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Wednesday, 14 September 1983
Page: 807


Mr CARLTON(9.15) —I refer to the provisions in original clause 12 of the Health Legislation Amendment Bill, together with the amendment moved by the Minister for Health. I point out to the House that this clause is the one which extends the Government contribution to medical services in Australia from 30c in the dollar to 85c in the dollar on the schedule fee. This is a critical clause in the Bill as far as we are concerned because it is one of the clauses which shift substantially the role of the Government in intervention in health care delivery in Australia. It is also a clause which extends substantially the clawing back of tax from people in the community for health services, as opposed to the provision of health services by private insurance or by private payment. The additional cost in a year of extending the Commonwealth contribution to the medical service in each individual case from 30c in the dollar to 85c in the dollar is of the order of $800m. It makes up a considerable proportion of the $1 .7 billion additional tax raised from taxpayers in Australia to bring in this Medicare measure.

We have the strongest possible objection to this clause. We propose to vote against it. We make it absolutely clear to the House and to the Australian people that we are totally opposed to extending the intervention of the Government into every single medical service from a 30c in the dollar subsidy to an 85c in the dollar subsidy. Let the stand we are making on this particular clause be perfectly clear. The amendment that the Minister has moved to this clause represents the 'substantial' concession wrung from the Minister by Senator Haines of the Australian Democrats. This is the amendment by which the Minister fulfils his contract with the Australian Democrats and enables them to salve their consciences in letting through the Senate last week the Health Insurance Commission regulations. This is the clause which the Australian Democrats will point to as their victory as they preside over the sacking of 5, 000 employees in the private health insurance funds.

This amendment will apply to anybody who amasses a total in one full year of $ 150 in gaps. The technical side of this may not be clear to all. If the sum of gaps between what the Government pays-the 85 per cent-and the schedule fee, over a series of medical consultations or procedures totals more than $150 in one year, the Government comes to the aid of the medical practitioners subsequently serving that patient and pays 100 per cent of the schedule fee thereafter. I point out to the House one particular quirk of this procedure. In the five months from 1 February that this will operate during the current financial year, the limit in this case of the sum of gaps is only $62.50. This means that anybody who undergoes any major surgical procedure in a hospital, with substantial medical attention during that period, with prior consultations, surgery visits and various items of attention by doctors in a hospital, may easily amass a total within the first couple of months of that five months period of $62.50 in gaps, if we can call it that. That means that from then until the end of the financial year the person concerned can go to any doctor, who will receive 100 per cent of the schedule fee direct from the taxpayer by agency of the Government. In the subsequent year it will be $150 before that position is arrived at, but again similarly it is possible in any major incident for a person to amass the $150 and thereafter practitioners are able to get 100 per cent of the schedule.

What is overlooked in this by Senator Haines of the Australian Democrats and possibly by the Minister, although I do not believe it would have been overlooked by the Minister because he treated the Australian Democrats so cynically in this exercise as he did with the post box proposal for the passing on of Medicare claims, is that it would be quite possible to meet Senator Haines 's original request-to allow the private health funds to insure for the gap-at much less than $150 a year. Was that ever asked of the private funds? Did Senator Haines even for a moment consider that the Minister might have been fobbing her off instead of putting this across to private funds as a possible way of extending their business and saving a few jobs at the edge? Was it even considered that the Minister might, with his alternative proposal, extend the government funds, that is, the taxpayers' funds, by $10m instead of saving jobs in the private funds? We totally oppose the procedure whereby the Government will intervene not to the extent of 30c in the dollar for each surgery consultation or medical procedure but to the extent of 85c in the dollar, with the clear intention of making the 85 per cent 100 per cent and thereby controlling the medical profession. We are totally opposed to the extension in a year of the use of $800m of taxpayers' funds to bring this about. We think it is a thoroughly bad deal. We totally oppose this amendment and we shall vote against it.