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Tuesday, 28 May 2002
Page: 2514


Mr SLIPPER (Parliamentary Secretary to the Minister for Finance and Administration) (9:34 PM) —in reply—I would like to express my gratitude to honourable members who have contributed to the debate on this very important topic, the Taxation Laws Amendment (Medicare Levy and Medicare Levy Surcharge) Bill 2002. The member for Lowe said that the Australian Labor Party supported Medicare and bulk-billing. The facts are on the record: the Howard government have supported Medicare, and we as a coalition are committed to a viable and universal publicly funded health system, which we all know as Medicare.

The coalition believe that all Australians should have access to a high-quality health care system. If one had listened to the speeches by honourable members opposite, one would have thought that the government are not so committed. The government have delivered a balanced health system, and we will continue to improve Australia's health system by reforming Commonwealth-state relations and by emphasising quality care and preventive treatment. The coalition will continue to provide Australians with a choice of private care combined with a quality public hospital system. That means that Australia will have an affordable high-quality and world-class health system for the 21st century. I suspect that anybody who stops for a moment and contemplates the quality of health care provided in Australia will have to admit that this country is particularly fortunate to have the world-class system to which many other countries can only aspire.

This bill reflects in a small way the government's commitment to keeping health care affordable. As honourable members who have been here for a while will understand, every year the threshold over which taxpayers are required to pay the Medicare levy is raised in line with the annual increase in the consumer price index. The phasing-in threshold is also raised for people who pay a partial levy, and there is an increase in the per child component of the low income threshold. The measure applies for the 2001-02 and later financial years.

With the increases, low-income taxpayers can receive more income and still be exempt from the Medicare levy or pay a reduced amount of levy. Honourable members will be pleased to understand that these measures are entirely beneficial. This bill ensures that where pensioners below age pension age do not have an income tax liability they will not have a Medicare levy liability. The increase in thresholds also affects liability for the Medicare levy surcharge. The increase in the low-income threshold also flows through to the individual low-income members of a couple.

People listening to this parliamentary broadcast will no doubt have shared the offence I experienced when I heard Labor members suggesting that this government does not support Medicare. I reiterate that this government is indeed committed to a viable and universal publicly funded health care system—Medicare—and the fact that we have given some incentives for private health insurance does not mean that the government does not support Medicare. As a government, we have no intention of allowing Australians to opt out of Medicare. Medicare will remain a universal system available to all Australians. All that is happening is that the government is restoring the balance between the public and private systems to what it was when Medicare was introduced.

The government rejects the second reading amendment moved by the honourable member for Perth. It is full of Labor propaganda and anyone reading it would understand that the Labor Party is clearly some distance from understanding the facts in relation to our health care system. One only has to draw the attention of the House to paragraph (3) of the second reading amendment where the Labor Party asks the House to note:

... that those who can afford private health insurance have been subject recently to substantial increases in premiums, on average $150 extra per year;

It is true that premiums have gone up but, if it had not been for the government's 30 per cent rebate, private health insurance would have continued to collapse, it would have been unsustainable and the public health system would not have been able to cope with the additional numbers of people who would have been forced to use it. The Labor Party ought to recognise this and give credit where it is due, and the government is of course particularly proud of the fact that we have brought in this rebate. It has made and kept private health insurance viable, and it gives people very real choice.

We will all recall that the Hon. Graham Richardson was Minister for Health in a former Labor government. He said:

Medicare was always intended to coexist with the private health system, not replace it.

However, if one ponders the utterances of Labor members, one would think that private health insurance is evil, that somehow it is inappropriate and that we ought not have it. Graham Richardson was a much more realistic representative of the Labor Party when he was the health minister and he pointed out that Medicare was always intended to coexist with private health insurance and not replace it.

The very fact that we are debating this bill tonight is evidence of the government's ongoing support for the Medicare system. The bill has the effect of exempting more people from the Medicare levy without in any way limiting the access of those people to health services. Under the coalition, Medicare has received its highest level of funding ever.

There has been some discussion in this debate about securing the future of the Pharmaceutical Benefits Scheme. There has been criticism of the very necessary measures included in the budget which were required to ensure the long-term sustainability of the Pharmaceutical Benefits Scheme. The Intergenerational Report, included as part of the budget for the first time, looked at where Australia would be in 40 years time. We recognise in the budget the need to maintain the Pharmaceutical Benefits Scheme and our actions in the budget ought not be looked upon—as the Labor Party would have people accept—as an attack on the PBS, rather they are underpinning the long-term sustainability of the Pharmaceutical Benefits Scheme. The measures were quite moderate and it was necessary to take steps now to make sure that, as we go on with a declining birthrate and an ageing population, Australia as a nation is able to continue to afford this very important underpinning of the health needs of Australians.

The copayment for prescriptions was increased, restoring the balance between what the government pays and the contribution patients make to the cost of their medicines. From 1 August 2002, concessional cardholders will pay an additional $1 per script, up from $3.60 to $4.60. General patients will pay up to an additional $6.20 per script, an increase from $22.40 to $28.60. People have suggested that this means that the minimum cost for scripts will be $28.60 for general patients and $4.60 for concessional cardholders. The fact is that if the cost of a script is less than the $28.60 or, for that matter, the $4.60, only the lower price will be paid. It is quite misleading to suggest that the cost of all scripts is going up to $28.60. Many cost less than that and those that do will remain costing less.

Concession cardholders will pay a maximum extra of $52 per year, which is $1 per script and, in effect, over a whole year would be no more than $1 per week. So I have to say that I very much regret the scare campaign which members of the Australian Labor Party are maintaining in the Australian community. They are trying to turn the Australian community against the very forward thinking and necessary measures contained in the budget, which is being debated in the chamber over the coming weeks. There were very many other benefits in the 2002 health budget—in relation to cancer treatment; arthritis; Visudyne therapy; palliative care; and $11.4 million towards the acquiring and stockpiling of a range of medicines, antidotes and vaccines to ensure a rapid and effective response to any acts of bioterrorism.

Something near and dear to my heart is the delivery of services to Australians in rural, regional and outer metropolitan Australia. The government is committed to creating a more equitable distribution of medical services across Australia. Programs from the 2000-01 budget's $562 million regional health strategy are currently ongoing. In addition, the 2002 budget provides a further $80 million to increase the number of doctors working in designated outer metropolitan areas by 150 and provides $9 million to continue access to Medicare claiming facilities through local pharmacies. Honourable members would also have been pleased to see the increase in funding to fight the scourge of drug abuse.

As I have said, Labor Party members have come in here and have endeavoured to mount a scare campaign against this government's commitment to make health care affordable for all Australians, to give all Australians access to health care services with priority according to clinical need and to provide a high quality of care. The government also emphasise the importance of Medicare and our very strong support for it, and we reject any suggestion by those opposite that we are in any way lacking in commitment to this important underpinning of our health care system. A policy of the government is to ensure that Medicare provides a universal and equitable health insurance system for all Australians regardless of age, income or disability. Those listening would be interested to know that the government is committed to maintaining Medicare in its entirety, including these principles of universality and equity.

There has also been a steady growth in expenditure on medical services and benefits, including rebates for general practitioner and specialist attendance. It ought to be noted that in the year 2002-03 these rebates are expected to be $8.3 billion, and this is in addition to the $7.1 billion to the states and territories under the Australian health care agreements. The current agreements focus on increasing public patient access and improving the efficiency and effectiveness of service delivery.

The member for Shortland in her speech referred to public hospital waiting lists. The states run these hospitals and, with the states receiving the benefit of the GST, it is about time the states appreciated that they do have an obligation to fund health. The Commonwealth is happy to continue to make its contribution, but it certainly is a disgusting cop-out to hear the state Labor governments simply allowing these long waiting lists for treatment to continue when, at the end of the day, the states do have an obligation to deliver health care in addition to the commitment which we as a government continue to give.

So the coalition will continue to improve Australia's health system by reforming Commonwealth-state relations and emphasising quality care and preventative treatment. We are not going to apologise for continuing to provide Australians with the choice of private health care combined with a quality public hospital system, and this means that we will continue as a nation to have an affordable, high-quality and world-class health system as we proceed through the 21st century. The government does thank honourable members for their support of the bill. We do reject the second reading amendment moved by the member for Perth.

Question put:

That the words proposed to be omitted (Mr Smith's amendment) stand part of the question.