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Tuesday, 9 September 2003
Page: 14660

Senator LEES (5:15 PM) —It seems that today there is general support by all sections of the chamber for the Health Legislation Amendment (Private Health Insurance Reform) Bill 2003. I will not speak for very long, but I want to make a couple of points. It is yet another example of what is almost an obsession of this government with private health insurance. Again we are tinkering with the rules to try and somehow make it more efficient and effective. The fact that the most efficient and effective system is our Medicare system seems to escape those who are drawing up our health policy and health legislation.

This bill effectively changes the way in which community rating will be assessed and monitored. Community rating is basically the system that makes sure that funds provide support for, and accept as members, those Australians who are the sickest. Obviously, they are the most expensive members of our community, and the funds would much prefer to have as members of their insured community people who are fit and well and who therefore rarely call on their finances for support.

I think the legislation will go through without any dissent. After listening to the previous speakers, I think there is a range of issues, but it will all come back to the health system itself and its structure—which is what the three-day health summit was about—rather than just funding. It will come back to looking at how the system is actually structured. This government seems to be locked into a silo-by-silo model where it is a matter of private versus public and states versus the Commonwealth, where there are a lot of opportunities to pass the buck, to pass the blame to somebody else when something goes wrong, to shift costs if possible. Indeed, in various Senate inquiries we have found people actually employed out there to do nothing but shift costs from one level of government to the other. This all makes for an enormous amount of waste, for considerable inefficiency. We can still all confidently say that our health system is a good one, but some major problems are emerging and some major cracks are appearing. Perhaps the most obvious is that now we rank only 17th in the world when it comes to equity of access.

It would be a really pleasant change for us in this chamber to spend some time debating those health issues that are really critical. If we as a nation, as a community, actually want to begin with our highest priority, I would argue that we should begin with those Australians who are the sickest—look at where the system is failing them and look at how we as a nation should begin to do something for those amongst us that are faced with chronic illness.

There is no group in our community as badly off for basic services as Indigenous Australians. Yet we know what works. It is not a matter of saying that we need another trial or saying that we should go out and have another committee inquiry. We know that what works are community Aboriginal-controlled health services where Indigenous peoples have a say in the level of services in various areas and set their priorities. We know this works. Looking at the funds pooling model in the Territory, we know what works, we know where there are really good and positive results. I congratulate this government for increasing the amount of money that has gone to Indigenous health, but these new funding models, these pool funding systems, can only operate in 10 out of the 21 Northern Territory zones, because we only have about half the funding we need to make sure that all the Indigenous communities out there have access just to the same level of services, the same amount of money, as the rest of us.

I say this to the government: while this piece of legislation will obviously get through today, how about bringing before us some ideas, some extra funding packages? Let us really concentrate on the areas of our health system that are in need, not have yet another example of tinkering with private health insurance and somehow hoping that we will get a model that is sustainable without the billions of dollars of subsidy that the government is pouring into it at the moment.