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Transcript of interview: Tuesday 29 April 2003: Brisbane: Medicare; pharmaceutical recall; reconstruction of Iraq; asylum seekers; sex trade; leadership.

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Subjects: Medicare; Pharmaceutical recall; Reconstruction of Iraq; Asylum seekers; Sex trade; leadership

PRESENTER: Good morning, Simon, have you had the phone call?

PRESENTER: Well that’s a very valid question. Has the phone not gone?

CREAN: No, but look, we’ve moved on from that. Kim knows what he’s got to do, but I know what I’ve got to do and that’s to keep punching through the message.

Particularly in terms of Medicare at the moment because what people are now facing, if this legislation goes through, they’re going to have to pay more for their health care, more to see a doctor. This is the end of bulk billing.

And look, this isn’t just a fight between me and John Howard, this is a fight to retain Medicare - a health system that is well recognised as being the best system you can have. And yet this Government wants to destroy it. Why would you do that? Why would you take a system that’s functioning properly, run it down and then give it a further knife in the back?

PRESENTER: Look, obviously you don’t want to talk about the leadership thing and we can understand that because I really don’t think that it matters a hell of a lot to most Australians anyway. What is important, though, is this issue of Medicare. Now, the Government would have us believe that this will provide more incentives for doctors to bulk bill and certainly pensioners and concession holders. It will get extra doctors and nurses for rural and remote areas. Yet medical people I’ve spoken to are saying it will have precisely the opposite effect.

CREAN: It will have the opposite effect. And just think about it. The only people it gives incentives to bulk bill to are concession card holders. That


means, John, that any family above $32,300 will now be faced with a co-payment because there is no incentive to bulk bill them.

Now, if the Government acknowledges that you’ve got to give additional incentives for bulk billed concession card holders and pensioners, why won’t it acknowledge that it has to give additional incentive to bulk bill all patients?

Because that’s what Medicare is. That’s what the Medicare contract is. The 1.5 per cent levy on your tax entitles you to a doctor that bulk bills. It also entitles you to free hospital treatment in a public hospital. But this government is taking that away. And it means that all families are going to pay more for their health care.

PRESENTER: But the Government will say that Medicare was never intended to be used by all and sundry, it was always for the lower income earner, the concession card holder and the people, really, that most need it?

CREAN: Well how is it that under Labor’s stewardship of Medicare, bulk billing rates went up to over 80%?

PRESENTER: But can we afford that, Simon?

CREAN: Yes we could afford it. We could afford it. And don’t tell me that in a budget of $30 billion a year - and this package which the Government dropped out yesterday is $900 million - don’t tell me that you can’t re-establish bulk billing.

Now, if you look at the graph in terms of what happened, in the last seven years of the Labor Government, bulk billing steadily increased. In every year since - under the Howard Government - it’s gone down. Why? Because they don’t believe in it, they’re not committed to it.

And they’re now trying to say, they’re trying to change the definition, they’re trying to say that only pensioners and concession card holders were those that could get bulk billed.

But I mentioned before the figure of $32,000. These are not wealthy people, John. These are families struggling to make ends meet. And if they’ve now, particularly with all of these concerns around about health, whether it’s the SARS virus, if these are families that have to go to a doctor and already they have to put $40 or $50 up front for each of the children - where are they finding that money? And this is a system which is just a licence to do more of that, to charge families more money.

Now, what I’m saying is the Australian community deserves better. We can afford bulk billing, we can afford to restore it. And we will only save Medicare if we do restore it. The choice is between John Howard who wants to destroy Medicare and me leading a Labor Government that will save it.


PRESENTER: But at the end of the day, the people who are going to make a decision on this are the doctors. I mean, they’re the one’s that no matter what system’s in place if they don’t want to bulk bill they won’t.

CREAN: Well, that’s true. But, if you look at the system that I talked about before, when Labor was in power the bulk billing rates went up to over 80 per cent. Under this Government they’ve fallen below 70 per cent.

And yesterday when John Howard and Kay Paterson were asked the question, `will you guarantee that this will see the end of the decline in bulk billing’, he couldn’t do it. Well I’m giving the guarantee. I am guaranteeing to restore bulk billing. Because, we will lift the patient rebate, we will progressively restore bulk billing in this country.

Now you can’t do it over night. I’m not trying to pretend you can do it overnight because this Government’s run it down over seven years. But it needs a down payment, it needs a statement that we are here to secure bulk billing and save Medicare. Because if we don’t have this argument now, if we don’t have this fight now, if we don’t block the legislation that’s going to destroy it you won’t get it back.

This is the beginning of the Americanisation of the Australian health system. Where your Medicare card doesn’t count and they insist on your credit card. If you go into a doctor he doesn’t ask for the Medicare card, he asks for your credit card. That’s not a system that we want and it’s a system that I will fight to ensure does not come in.

PRESENTER: The medical profession has reliably informed us that there are 8 million Australians who have a health care card. That’s far too many isn’t it? Would you advocate that there should be tighter regulations on the actual numbers of people who’ve got the card so if that could somehow be reduced, or more looked after, you know, across the board we might have a better system?

CREAN: What I’m advocating is that every Australian is entitled to a Medicare card and that Medicare card should give access to bulk billing. It should give access to the contract that was entered with this Government and previous Governments that if you pay your Medicare levy you get affordable health care.

That’s not happening at the moment. What John Howard is doing is introducing a two-tiered system. Only pensioners and concession card holders, if they’re lucky, can have access to bulk billing. Everyone else has to pay more. The co-payment is going to be entrenched. They’re even encouraging private health insurance to cover the gap. For the first time in this country, you’re having to take out private health insurance to see a doctor. That’s the Americanised health system.


PRESENTER: That’s not a key issue though.

CREAN: That is a key issue.

PRESENTER: Yes, but, when you say to see a doctor. The trouble is that is it’s getting increasingly harder to get in to see a doctor. Because we’ve got a vast shortage of GPs in this country, and not just in rural areas. And heaven help you if you want to see a specialist within about five to six weeks - even if you’re paying.

CREAN: Yes, I agree with that. And so two things have to happen. We have to increase the numbers of doctors and I welcome the initiatives in this package that do that. We’ve been calling for them for some time and we won’t be seeking to stop those measures if they really do hit the mark, if they do achieve the result.

The second thing of course is that the reason it is difficult to get into hospitals as well is because the emergency wards of hospitals are clogged up with people who can’t find a doctor that bulk bills so they go to the local hospital. Now, if what you’re really trying to do is to ease the pressure on the hospitals as well as give families affordable health care. That’s why bulk billing has to be restored. It’s a simple proposition.

Now, of course, it involves a commitment of resources but it’s not as if we don’t have the resources, it’s a question of where they’re prioritised. And this Government has got its priorities wrong. And if we’re spending…

PRESENTER: Where would you get the resources from? What would you run down to fund this?

CREAN: Well, already in this package there is a base upon which we can build to restore bulk billing. They’ve acknowledged that you have to lift the patient rebate if you’re to do something to save bulk billing. In their case they only want to save it for concession card holders. I’m saying do it for the lot. Let’s have a look, initially at the existing health budget. Let’s have a look at where there can be a better prioritisation because I make the point, with $30 billion of health expenditure annually by the Commonwealth Government you must be able to secure the base upon which our system depends. You must be able to save Medicare by restoring bulk billing.

PRESENTER: Mr Crean, the incentives to doctors in the system, started at $1 a patient, if you like, the $5.50 or whatever they are, would you suggest that the incentives to doctors should have been far higher in order to help them, to entice them to bulk bill?

CREAN: Yes, well even the Government’s own package acknowledges that in rural and remote areas. I think they get up to…


PRESENTER: $5.50 in rural areas or something like that.

CREAN: Somewhere around $6.00. So the point is, there’s recognition that the incentive under the current system isn’t there to encourage more doctors to offer bulk billing. So the patient rebate does have to be addressed. The Government acknowledges it but it doesn’t go far enough.

PRESENTER: But wouldn’t you concede that by giving an incentive to doctors that the Federal Government’s not trying to destroy Medicare they’re trying to get more doctors to bulk bill?

CREAN: No, they’re not because they’re only requiring, they’re only giving the incentive to bulk bill concession card holders. There’s no incentive for all of the other Australian families, the millions of Australian families, any family above $32,000. There’s not one extra dollar of incentive to bulk bill them.

Now if the argument is right, Ross, this is my point, if they acknowledge the argument that you’ve got to lift the incentives to bulk bill concession card holders, why not go the next step and provide the incentives to bulk bill all customers?

PRESENTER: Because they feel Australians over that $30-35,000 threshold can afford to pay.

CREAN: Well I think you should go out, and I think John Howard and Kay Patterson should get real, they should get out into the community and ask people - on $32,300 a year - whether they consider themselves wealthy. And whether they feel, when they turn up to a doctor next time, they’ve got to put a co-payment across the table simply to see the doctor.

That is not a fair system. It is not a just system. And it’s not a system that Australians deserve. They’re already paying for a system - through their taxes - that guaranteed them access to a doctor that bulk bills. John Howard’s torn up that guarantee. What I’m saying is, we’ve got to re-establish it.

This is a fundamental fight that the community has to have. If they don’t stand and fight on this issue they will not be able to afford health care into the future. And I tell you what - I’m going to be leading that charge in terms of that fight.

Because, I do believe that people should have affordable health care. I don’t think families should have to think twice about going down to a doctor if their kids are sick. I think they should be entitled to know that they’ve got their kids best interests at heart. They shouldn’t have to go to a doctor with one child sick, get a prescription filled out and share the prescription with the


other kids in the family. That’s not health care. That causes further problems down the track.

And what I’m saying is, this is a question of priorities. This is a nation that committed itself to providing affordable health care but it’s a Government that’s torn up that contract. I’m going to restore it.

PRESENTER: Okay, let’s move on, shall we, to a somewhat related issue I guess in the sense that it involves health and that is the Pan-pharmaceuticals recall and the withdrawal from sale of a wide range of products. It could go into the thousands. Do you concur with Geraldine Moses, for example, from the Pharmaceuticals Society who said on this program this morning that the Government has given these vitamin manufacturers way way too much rope?

CREAN: Well I’m very interested in her comments and obviously they’re facts that need to be further established. But I think the first thing that needs to be done here, John is that the full information for the public is made known.

Where, actually, are the risks, what are the products and what are the manufacturers that this company has produced for? I think the very first step that has to be taken is for people’s minds to be put at ease. That they know which of these vitamins, or supplements, these complements, which of these are putting them at risk.

PRESENTER: It’s surprising the number, naïve of me I guess, did it come as a surprise to you that so much, like 70 per cent of these products were coming from the one manufacturer, were just badge engineers for it?

CREAN: Well, I didn’t know that particular percentage. But, I think that what it does highlight is that when you’ve got that significant a base providing to a whole range of manufacturers, it’s important to have the safeguards in place. And I think that’s an issue that has to be further investigated.

But the initial step, John, has to be - let’s put the public’s minds at rest. I mean, I heard the Health Minister last night, or the Parliamentary Secretary and she was hopeless quite frankly, because she couldn’t answer the question as to what was at risk and what wasn’t.

Now, if this is a Government, and it’s got it’s Therapeutic Goods Authority out there, knows it’s got a problem, it should have had the information ready to go, unequivocally, all of the information available so that the public mind could be put at rest.

The question as to whether or not too much leniency has happened, the question as to whether or not there’s got to be changes - that’s a matter for


resolution further down the track. But the immediate step has to be to ensure the safety of the public and that can only happen if they’re given full accurate, unequivocal information.

PRESENTER: I think there’s a list of products that will surface over the next few days and other companies and…

CREAN: Yes but my point, Ross, is it shouldn’t wait a couple of days. I mean, if this is a problem, if it’s a problem the information has to be out as soon as possible. Otherwise you’re going to have all of this unease, all of this uncertainty and you know what people are like, particularly when they’re on different sorts of medications. But in this case the vitamins, the complements; they rely on them on a regular basis. They need to know whether they’re safe. They’re in a routine, they’re given advice to take them, they’ve got to know that what they’re taking is what’s been prescribed.

PRESENTER: There is a very large advertisement in today’s Courier Mail that lists all the registration numbers of the various base products. And you can find those on the labels if you do want to check for yourself whether you’re in any doubt.

CREAN: Well again I just make the point that even this morning there was a lot of confusion as to which products were safe and which ones were not. I think that the immediate task is, lets get that information out as quickly as possible and that’s what I would urge.

PRESENTER: All right. Let’s move on again to another subject. Earlier on in the, in our involvement in the conflict in Iraq when I and a number of other Australians perceived you to be equivocating on whether or not you actually supported the men and women of the armed forces who had been committed to the fight by the Government, made me angry, made me, well use a fairly uncomplimentary remark, Mr Crean, I will hold my hand up and admit. You’ve since made it very clear that you’ve supported that. On the subject of our ongoing - well supported the troops, of course. On the subject of our ongoing relationship with the United States do you think it’s important for John Howard to visit George Bush at his ranch in Texas?

CREAN: Well I think it’s important that the relationship between Australia and the US, particularly through the US Alliance continue to be strengthened. My disappointment with the way in which things have evolved over the last six months is that the fundamental strength of that alliance which says international conflict be resolved through the United Nations wasn’t pursued to its fullest. And I think if it had been pursued to its fullest we could have had a result in Iraq without the killings.

I go on to make the point though, that it’s terribly important now in terms of that relationship that we get the UN into Iraq as the overriding authority for the reconstruction of Iraq. It’s terribly important in terms of the peace


keeping exercise and the humanitarian exercise. I think it’s a very dangerous circumstance where the peace keeping role is confined to just the allied forces that are in there - which we’re obliged to do under international conventions. I want the troops home as quickly as possible. The best way to get them home as quickly as possible is to get the UN mandate in there overseeing the reconstruction…

PRESENTER: Well I think that everyone wants the troops home as quickly as possible.

PRESENTER: Yes, well the Government’s saying…

CREAN: What he should be saying, what John Howard should be saying to George Bush is, `get the UN mandate in to oversee the reconstruction of Iraq’.

PRESENTER: All right. Has this not though, if not immediately, but then very much appearing to be turning out to be a case of the end justifying the means?

CREAN: Well I don’t think that the end ever justifies the means if innocent civilians are killed in the process. And we still haven’t seen the outcome, the final outcome, in terms of the figures on that. But the fact is it’s happened. It’s happened and the war is over. What we’ve got to get on now with is the task of reconstruction, and we should learn from the mistakes of the past I suppose. And if in fact the UN - that has experience in this area of reconstruction and humanitarian relief - get it in there. Spread the activity and get the reconstruction of Iraq happening as quickly as possible.

PRESENTER: Ok another issue. We’ve had a couple of boats of boat people heading our way recently. You’ve been fairly vocal about that in years gone by. How do you think the Government has handled it in the past and how do you think it should, would you make any changes to the way it’s being handled with this current situation?

CREAN: Yes. I think that, I said that what we really need is the international agreements - in particular with Indonesia - with our near neighbours that say that we will not receive people who come down who have been passed on from those countries. We had those arrangements with China previously, we still have them in place with Vietnam, from our Government’s operations.

We also need an international framework in which there’s consistency about the definition of what constitutes refugees and humanitarian so that the people smugglers can’t country-hop. That’s what happens at the moment. They get down to one country, they’re pushed on to another and they think they can get more favourable treatment. We need an international


framework. What Australia hasn’t done well, Ross, is to develop those agreements in our region.

PRESENTER: Particularly with Indonesia?

CREAN: And particularly with Indonesia.

PRESENTER: With Megawati.

CREAN: And if that agreement was in place we wouldn’t have had the potential problem that we faced with these boats of recent weeks.

PRESENTER: So you would be advocating that we should be looking at our Indonesia relationship a little more?

CREAN: Well, I think that we need to look at that on a broader scale. But, specifically for this, if we had the good relationship with Indonesia, my view is that we can secure the same sort of understanding with Indonesia that we had with China.

PRESENTER: OK time is getting away on us but very quickly, we have a report from a wire service this morning that Labor, yourself, and your Opposition Immigration Spokesman, Julia Gillard are calling for a wide ranging judicial inquiry into women and girls being brought into Australian for the sex trade.

CREAN: Well I think this is a terribly important issue and the Government seems to be acknowledging the problem but not prepared to do anything about it. Obviously people, and these are again - well you’d call them people smugglers - but people that play on human misery, play on their poverty, play on their disadvantage, get them here under false pretences and then subject them to awful sorts of commitments.

What we have got to do is to have the inquiry that gets at the source of this problem. That stops it at source. In the same way as we talked about agreements with these other countries, find out the source, prosecute them and ensure that we bring an end to this awful, antiquated system and demeaning system.

PRESENTER: And finally now, just moving back if we may briefly, to the leadership issue, what do you make of the commentators who say that what’s effectively happened here is that Kim Beazley has shut up and taken a step backwards and that you are being given a second chance through the budget session of Parliament to see how you perform and that after that it might well all be on again?

CREAN: I say that I’m not going to be distracted. I am determined - and you saw this yesterday and again today - I am determined to take the



fight up to the Howard Government to save Medicare. Why? Because I believe that it’s in the interests of all Australian families that they have affordable health care.

This is something that Labor Parties have fought for under Whitlam and Hawke and they are going to fight for them again under Crean. And I am committed, in Government, to restoring bulk billing and saving Medicare. But today we are launching the campaign to get public mobilisation to insist that Medicare be saved and bulk billing restored. That’s what I’m focused on totally.

PRESENTER: Mr Crean thank you for coming in and talking to us this morning. And if it’s any consolation we put a call into Kim Beazley’s office as well and he hasn’t returned ours either so, there you go.

CREAN: Ok well maybe you can put him through on a party line today.

PRESENTER: Okay. He’s got all my numbers. Good luck and thanks again for your time.