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Wednesday, 31 August 1994
Page: 700

Senator KNOWLES (4.06 p.m.) —Today we are debating a matter of public importance proposed by Senator Bob Woods relating to the government's continued failure to understand the extent of the crisis in health funding in Australia and its failure to devise the correct policy response. One of the best ways for us to try to get some decent answers in this place would be for the government, if it really treated this issue seriously, to give us a minister in the Senate who could understand and respond to the serious questions being asked.

  The comments today of the Minister for Family Services, Senator Crowley, were nothing short of very disturbing. For a minister in this place to stand up and say that Medicare is the solve-all and be-all of everything and that there is nothing wrong with the health system is just appalling. The suggestion that there are no waiting lists and that this matter is of no concern bears no relevance whatsoever to the reality faced by those who are on waiting lists. One day Senator Crowley may well be on a waiting list. Needless to say, as a high income earner and as a Labor member of parliament, she is not privately health insured. I hope for her sake that she does not end up on the back end of a waiting list because that is when she will find out what the reality is.

  The minister then tried to say how wonderful the public hospital system is for patients who have heart attacks, because they are taken to a public hospital. Could Senator Crowley tell me where emergency patients are generally taken when they have a heart attack? Of course they are taken to public hospitals and invariably they are then transferred to the private hospital of their choice. They can choose to be transferred. We have been down that track.

   The problem is that Senator Crowley does not understand all of the ramifications of what is going on. To say that there is no problem flies straight in the face of what former senator Graham Richardson said when he was health minister and also what the current Minister for Human Services and Health, Dr Lawrence, is saying—that is, that the whole system needs to be reformed. If they were to take Senator Crowley's advice they would sit on their hands and do nothing. What has happened today is the next best thing to doing nothing. What has happened today has not pinpointed the problems so that they can be resolved. The continuing false argument—I do not know what Senator Crowley is trying to say—about waiting lists is very serious.

  Senator Crowley also added that the measure announced today will put premiums up. Senator Crowley said that with some pride. I would suggest that increased premiums will be a further disincentive for people to join the private health insurance system. There was a 70 per cent coverage rate by private health insurance in the pre-1984 era. However, since the introduction of Medicare that rate has dropped to 37.2 per cent.

  She is talking here about Medicare being so wonderful, and how we can indulge ourselves further by increasing health insurance. It is just remarkable. She mentioned in the Senate, and the minister for health mentioned in her press release, that people are voting with their feet and getting out of private health insurance schemes. That is quite right, to one extent: they have to because they are being booted out. They are feeling the force of a foot, all right. They are feeling the force of a foot right in the backside that is pushing them out on an economic basis.

  This government could not give a continental about that. It could not care that it is forcing more and more people out of a system because they can no longer afford to pay it. This government must recognise that it is pushing the system out of the reach of so many ordinary Australians. The number of pensioners who are actually insured in the private health insurance system at their personal expense is extraordinarily high. Why? Because they do not trust Medicare. Why? Because when they might need a hip replacement, they cannot get one. Why? Because when they might need a cataract operation, they cannot get one.

  Therefore, this government has a responsibility to make private health insurance more affordable. But it is not doing that. The issue of gap insurance, for example, has long been a stumbling block for this government. The latest attempt by Dr Lawrence is this preferred provider plan which allows insurers to make deals on fees with doctors in private hospitals, allowing them to set lower insurance premiums for people who agree to be treated by such providers.

  That might sound good on the surface, but let us have a look at the reality of the whole situation. There will be, as Dr Nelson said, the possibility of monopolies and oligopolies. But does this government care about that? No, it does not care about the oligopolies. It could not care less. The government must know that there is a crisis, and yet the minister for health refuses to speak to the doctors.

  Dr Nelson, the federal president of the AMA, has phoned the minister for health three days in a row and she refuses to return his phone calls. Until such time as there is some determined attack on this, we will see a further decline of the private health insurance system. In her press release today, the minister said, `In recent times consumers have been voting with their feet.' As I say, they have been doing that quite clearly for very obvious reasons.

  She also went on to say that the private health insurance industry is an important and successful part of our health system. Well, bully for her! Why then have government policies been so determined to run that very same system down? Insurers can offer preferred provider packages which will supposedly offer reduced premiums, but they lose their rights. Where can they then start to have a total right of where they want to go, and why should they not have a right? Everybody should have a right. But once again, what we are talking about is further government control.

  It is very serious in those states, such as mine, where there is a monopoly—and I am not saying that the Hospital Benefit Fund is not a superb private health insurer. As a member of it, I know that it is a superb private health insurer. But the fact of the matter, as Senator Woods has already said, is that there is a risk that these private health insurance companies who own hospitals can then manipulate the system. I do not want to see that risk being run, but this government does not seem to care about that.

  If there is one certain outcome from Dr Lawrence's submission to cabinet this morning, it is more uncertainty and a less clear future for people who need to get into private health insurance. The private health insurers will be given more power than is desirable in the preferred provider plan, and that is something that we need to focus upon.