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Thursday, 14 May 1970

Mr HAYDEN (Oxley) - by leave -I move:

In proposed section 82s. at the end of sub-section (1.) add the words "plus any specified excess detailed in the schedules".

In proposed section 82s, at the end of sub-section (2.) add the words "but in no case will a contributor receive less than an amount equal to the daily cost of public ward treatment in a public hospital in his State for each day he is charged for hospital treatment".

In proposed section 82t, sub-section (2.) at the end of paragraph (e) add the words "plus any specified excess detailed in the Schedules".

In proposed section 82t, sub-section (2.), at the end of paragraph (f) add the words "plus twothirds of any specified excess detailed in the Schedules".

In proposed section 82t, sub-section (2.), at the end of paragraph (g) add the words "plus onethird of any specified excess detailed in the Schedules".

After proposed section 82t insert the following proposed section: "82ta. For the purposes of sections eighty-two s and eighty-twot a person entitled to the benefits proposed under these sections shall not be debarred from those benefits merely because he failed to apply for them by registering as a contributor provided he does so within two years of the first date on which he otherwise qualified for medical or hospital benefit.".

The first 5 of the 6 amendments relate to the subsidy to low income earners for hospital and medical benefits. The approach of the Government to the subsidy For low income earners in respect of hospital and medical benefits is not that approach which the Labor Party would adopt. In our approach, as we made quite clear, we would identify the poverty line and would make an allowance for each dependant. Accordingly the people who fall within that category and who were to benefit from subsidised insurance in our universal health insurance scheme, as distinct from the present inefficient scheme operated by the Government, would pay nothing at all. It is quite irrational to establish that someone lives-

The CHAIRMAN (Mr Lucock - Order! I point out to the honourable member for Oxley that again the effect of the 6 amendments that he has moved would beto increase the amount of the appropriation required. Therefore I rule that the amendments are out of order.

Mr HAYDEN - I move:

That the clause be postponed.

I continue to indicate what the effect would have been had we been allowed to move our amendments and had they been upheld as being valid. In doing so I indicate what our attitude is to this provision. Our feeling is that once it has been established that low income earners live within an area, which is identified as one of want or of poverty, it is irrational then to say that they are to be charged for health protection. These are the people who, more than most people in the community, need the benefits of a comprehensive range of health services. They are deprived from benefiting in this way to some extent if charges are to be imposed on them. In fact, there will be charges imposed On these people even where the income earner receives less than $42.50 a week - this is the minimum wage - because there is still an excess amount which hasto be met.

This is an obligation on the person who would be covered. I could give some examples from the Nimmo Committee's recommendations, which were not adopted by the Government. We do not uphold the report of the Nimmo Committee as an outstanding examplar of what ought to be done in health insurance. We draw attention to it only because it was a rather vigorous broadside blasting the deficiencies in some areas of the Government's health insurance scheme, while at the same time restricting itself the recommendations consistent with the operation of the present scheme.

Under these recommendations, a person with more than 2 children, on the minimum wage would be allowed an additional $4 a week per child- and would obtain cover for health insurance. This would mean that a person with 6 children and earning $58.50 a week would be receiving some cover if those recommendations had been upheld. In actual fact, a person without dependants and receiving $48.50 a week will get no benefit at all. This is somewhat anomalous. On the basis put forward by the Nimmo Committee there was a clear case of want for a man, a wife and 6 children trying to exist on $58.50 a week. They will receive no concessions at all. But a married man with a wife alone and no dependants on $42.50 a week will be getting full protection under the subsidised scheme. A person receiving between $42.50 and $45.50 a week will pay only one-third of the cost of the insurance. A person, earning between $45.50 and $48.50 a week will pay two-thirds of the cost. This is anomalous. It means that child-bearing and child-rearing are recognised as offences by the Government. Accordingly those guilty of this are penalised with a monetary imposition or a monetary fine.

Let me deal with some of the financial aspects of the Government's proposal. A person in New South Wales earning between $42.50 and $45.50 a week will pay 63c a week on the adjusted scale for hospital and medical insurance. Those earning between $45.50 and $48.50 will pay $1.26 a week. Let us take as an example the case of a man supporting a wife and 6 children. If he is earning only $46 a week, which is not very much money to be supporting 7 dependants as well as himself, he would have to pay $1.26 a week, because he would be paying two-thirds of the insurance rate. If he has to pay on top of that rent at $16 a week, which is extremely cheap rent in relation to the market standards at the present time, and a food bill of $22 a week, which is a rather Spartan diet for a large family, he will be paying $39 a week out of his weekly income of $46. This leaves only $7 with which to provide extras, such as clothing, transport, school books for the children and so on. This works out at 85c for each person in the household. This is an absolutely ridiculous situation. It is quite unreasonable of the Government to expect that a person in these circumstances will be able to surrender this extra $1.26 a week to try to cover himself and his family with health insurance when he knows very well that in any event he will still have to meet some of the expense.

He will have to meet the excess charges under this present scheme. If he is unfortunate enough to go to a doctor who does not adhere to the common fee concept, he will be paying more than the excess charge which is struck in the schedule attached to the Bill. This is particularly true in New South Wales because thousands of doctors who are members of the General Practitioners Society in that State have declared that they will not adhere to the common fee concept, that they will charge more. This to me is not a reasonable proposition at all and in no meaningful way ameliorates the problem of people on low incomes relative to the size of the family. It is an established fact that poor people do pay more in our society. They are exploited. They are regarded as bad risks solely because they have a low income and a limited surplus, if any, to provide for an extra purchase, whether it is a motor car, which becomes essential in our society for so many workers, or whether it is a television set. We cannot blame people who live in a depressed environment for trying to escape in the television tube to get away from the depression which their environment fosters.

Again, one does not blame a man for going away and drinking at night. I can well understand this situation if it is one way of drugging his senses against the depression and frustrations of living in an environment of want. These are well established social factors. Sociological surveys have established that these are causes for people reacting in a way which traditionally is condemned by the complacent, conceited middle class in our society. It is not condemned by all middle class people because there is a growing radical strain within the middle class which is expressing concern about these people living in want. But for goodness sake, that growing radical, informed middle class group is not responsible for defining this legislation now before us.

I want to mention one other point quickly. God knows that we have to move quickly in this House with the application of the guillotine or else we will get our debating heads cut off. We have already missed out on moving 2 amendments that we wanted to move which were of fair significance to this measure. We are given 6 hours in which to debate the whole Bill. The Government Parties have been squabbling over it for weeks in their Party room. They have had more time than the national Parliament has had to decide this.

The effect of our other amendment is that a person shall not be debarred from the benefits of the subsidised scheme solely because he failed to apply for them by registering as a contributor provided that he does so within 2 years of incurring the expense for which he is seeking benefit. AgainI refer to what I said earlier. A lot of these people who live in this area of low income do not have the benefits of much education and find it difficult to equip themselves to handle the challenges of daily living. Frequently they miss out on registering claims not only for medical benefits but for other benefits in society. They ought not to be deprived because of the failure of our system which allows them to exist in this vulnerable fashion. This is why we have moved this amendment too.

Question put:

That the clause be postponed.

Question resolved in the negative.

Clause agreed to.

Clauses 43 to 46 - by leave - taken together, and agreed to.

Proposed new clause 46a.

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