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Wednesday, 14 September 1983
Page: 821

Dr BLEWETT (Minister for Health)(10.56) —I have argued at length that the fears of the impact of this measure on doctors' freedom, the fears of the impact of this measure on doctors' incomes and the fears of the impact of this measure on overservicing are grossly exaggerated. But just let me try briefly to deal with a couple of specific points raised on this occasion without going over this whole dreary debate again. I must say that there is illogic in much of what the Opposition is arguing. If it claims that the problem with bulk billing is that it removes the moiety, why does it not strongly argue against gap insurance which equally removes the moiety? It is true that in some ways bulk billing removes the moiety for the poorer sections of the population and removing gap insurance removes the moiety for the better off section of the population, but if there is a problem that arises from people not paying a moiety, that is as true of those who have got gap insurance and are charged the schedule fee as it is of people who are directly billed. I really think that if we look at this overservicing problem we will agree that it is a problem of insurance. I do not think there is much evidence to suggest that this change in direct billing, accompanied as it is by cutting back on gap insurance, will increase that overservicing problem. If honourable members look at clause 57 of the Bill, they will see that we have taken up the specific recommendations made by the Joint Committee of Public Accounts in relation to better administrative ways of dealing with direct billing in order to protect against fraud and overservicing. Those recommendations of the Public Accounts Committee are taken account of in clause 57 of the Bill.

In relation to the point raised by the honourable member for Bass (Mr Newman) the problem at present, which explains the very great delays, is that we have got a very complicated system. Each direct billing claim has to be checked to see whether the person who has been direct billed is entitled to that direct bill and the person has to fall into one of those protected categories. Then the numbers have to be identified in relation to pension cards and health care cards . In addition, before this Government rightly fell from office it added to the complications by increasing the social security number by two and adding further checks that had to be carried out. So we are now faced with a bureaucratic maze of cross-checking between the number on the assignment voucher and the entitlement records of the Department of Social Security. This is the major reason for the current-I agree with the honourable member for Bass-quite unacceptable delay in doctors receiving payment for the direct billing claims. Indeed, the introduction of these checks by the previous Government earlier in the year has increased the number of claims being rejected from 5.5 per cent to 14 per cent and therefore increased the number of claims requiring double checking and double handling by over 150 per cent. Under Medicare, because all that type of checking is not required, the doctor will be free to direct bill any patient, and then all of that bureaucratic maze can be avoided, plus the fact that we will be using a much superior computer system through the Health Insurance Commission than the somewhat obsolete system that we have now. I must also point out that another problem that the previous Government bequeathed us was that bulk billing has been increasing because the dole queues have been increasing. The previous Government had made no effort to provide extra staff to handle the increased number of direct billing problems arising as a result of increases in unemployment and, therefore, increases in the number of people entitled to direct billing. We have taken action in that field by increasing temporarily by over 111 the staff dealing with these problems to try to speed up that quite unacceptable delay. I am very confident that under Medicare, because of all of those checks being removed, that will not be a problem.

The employment issue was dragged into the debate on this clause. The Deputy Chairman did not object, so I will briefly respond to it. The figure for the potential problem of unemployment in private insurance funds has always been grossly exaggerated. It is not sustainable by any examination of employment in the private funds. These figures have been regularly peddled without any examination, so they are exaggerated figures to start with.

Mr MacKellar —How? Detail how they are exaggerated.

Dr BLEWETT —If the honourable member looks at total employment in the private insurance industry, he will see that the potential threat is to some 4,000 jobs. Let me talk about those 4,000 jobs. There are some 2,500 positions in the Health Insurance Commission. Some of those are part time, so the total number of jobs would be about 2,800. There is a significant element of part time employment in the health insurance industry. In addition, the honourable member for Bradfield (Mr Connolly) raised the matter of the non-coincidence of the employment pattern ; that we would be taking on employees in the Health Insurance Commission in October-November and the private funds would still require all of their staff until February-March. That has been coped with by providing that, apart from private health fund employees, employees taken on in this early period would be temporary employees. So private fund people would be able to stay on with their fund while they were being used and then transfer to the Health Insurance Commission.

Indeed, the efforts we have made to cope with the problems we recognise compares more than favourably with the way the Health Insurance Commission was required to run down its staff in the previous period. If the private health insurance funds are genuinely non-profit organisations, with the protections we have given them in relation to administrative costs, they should be able to cope with perhaps slightly surplus employment for a relatively short period, again given the turnover that takes place in the private health insurance industry.

The DEPUTY CHAIRMAN (Mr Millar) —I call the honourable member for Bass.