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Wednesday, 22 August 1979
Page: 452

Dr BLEWETT (Bonython) -The speech of the Minister for Health (Mr Hunt) fell into the usual pattern of his speeches on matters of public importance. It was in two parts. Firstly, we had his stale rhetoric on the actions of the Whitlam Government and, secondly, we had his quite incredible display of complacency about the mess over which he now presides. I will discuss briefly both of these matters. Firstly, in reference to the Whitlam Government's period of office, it is quite clear from the results of every gallup poll that what the Australian people are now interested in is the health scheme for which the Minister is responsible. After four years of ad hockery- of jumping, twisting, turning and changing the policies- he is completely responsible for the health policies under which we now live.

The other feature of his speech, which is a feature of all his speeches on matters of public importance, was the kind of complacency he displayed about the whole situation, about what his Government is doing. In this regard I refer him to a speech of the honourable member for Murray (Mr Lloyd), who in my view is the only man on the Government side who talks about health insurance reasonably and with some sense of humanity. On 4 June 1979 he commented on the scheme about which the Minister is so complacent. He talked about the withdrawal of the 40 per cent government subsidy, which the Minister has defended, as being an abortion. He regretted the changes that had taken place; he worried about the 20 per cent maximum payment and the way in which it would operate. More importantly- I will be very interested to hear his comments today- he said even at that stage:

This raises the parallel problem that chronically ill people are presently placed under financial stress by repeated medical benefit prescriptions at $2.50 a time.

This amount has been raised. There is at least one honourable member on the Government side who is seriously concerned and who is not complacent about what is being done to the health schemes of this country for which the Minister is responsible. Within a period of 18 months at the most the Minister will be called to reckoning in relation to those schemes. It will be of no use his uttering the stale rhetoric about what happened in 1972-75.

I think that it is important to see, as my colleague the honourable member for Prospect (Dr Klugman) did, this health insurance scheme as part of a strategy now being pursued by this Government to add to the financial burdens of the ordinary people while still conveying the illusion of its being a low tax government. It has embarked upon increasing the burden of the ordinary citizen in a number of ways. But there are three characteristics that run through this evasive strategy. Firstly, the Government uses a fine principle with which we all agree- but it uses it in a shoddy way- to defend what it is doing. But the real reason for its actions simply is the Budget deficit. Secondly, it has little concern for the equity of its proposals. Thirdly, and quite surprisingly, it rather ignores the inflationary potential of its proposals. We can relate this approach both to the matter before the House now and to the petrol levy.

For instance, in regard to the petrol levy, quite clearly the principle being used is one with which we all agree, namely, that we must conserve energy resources. However, we all know that the energy situation of Australia would allow us to do that in a more gradual way. That fine principle is being used simply to solve the deficit problems of the Government. The petrol levy is designed to save the deficit, not Australian energy supplies. Equally, the excuse offered time and time again by the Minister for Health for health insurance changes is the spiralling health costs in this country. We all agree that those costs have to be faced. But the Minister knows and his party knows that that is not the reason for the introduction of these changes. They were introduced simply to solve the immediate deficit problems of the Government.

In the case of both the petrol levy and the health insurance changes there is no real concern for the equity problems that arise. A lot of work has yet to be done regarding the petrol levy but I have no doubt that it will prove to be a highly regressive tax in the way in which the burden is felt in this community. Thirdly, the inflationary potential of both the petrol levy and these health insurance changes seems to have been neglected. Surely these problems could have been faced without adding to the kind of inflationary impact that they will have on society. Those measures are part of a strategy. We have to see them in terms of a strategy in which the Government maintains the illusion of being a low tax government by these kinds of evasive devices.

If we look at the costs that will be imposed on the ordinary person as a result of these health insurance changes and if we look at the situation in all the States- I know that the increases are different in Queensland and that they are very different in my own State, so we have to try to average them out- we find that as a conservative estimate people will be paying an extra $100 a year for a basic cover. For some forms of full cover people will be paying an extra $200 a year. But, as a conservative estimate right across the board, people will be paying an extra $100 a year from 1 September 1979 for basic hospital and medical cover. Thus the tax relief amounting to $4 a week which will follow the promised abolition of the tax surcharge from 1 December 1 979 will be almost completely eaten up over the course of the year by the increased premiums paid by those who cover themselves with health insurance.

The general expectation in the community and certainly amongst the health funds is that there will be some increase in the number of those who simply abandon insurance. Before these changes were announced we knew that approximately 25 per cent of the population was not insured. Indeed, Mr Mansfield of the Voluntary Health Insurance Association of Australia fears that there will be a massive drop-out by contributors because voluntary health insurance is pricing itself out of the community's reach. Who will contract out? If we are to adopt a responsible system we have to look at these things. Firstly, there are people who will not be able to afford the $8, $9 or $10 a week basic cover. People will drop out simply because the burden has become too great. In many instances people will do this unwisely and problems will be created for them, but they will drop out of health insurance because of the weekly cost burden. Secondly, many young and healthy people will tend to drop out of the health funds, because if people are reasonably young and healthy they will be prepared to take the risk of not paying health insurance. Thirdly, some wealthy people in our community will drop out of the health funds because they have the resources to meet major medical or hospital costs. In addition they can claim these costs as a tax deduction. These are the types of people who will drop out of health insurance: Those who cannot afford it, the young and the healthy, and the wealthy people in the community who have the resources to meet unexpected medical costs. In other words, the whole universal system of health insurance cover is already compromised and is likely to be increasingly compromised.

One of the real worries in the community- I think this is why in the latest gallup polls health is beginning to turn up again as a major matter of social concern in this community- is that we are returning to the pre-Medibank system. We now have approximately 80 competing private insurance funds, with all their overheads, administrative costs and advertising costs.

Mr Hunt - We have had them all along.

Dr BLEWETT -But you are giving them a much bigger share of the market. You have brought the situation back to that of the preMedibank period. The whole of the Government's policy has been to bring the private health agencies back into the centre of health insurance in this country. We are running into exactly the same problems as those we encountered with them prior to 1972. Increasingly people are being faced with a complex and puzzling set of options. The Sax report pointed out that one of the principles of any medical insurance system should be at least to provide relatively simple options so that people can make rational choices. I have said already that a significant proportion of the population is not covered by health insurance. One of the reasons why we had to alter the health system in the early 1970s is that a significant part of the population was in no way covered. Finally, the insurance burden is inequitable in its incidence and increasingly burdensome on the ordinary members of the community.

The Minister said- I agree with him- that the community pays the bill in one way or another. It has become a platitude. It is a very favourite one of his. But we can agree with it. In one way or another, through tax, levy, insurance or some other system, the community will pay the bill. But what we say- and this is the basis of the policies we will be compelled to introduce either at the end of next year or even at the end of this year if things go well- is that in determining this bill we will be guided by four principles which the Government has neglected. Firstly, the system must be efficient. The mounting evidence of the kind of mess we are now in shows that it is not an efficient system. Secondly, the burden has to be spread equitably; that is, we have to have a system which is equitable. That means bringing most people into the system so that the burden of health care costs in this community rests not on a narrowing group of the sick but right across the community. Thirdly, it has to be simple. We have to have a relatively simple system. Fourthly, above all, it has to be a universal system. I am suggesting that they are the principles upon which the Government needs to judge its policy. The Government will have to change its policy again. Let us be quite frank. If the Government survives for more than six months it will have to change its present health policy. I suggest that next time the Minister, rather than allowing the

Budget deficit to dominate his thinking and being told what to do by the Treasury officials, should work towards a scheme which is firstly efficient, secondly equitable, thirdly simple and fourthly universal.


Order! The honourable member's time has expired.

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