Note: Where available, the PDF/Word icon below is provided to view the complete and fully formatted document
 Download Full Day's HansardDownload Full Day's Hansard    View Or Save XMLView/Save XML

Previous Fragment    Next Fragment
Monday, 12 November 1973
Page: 3152

Mr THORBURN (Cook) - I rise to speak on this matter of health insurance which I consider to be probably the most important social legislation that this Government will introduce into this place. It has been grossly and irresponsibly misrepresented by a number of organisations, the worst of which has probably been the Australian Medical Association.

Mr Nixon - Who wrote that?

Mr THORBURN - Will you be quiet?

The DEPUTY CHAIRMAN- Order! The last six or so speakers have been heard in relative silence. I hope that the same courtesy will be extended to the honourable member for Cook.

Mr THORBURN - The AMA has misrepresented this scheme. I was very interested to read, I think in last Friday's 'Canberra Times', a statement by Dr Repin that the Government had altered a number of things in the scheme and that this just showed the stand that was taken by the AMA, of course, was a correct stand. Let me say at this time that of all those who contributed to the great amount of debate and discussion that has gone on since the Green Paper of the Health Insurance Planning Committee was introduced into this Parliament - I remind the House that this was one of the few occasions on which a scheme has been presented to the Parliament and to the people who are interested in it - one of the poorer contributions was that of the Australian Medical Association. Many people who are associated with health care in Australia were prepared to come forth to debate and discuss the matter sensibly and to give up a great deal of their time to see whether this health scheme, whilst it may not have been exactly what they would have chosen themselves, was something that would be to the benefit of the Australian people.

It was only in the latter times of the public debate that the Australian Medical Association condescended to discuss with people involved in the Government any irregularities that it might have seen in the scheme, and I must say that its contribution was the least of all the contributions. Yet its members have decided to embark on a vast propaganda campaign against the Government's proposed health scheme. One can only imagine, because of its slowing down now following publication of the proposal contained in the White Paper on the Australian health insurance program which has been tabled in the Parliament and the impending legislation that will be placed before the Parliament, that it did not get the anticipated result from doctors and others to its fast funding scheme.

Two things have been grossly misrepresented to the people of Australia, and that misrepresentation has been very apparent in the correspondence that other members and I have received. I refer to the health schemes in Great Britain and Canada. The British national health service has received a great deal of criticism in this country from people who evidently are bent on seeing its failure and many of whom do not truly appreciate the significance of the scheme. It seems to me that the scheme has been quite a satisfactory one. Indeed, as time goes by, the scheme is improving. But there is no relationship between the scheme that the Australian Government is presenting to the Australian Parliament at this time and the British national health scheme. The 2 schemes are entirely different. They bear no comparison whatsoever. For example, the English scheme is a per capita scheme. It is based on a patient register. In other words, a medical practitioner is allowed to enrol up to a certain number of patients whom he is allowed to treat, and he gets a per capita payment for the number of people who appear on his register. The Australian scheme is exactly the opposite. It is different in every way. The general medical practitioner service here is based on doctors in private practice receiving a fee for service, and the Government's self insurance program is based exactly on this principle. In other words there will not be any change from the present practices of the general practitioner or from the right of people to choose their own practitioner. So the proposed scheme is exactly the same as the present scheme.

The AMA has represented the British scheme to the people of Australia as being a dismal failure. It is interesting to see just what the 'Lancet' of 30 June this year said in relation to the British scheme. It said that the British national health service has 'reached full adulthood not without blemishes but is virile and popular and indispensible' and 'that in every country, developed and developing, the growth in the costs of health services threatens to get out of hand'. It went on:

In the UK, the pace, judged by any of the several admittedly imperfect yardsticks is slower than elsewher

So I think the first thing that should concern the Australian people is that in most countries, certainly in most Western developing countries, the costs of health services are taking too much of the national resources. We are spending far too much above what we ought to spend on these services. I thought that the Minister for the Environment and Conservation (Dr Cass), when speaking recently, made a very valid point, that is, that it is most unlikely that in various areas people are healthier or unhealthier than in other places. It is interesting to look at the United States system, the costs of which have spiralled out of all proportions in recent years. Milton Ferris in his article 'Crisis and Change in America's Health system' said this:

It is a shocking fact that the United States has twice as many surgeons and twice as many surgical operations per capita as England and Wales, where surgeons are paid by salary.

I think honourable members can form their own opinion on what Milton Ferris and the Minister were getting at. The fact of the matter is that an over-utilisation of medical services can occur, and this has been the case in the United States where the costs of health services are totally out of proportion with what they oght to be in relation to the nation's resources.

Mr Cohen - If the schemes are so bad in this country why have conservative governments not repealed them?

Suggest corrections