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Thursday, 27 November 2014
Page: 9564


Senator DI NATALE (Victoria) (15:33): I move:

That the Senate take note of the answer given by the Assistant Minister for Health, Senator Nash, to a question without notice asked by Senator Di Natale today relating to co-payments for medical services.

It is hard to escape the conclusion that what we are witnessing is a government unravelling here. It seems that the current government has taken only a year to get to where the previous government got to after at least two years. We have a Prime Minister who leaked to a number of senior journalists: 'The GP payment's gone. It's dead. We're not going to proceed with it. It's one of the barnacles that's going to be cleared away.' Then this morning we heard the Leader of the Government in the Senate, Senator Abetz, state, 'Actually this thing is back on life support.' We have a Minister for Health who suggests that indeed the issue is going to be prosecuted, perhaps not via a co-payment introduced through legislation but through a mechanism whereby regulation is introduced.

The co-payment was a dog of a policy, but at least there were some protections built in for concession card holders, for kids, for pensioners. If this policy is to be introduced through regulation, they are gone. It will make a terrible policy much, much worse. You are basically giving a hit to everybody, to the poorest and most vulnerable people in society, without any protection. The government is currently refusing to rule out introducing the co-payment through regulation.

And why are we having this debate? It is a debate based on a lie. The idea that healthcare spending is unsustainable is just nonsense. We have one of the most efficient health systems anywhere in the world. We spend about nine per cent of our GDP on health. The US spend double what we spend and they get much worse health care. We are rightly proud of the primary healthcare system that is delivered and funded through Medicare. We are rightly proud of it. We do not want it to be dismantled.

The Minister for Health said, this very morning, 'The last thing we want in Medicare is greater complexity.' He made that statement in response to a question. Well, what does the AMA have to say about the co-payment that he so desperately wants to see introduced? The AMA says:

… the co-payment also added yet another layer of administrative complexity and red tape for general practice: "Simple bulk billing will now be replaced with a complex system of part payments by patients …

Again, we have a minister saying one thing and doing another. If the last thing you want to do is introduce greater complexity into Medicare, why proceed with the co-payment? Put this dog of a policy to bed. Put it in the graveyard of bad ideas. That graveyard is getting mighty crowded at the moment. But let us knock it off and let us not send a ransom note to the people in the community who would benefit from an investment in medical research. We have got a government that is effectively blackmailing the Australian community: 'Support the co-payment or medical research gets it in the neck.' That is what the government is effectively saying to members of the Australian community. It is a bad way to do policy. It is a policy that should either stand or fall on its own.

We support the Medical Research Future Fund. We think it is a good idea. It is one of the few good ideas that was released in the previous budget. So let's ensure that we work together with those members from the opposition and the crossbenches who want to see a greater investment in medical research, who support the model that has been proposed by the government but do not want to see it funded on the back of the sickest and poorest members of our community.

What we have effectively at the moment is a government that appears to be unravelling: the left arm not knowing what the right arm is doing. It is creating a deal of uncertainty for those members of the community who are sick, have chronic disease and need to visit their GP on a regular basis.

If the policy was going to save some money at the expense of fairness, there may be an argument for why we should proceed—not one I would agree with but at least some sort of logic behind the premise. The problem with this policy is not only is it unfair and inflict a burden on those people who can least afford it but it just imposes costs down the line. Those people who will be deferred who will respond to a price signal—in the government's own words—are the ones who are most likely to end up in emergency departments, because their chronic disease is not being managed. Let's put it to bed, let's move on and let's salvage the Medical Research Future Fund.

Question agreed to.