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Monday, 25 June 2018
Page: 3815


Senator DI NATALE (VictoriaLeader of the Australian Greens) (17:51): When you consider what we're elected to do in this place, and when you consider what the role of government is, there is nothing more important than ensuring that we provide a health system that looks after people. Election after election, people tell us they want their governments to invest in health care. They want their governments to ensure that there is a health system that they know will look after them if they're sick and will look after their loved ones if they become unwell. Of course, Medicare and our public hospital system are the fundamental pillars of our health system. They are absolutely critical if we're to ensure that people are looked after.

We know that Australians value decent health care. We know that Australians, when asked the questions, 'Would you prefer to have a tax cut?' versus: 'Or would you prefer to have a greater investment in Medicare, ensuring that you and your children aren't faced with big out-of-pocket costs? Would you prefer to have Medicare funded dental care?' always tell us: 'We want to see a better health system. We want to see schools that are well funded.' And that's why I'm glad that Centre Alliance have put this issue on the agenda.

It was just last week that they sided with the government to lock in $140 billion worth of tax cuts—tax cuts that will go disproportionately to people on high incomes and tax cuts that will ensure that bankers, CEOs and politicians get an extra $11,000 in their back pocket while a few hundred dollars in scraps are given to people on lower incomes. The consequence of that decision is that we have less funding available for all manner of public services, with our health system chief among them. You can't rip $144 billion from the health system and expect it to be able to function in a way that you want.

We have a very good health system, but we can do better. Compared to spending right across similar countries, we spend about average; it's approaching 10 per cent of GDP on health care. When you look at what the US spend, it's something like 17 per cent of their GDP on health—with much worse health outcomes. So we've got a pretty good system, but there are challenges.

A PwC report last year for Australian Unity showed that by 2040 we're going to need an additional $57 billion in capital costs and an additional $30 billion in annual operating costs for both aged care and hospitals. There needs to be a much greater investment over the next few decades. Yet when you see the $144 billion in tax cuts—and now we have a debate this week around cuts to the company tax rate—it's hard to see how we're going to be able to find the revenue to invest in those things. What's the consequence? The consequence is that people on public waiting lists, waiting to have their hips done, are going to have to wait longer. A family with a sick child at midnight in an emergency department is going to have to wait longer before their child is seen.

There are already huge pressures on our hospital system. When you consider what the Abbott government did in scrapping the National Health Agreement when they were the first elected, it ripped billions out of our hospital system. There are huge challenges. We continue to give $6½ billion—and growing—in a wasteful subsidy to the private health insurance industry. And of course when we talk about transparency in our health system, that is one area where people tell us that they are sick and tired of the big up-front, out-of-pocket costs they face when they get health care within a private hospital. We know there are a few rogue operators; we know that, and we welcome some of the measures addressed to make sure that there is transparency around the costs that some rogue doctors are charging. But the problem's a systemic one. We can't predict whether there's going to be a complication. We can't predict what the course of treatment might look like for each individual person. Therefore, it's very hard to say to somebody, 'Well, here are the out-of-pocket costs you're facing if you utilise the system through a private provider.' You simply can't do that.

The best investment we have is ensuring that every cent is invested in our public hospitals, in Medicare, in all the foundations that we know lead to better health outcomes and a better use of the taxpayer dollar. If we did this right we could have Medicare funded dental care. If we didn't give tax cuts to people who don't need them, if we didn't give tax cuts to some of the wealthiest companies, every person in this country would be able to access a dentist and have it funded through Medicare. We need to do much better, and the way to do that is to ensure that we've got the revenue base to invest in our health system.