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Wednesday, 29 April 1987
Page: 2002

Senator TEAGUE(4.31) —The Liberal Party makes no apology for raising in the Senate this afternoon the following matter:

The hardship imposed on Australian families by the failure of the Hawke Government's health policies.

Labor spokesmen in the debate have not been convincing. They have admitted the deficiencies of the Medicare system, but they have not been able to maintain that in this chamber and they will not do so with the public in this election year. Our protest is at the Government's Medicare system, the costs that it imposes on Australian families and the inadequate access to health services that it provides to Australian families. We are not protesting about the adequacy of health professional services. Doctors and nurses are increasingly well trained. We do not receive from our constituents complaints about those noble professions and the exercise of that professional work. There is also increasing emphasis on good, preventive health measures in Australia.

Although we can all come up with improvements for the training of medical personnel, we are not concerned here with the actual delivery of one average health service. We are concerned about the burden that the Labor Government has placed on Australian families by way of cost and by limiting access. It is that which Australians are crying out for the Government to remedy. If this debate is only one instance of this election year debate in the community at large, let the people of Australia ask themselves whether they are better off after four years of this Labor Government's health schemes or whether they were better off under the previous Government's schemes. Are costs higher now? Of course they are. Is access more restricted, especially to hospitals? Of course it is. It is those concerns that we bring forward. There is hardship for Australian families and we want that to be well understood in this chamber.

The costs for health services to the average family have increased from $500 a year to $750 a year during the past four years under the Labor Government. That represents a 50 per cent increase in costs to the average Australian family. The rate of increase is rising at twice that of inflation. I am concerned about that, as is the Liberal Party. To be more concise for the purists who read Hansard, there has been an increase from $9.66 a week prior to the election of the Hawke Labor Government to a present cost of $14.30 a week. In round figures, there has been an increase from $10 a week to $15 a week, or from $500 a year to $750 a year, for the average family. Those real costs are being felt by the pockets of Australian families, which is why they are putting the thumbs down to the Labor Government's health delivery system. That is why Medicare is being rejected by those families that complain about the costs.

Let me give some examples that come together as to why health costs have gone up for the average family. Firstly, the Medicare levy pays for medical services; that is, when a person consults a doctor. It also pays for public care in a public hospital; that is, a person does not have a choice of doctor. Returning to Senator Coates's remarks just now about why even those on the lowest incomes take out private health insurance, the reason they do so is that they want a choice of doctor. They want to be able to go to even a public hospital and have the doctor of their choice. I remind Labor senators that half of the beds in public hospitals are private beds because the patients who go to even half of the public hospitals, let alone all the private hospitals, want to exercise their choice of doctor, the doctor who knows them best, who has their medical records and who has referred them to a particular specialist. They want that ability to choose; they do not want the willy-nilly doctor on roster that evening or afternoon in the hospital. That is why it is still sound for private medical health insurance to be taken out.

The Medicare levy was proposed by the Minister for Health (Dr Blewett) and by the Government as one per cent of taxable income. For the average family with a taxable income of $500 a week the Medicare levy is one per cent, or $5 a week. A family with an income of $1,000 a week-that is, a wealthy family-pays $10 a week. Despite the assurances before Medicare was introduced that the one per cent level would be maintained, lo and behold the levy was increased in the last Budget. For next year, it has gone up to 1.25 per cent of taxable income. Everyone's levy has gone up 25 per cent. This year, in the tradition, because it will take effect from 1 November, it has gone up by 14 1/2 per cent. When everyone pays their tax at the end of this financial year they must add on 14 1/2 per cent to the Medicare levy.

The second example concerns private health insurance. At the end of 1982, in the Fraser Government period, the cost of basic table hospital insurance in my state of South Australia was $7 a week. Because we had a full tax rebate for that payment-a third could be taken off-the net cost was $4.70. What is the cost now of insuring on the basic rate for the same hospital bed? It is $9.40. So not only have we gone from zero levy to one per cent and then 1.25 per cent; we have also gone from an effective $4.70 a week for private hospital cover to $9.40.

Thirdly, Medicare pays for only 85 per cent of a hospital or medical service. The other 15 per cent is called the gap and it is to be paid for by the user. People used to be able to insure for the gap, but that has been banned; they cannot insure for the gap. There was also a ceiling; the gap could not exceed $10 for a medical service. In the last Budget, the amount was increased to $20. In our day, pharmacy prescriptions used to be $4. Then they became $5. Now the maximum that the general public can pay for a prescription is $10-that decision was taken in the last Budget-except for those few items that cost the pharmaceutical industry less than $10. Fifty drugs have been taken off the free list, even for pensioners, who for the first time must pay for those 50 items directly.

The fourth example concerns tax deductions. I have said that, under the Fraser Government, all medical expenditure, including health insurance, was tax deductible. Not only have tax deductions for contributions to private medical and hospital insurance funds been wiped out by the Government; the Government has also wiped out the concessional expenditure rebate. In the past, as people filled in their tax returns they would write down the personal contributions they made; the amount of gaps-that is, the 15 per cents that they paid to their doctors-or what they paid to a hospital. If they had insured for the use of an ambulance, a dentist or a pharmacy item, all of those matters could be listed and they would gain a rebate and a third of that amount would go back into their pockets. That has all been wiped out. On whatever level we look at this question, the costs have gone up. As has been pointed out by my colleagues Senator Michael Baume and Senator Walters, in 1986, according to the official figures throughout the whole of the last calendar year, health costs increased by 26 per cent. That is nearly triple the rate of inflation. This has occurred because of the sorts of factors I have mentioned. It has occurred because the present Government maintains the Medicare monopoly which prevents competition in the provision of medical and hospital services.

Senator Coates —Oh!

Senator TEAGUE —It does. It has also eliminated the subsidy from the private hospital system and the reduction in the reinsurance trust fund, as a consequence, has forced up the contribution rate for private health insurance. No one can argue about that. Because of the Government's decisions there are additional health costs to the public.

I have already mentioned the increase in the maximum gap for a doctor's consultation from $10 to $20. This includes prescription items as well. When we take all these matters into account, there has been a 26 per cent increase. This is the matter which is the burden of our debate in the Senate today. It is not that if a person can get to a doctor or a hospital, or if he can get the services of a nurse, his treatment will be any the less. They provide professional, good services. But the cost and the delay in getting to that doctor or to the hospital as a result of the structure this Government has applied in Medicare has become such a large burden that this is one of the major election issues in this election year.

I turn again to the general summary that I mentioned at the beginning. Because of the Government's structuring of Medicare, health service costs to the average family are 50 per cent more now than they were before this Government was elected. The rate of increase in that cost is twice the rate of inflation. Let me turn to access, the insecurity that Australian families have in regard to health services. I acknowledge that, to some extent, this has arisen because of an increase in the general number of surgery cases in our hospitals. It also has arisen to some extent in particular hospitals because of a shortage of nurses. Nevertheless, I make the point most assuredly that the biggest factor is the Medicare factor. Let me quote from an article in the Age last month regarding Professor David Penington. It states:

Professor David Penington, who has advised federal and state governments on health policy, said the community rightly expected to have access to public hospitals in return for the 1.25 per cent Medicare levy.

Speaking in a personal capacity, Professor Penington said demand for public hospital services, which were becoming increasingly sophisticated and expensive, was not being met because public hospital budgets were being squeezed by shortfalls in Medicare funding.

He makes the point that Medicare is a major reason for the lack of access to the hospitals. The article continues:

The average expected waiting time for elective surgery for all specialists in Victoria was 2.85 months on 1 January.

. . . .

The waiting time for ear, nose and throat surgery at the Royal Melbourne Hospital is 37.8 months; for vascular surgery 20.8 months.

Members of the Australian public are saying: `We are paying 50 per cent more in costs; surely we ought to get an improved service'. They are getting a worse service. That is why they condemn the socialist scheme of Medicare and its inability to provide a low cost accessible health service for the average Australian family. That is why we will reform it. Many a statement is made in Australia today that the present Hawke Labor Government has adopted many of the Liberal policies. We hear it said about defence, about monetary matters, about the exchange rate and about the Minister for Industry, Technology and Commerce (Senator Button), the good Minister sitting opposite, with regard to his tariff reforms that have gone entirely in the right direction. Whilst that is said about a number of cases of the present Government adopting Liberal policies, it is never said about health because Medicare is as clear an example of a socialist scheme that is still retained in Australia. It is not effective or efficient. The public knows this because of its costs and because of its denial of access. It needs drastic reform, and the only way that can be achieved is by a change of government. The way to obtain a solution to the costs and the restricted access to health services in Australia is to change from a socialist government to a Liberal government. That will be the way to gain a solution to this matter for Australian families.

The ACTING DEPUTY PRESIDENT (Senator MacGibbon) —Order! The honourable senator's time has expired.