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Australian missionaries on home leave rejected as ineligible for Medicare benefits

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Media Release / Dr Bob Woods “

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An Australian couple who have returned home for the birth of their baby after working as missionaries in Papua New Guinea for the past 3 years have been refused Medicare Cards and Medicare benefits on the grounds that they are not "Australian residents." This is despite the fact they were both born in Australia, have lived here permanently until their trip to New Guinea and have paid Australian taxes and the Medicare Levy for most of their working lives, Federal Shadow Minister for Health Dr Bob Woods revealed today.

" The refusal by the Health Insurance Commission (HIC) to allow Australian missionaries access to benefits under Medicare on their return to Australia, makes a mockery of their liability to pay the Medicare L e v y and Australian taxes and should be a warning to all other'Australians working abroad " said Dr Woods,

" The Government's ban on private insurance against medical fees makes the situation even more intolerable effectively preventing a person protecting themselves against medical expenses in any way. The HIC ruling means that the people in this category are also not entitled to be admitted as public patients to public hospitals. It means that if

an Australian citizen working abroad returns home temporarily, they will only be able to claim the benefits of Medicare if the country where they have been resident has a reciprocal health agreement with Australia and they claim as residents of that foreign country!

So much for their Australian citizenship! So much for payment of the Medicare L e v y and Australian taxes!.

As the couple prepare for the birth of their second child in January they are faced with doctors fees and hospital charges for which they get no Medicare rebate. Worst of all, they will have to meet the full cost of the confinement which could cost as much as $3,800. Even in the public hospital system, if they are not eligible for Medicare, the cost

could be as much as $2000.

Out of the goodness of their hearts the couple have given their time and effort to helping others and yet find on their return to their home, rather than being rewarded, they are being penalised.

This is an appalling situation which Minister Howa should rectify immediately. It is not an isolated case.

It is bizarre that even i£ycu are an Australian citizen, pay both your taxes and the Medicare Levy, and are regarded by the Australian Tax Office and the Department of / COMMONWEALTH

____ _______________________________________________________ _ PARLIAMENTARY LIBRARY


i’sr further information contact Dr Woods or LeLsa O'Conner on 06 277 4661 After hours cor.tsct *

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Social Security (DSS) as an Australian resident, you are not entitled to the benefits of Medicare unless you satisfy the Health Insurance Commission's definition of an "Australian resident".

It says "Australian citizens who ordinarily reside in Australia and who are temporarily absent overseas, usually on holidays or a short term contract of employment, are eligible for Medicare during return visits to Australia. Australian citizens who reside overseas, however, are ineligible for Medicare during short term return visits (even

when they have continued to pay the Medicare Levy). To become eligible they must return to Australia and resume residence."

The problem arises because "short term" is not defined in the health legislation.

Correspondence from the HIC says '' Commission staff look at "living arrangements (house, flat) whether they have a car, furniture, children at school, bank accounts, their inclusion on the electoral roll etc". It is clear that in practice these "guides" are not resulting in equitable decisions as to entitlement.

This position also represents a complete policy somersault by Medicare on the status of missionaries. In 1984 correspondence it said " Australian missionaries attached to and participating in the normal activities of an Australian mission, who maintain a definite intention to return to Australia are eligible indefinitely

The situation is even more confusing because the HIC position is clearly contrary to the the Department of Social Security position on missionaries. The DSS makes specific provision for missionaries. In its "Guide to Administration of the Social Security Act" the DSS notes that irrespective of the time spent overseas, Australian missionaries are

accepted as Australian residents for the purposes of getting health care cards.

Therefore it is obvious there is a gross inconsistency between the DSS and the HIC. The DSS is saying yes they are residents yet the HIC is saying no they're not.

This affects all Australian working overseas who return home for a short term but is especially callous in the case of Australian missionaries who do such humanitarian and lowly paid work assisting victims of war, famine, and poverty in places like Somalia and Chad.

There are an estimated 5,000 or so such missionaries and doubtless thousands of other Australians working overseas who would be caught by this crazy anomaly. So much for universal access to health care for all Australians under this Government.

This is clearly a ridiculous situation and surely rates with the HIC's now infamous ruling some months ago when it refused to pay its share of the $40 doctors fee incurred by an 80 year old Melbourne woman whilst in the middle of the Bass Strait. In that case the elderly woman was struck down by a viral infection whilst on

board a cruise ship from Melbourne to Tasmania. At that time the HIC defended its refusal on the grounds that the Bass Strait "was not part of Australia"!

This latest example of the ridiculous operating practices which this Government condones will be rectified by the Coalition after the election. While it is important to ensure that unscrupulous overseas visitors do not abuse our health system, Australian /citizens in these circumstances, particularly missionaries, must be protected."

15th October 1992

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