault. People should face price barriers before they go and see a doctor.' Again, this is despite the evidence that says that health care that is universal at the point of access is not just the fairest way of providing health care but also the most efficient. We only need to look to the US to see that. They spend twice what we spend on their health care—18 per cent of their GDP. It is a user pays system. What they get is worse but much more expensive health care and a much less fair system.

The government are proposing a co-payment that does nothing other than shift costs on to patients and, even worse, state governments that are already struggling to fund their hospital systems. We are going to see people move from primary care, one of the most efficient ways of delivering healthcare services, into emergency departments, which are much more expensive and are worse at providing health care to people with chronic disease. It makes no sense at all. It is a triumph of ideology over evidence.

Then we saw the freeze on indexation. This is a freeze that, over time, will have a more substantial impact than the Medicare co-payment. I will say that again. While all the debate has been about the Medicare co-payment, it is that freeze on Medicare rebates that, over time, is going to bite harder and will effectively mean the end of universal health care.

Perhaps even worse than all of that is that, from a government that promised the adults were back in charge and that they would be grown up and accountable, they cannot even implement this policy properly. They cannot even implement bad policy properly. This is version 3. Version 1 was a thought bubble dreamt up before the budget. Version 2 was dreamt up by the Prime Minister in December last year. Then we saw the new health minister given the hospital handball, forcing her to ditch version 2 and to announce version 3, which received just as much praise as the original policy.

What needs to happen now is for the government to press the reset button on their health policy. They need to talk to the crossbench. They need to engage in a constructive conversation with the medical community and consumer groups. We need to start tackling the real issues in health care.

Question agreed to.