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Thursday, 6 December 1973
Page: 4425

Mr McKENZIE (Diamond Valley) - It is a privilege to speak in this debate, which I believe is one of the great debates of the current session of Parliament. I am convinced that the people of Australia need the standard of health services that only this legislation can provide. I was greatly surprised earlier this afternoon at the remarks of thehonourable member for Hotham (Mr Chipp). I thought that he would have been prepared to argue the case on its merits. However, he spent a great deal of time name calling. He referred to the Minister for Services and Property (Mr Daly) as a hatchet man and then went on - quite incorrectly - to use phrases such as socialised medicine, nationalising doctors, nationalised medicine and the socialist Minister in Canberra. The honourable member for Hotham's facade of reasonableness was stripped away once and for all.

We have just heard a speech from the honourable member for Chisholm (Mr Staley) in which he made reference to the debate at the National Press Club luncheon between the Prime Minister (Mr Whitlam) and the Leader of the Opposition (Mr Snedden). I watched the debate on television and, allowing for my natural bias in this matter, I would say that the Prime Minister won hands down. But in any case, in reality what the Prime Minister said was that if the people decided next Saturday to give the Australian Government power to legislate with regard to incomes this Government would implement the decision of the Medical Fees Tribunal. It is well known to the people of Australia that many people who earn money by way of salary or wage have their incomes regulated. I would think that one of the very good arguments that would persuade the people of Australia to vote 'Yes, Yes' on Saturday would be the knowledge that, if we had this sort of control, there would be regulation of doctors fees, medical fees generally, legal fees and other things. I believe that in the sort of society to which honourable members on both sides of the House purport to want to belong, this is the sort of thing we all wish to see happen.

What are the results of the present health scheme which has been so lauded by speakers from the other side of the House? I wish to refer to one example that came to my attention recently in my electorate of Diamond Valley. I shall quote from a letter which I shall be happy to show to any honourable member. The letter states:

Dear Mr McKenzie,

I enclose a copy of a letter, sent recently to The Age but not printed, which I feel may be of interest to you as a piece of contrete evidence of the state of health services in your electorate.

The old lady who signed the letter - whichI drafted - Is due to come out of hospital to-day, after eight weeks. We sent a covering note to The Age requesting that the name of her home suburb should not appear as this would enable readers to identify the clinic concerned and perhaps render her liable to legal action. However, she stated that she would be prepared to verify, all her information if any authority wanted to investigate the case, and this promise still stands. Possibly The Age preferred to avoid printing such a specific allegation.

The letter which was enclosed states:

I feel I ought to bring to public attention the following performance of 'the best health service in the world'.

I am a pensioner in my sixties, a widow. A sore on my foot recently erupted, leaving me in pain and unable to move. A friend rang up the local clinic, and was told by the receptionist (who first ascertained that I was a pensioner) that a doctor would attend me by a certain hour. When the hour came and no doctor had appeared, my friend rang the clinic again to be told that my ailment was not serious enough to warrant a home visit, and that I should take a Disprin and rest my foot. My friend's protests were unavailing, and as my condition was obviously serious another clinic, further away from where I live, was contacted. A doctor came (without inquiring if I was a pensioner), and diagnosed gangrene.

I am now in hospital recovering from the amputation of a toe. I would like to thank the doctor who travelled some distance to see me and certainly saved me from the loss of a limb, or worse. The behaviour of the local clinic speaks for itself.

I am pleased to say that very few members of the medical profession would regard pensioners in that way. I do not wish to attack members of the medical profession by reading out that letter but I think it does indicate that all is not well with the present health scheme.

The Opposition has revealed 2 main things in its attempt to pretend that it has a policy on health insurance. It has demonstrated that it is so bankrupt of ideas that its only recourse is to accept the role of mouthpiece for the Australian Medical Association, the General Practitioners Society and the big business private health funds. Moreover it has shown that the only ideas that appeal to it in the provision of health care stem from what can best be described as an 'animal farm* philosophy - in other words, the concept that while we pretend that everybody is equal, we make sure that some are more equal than others. Let it be noted that this same philosophy as expressed by George Orwell in 'Animal Farm' is there for all to observe behind the Opposition's machinations on education, no matter how desperately its spokesmen squeal out their chorus of 'double-think' in an attempt to camouflage their philosophy.

We hear much from the Opposition about voluntary health insurance. Of course, in reality, it is not voluntary at all. At the moment if anybody wants the benefit paid by the Government he must join a health fund. What is voluntary about that? In their attempts to conceal the social inequity of their outmoded and so-called voluntary system of health insurance, the Opposition spokesmen have claimed that improvements in the provision of subsidised health benefits and the inclusion of pensioners within the insurance system will put everything to rights. What a pious hope. What a coincidence that these simplistic sounding remedies are exactly the same as have been prescribed by the AMA and the managers of the big health funds in their efforts to preserve a system which is geared so much in their favour and so much against the ordinary citizen.

In this context it is worth recalling the words of the AMA statement on the Govern ment's White Paper. The AMA commended the Opposition parties for their opposition to the Government's program and then, with typical arrogance, delivered its instructions. The Australian Medical Association', it said, believes that this opposition should continue to be expressed when legislation is introduced'. Meekly, and in due course, we now have the Opposition spokesmen mouthing the AMA catalogue of self-interest. What a truly demeaning position for an Opposition to find itself in - to be merely the echo of a reactionary group which has opposed any advance in social equity within the health insurance system. This comes from those people who for years claimed that members on this side of the House were influenced by outside bodies. How shallow those assertions sound now. The AMA, in attempting to camouflage its elitist instincts, has circulated in its so-called appraisal of the health insurance program an argument more remarkable for its dialectic gymnastics than for any truth or relevance.

I am pleased to say that very many doctors reject the specious arguments of their professional association and recognise that the scheme proposed by the Government will benefit patients, doctors and the Australian community. The AMA claims that the rich man and the poor man are equal under the present health insurance scheme.

Dr Jenkins - That is not right.

Mr McKenzie (Diamond Valley) - Of course it is not right. It just so happens that the rich man is left with more money after paying for his essential outgoings. The AMA has, by the way, circulated this remarkable example of verbal sophistry and sourced it to an official of the Commonwealth Bank Officers' Association, despite the fact that that Association has completely disowned the statement. No amount of word play can hide the fact that under the present health insurance scheme the rich man, because of the value of his taxation deductions, pays comparatively less for his health insurance coverage than does the poor man. The facts are that the price of so-called voluntary health insurance is different to different people and that fat cats in all ranks of life get more for their money than thin ones.

Mr Deputy Speaker,we can hear honourable members opposite screaming out their interruptions because they cannot take the facts. The Opposition apparently sees that this is politically embarrassing and there*""* accepts the AMA idea that the way to conceal the injustice of the whole system is to create a whole class of charity patients by subsidising low income people and pensioners into the present health insurance scheme. We heard the honourable member for Hotham talk about the poor and the indigent. This kind of social classification belongs to the 18th century. The Opposition should be ashamed to present such ideas in this day and age.

Dr Jenkins - That is very generous.

Mr McKenzie (Diamond Valley) - Yes. It is more like the 12th century.

Mr Bryant - It is mediaeval.

Mr McKenzie (Diamond Valley) - Well, evil anyway. Australia does not want a health insurance system which divides people into classes. We are going to see to it that everyone is covered automatically and that everybody contributes according to his or her ability. As I mentioned before, the Opposition spokesmen pretend that their scheme is voluntary and find abhorrent the idea of everybody in the community contributing towards an equitable and efficient health insurance program. Let us be quite clear that the present scheme is not voluntary. Health insurance coverage for ordinary Australians is not a matter of choice; it is an economic necessity and, as a social utility, it should be financed in just the same way as is education or defence. We do not hear members of the Opposition claiming that people should be free to pay or not to pay that part of their taxes which supports the armed Services or education institutions although of course we know how they like to juggle the education allocations. Our proposal is that, through extra taxation and revenue payments equal to the amounts at present flowing through the inefficient private health insurance system, we will run a program which offers everybody access to high standard medical and hospital treatment.

If the Opposition wants to apply the philosophy which they claim lies behind their voluntary* health insurance scheme then they will also have to allow people a choice about whether they pay any taxes at all. By claiming that a person should be free to contribute or not to contribute to the health care costs of the community, the Opposition is once again revealing its real feelings about health. It is quite plain that it simply does not believe health care services are a right which should be enjoyed by everybody and that instead it wants to ensure that health services should be marketed as a commodity and be available according to the financial resources of each person and family. The Government rejects that, I reject it, and most of the people in this country reject it. In short the Opposition continues to see health services as a privilege to be bought and sold.

This is what is behind its opposition, and that of the AMA, to the concept that provision should exist in any health insurance program for medical services to be free at the point of delivery. This prospect causes the Opposition, again mouthing the arguments of the AMA, to predict over utilisation and abuse of such a system. I wonder whether honourable members saw that marvellous cartoon by Pickering in the 'Canberra Times', which I think summed up the feelings of a lot of people. Members of the Opposition have no evidence that such abuse would happen, only their apparent belief that all patients are potential malingerers and all doctors potential cheats. I reject both those concepts.

Having no evidence, they attempt to malign our program by comparing it with socialised schemes overseas which they allege are abused and over-costly for taxpayers. So let us look at these socialised schemes. In Britain, which of course has a different scheme from ours and which, if you like to express the term, is much more socialist, such radical socialists as Sir Winston Churchill, Mr Harold MacMillan, Sir Alex Douglas-Home and Mr Heath have in recent years presided over a health scheme which has been maliciously slandered here in Australia. The 'Lancet', probably the most respected medical journal in the world, said recently of the British scheme:

No country, literally no country, can afford more than one health service system. This truth will be concealed for as long as possible by insurance companies and other enterpreneurs; but it cannot be hidden forever. In countries where medical expenses are still met from personal purses with or without an element of private insurance, any long or complicated illness may spell financial ruin for families which, until the illness, were not poor. This reality, if nothing else, will sooner or later drive other countries to follow the example of the National Health Act of 1946 - Britain's most important single item of social legislation in a century.

The Australian universal health insurance program will not be a national health service in the same sense as the British scheme, since Australian doctors will still collect .a fee for every service they perform and will not work for the Government. But, like the British national health service and the Canadian insurance scheme, the Australian universal health insurance program will ensure that everybody in the community will receive health care as a basic right rather than as a purchased privilege.

The Opposition spokesmen who seek to denigrate our proposals by pointing to Canada's Medicare scheme should here and now take note of the facts that the Deputy Minister for Health in Canada, Dr M. Le Clair, and the Director-General of Health Insurance, Dr R. A. Armstrong, have recently sent in writing to Australia outright denials of statements made by medical pressure groups and spokesmen claiming that the Canadian system of universal health insurance is too costly and is being over-used. Many Canadian doctors reject the claims that are being made. The facts are that in Canada the costs of medical care are rising more slowly than they are under Australia's present ramshackle health insurance scheme and that the Canadian system is not being over-used even though it has made medical and hospital care equally accessible to everybody. On this latter point a comprehensive, expert study has shown that what are classified by doctors as unreasonable calls for medical treatment have risen by a factor of less than one in one hundred patients under Medicare. So much for that argument. At the same time Medicare has allowed people who would otherwise have been financially deterred from seeking medical care at the right time to go to their doctors early in the course of their illness. By receiving treatment at the right time, they then avoid the illness becoming complicated and therefore requiring more of their doctors' time and skill, and naturally more money, to treat. These are the facts and Opposition members who persist in making claims about abuse of the Canadian system stand in the same danger of having this deceit explode in their faces as did the AMA when it received a letter from the President of the Nova Scotia Medical Association rebuking it for its misrepresentations of the Canadian scheme.

The reason why our program has been the subject of such malicious misrepresentations must, I think, by now be apparent to the public at large. There can be no real question that our equitably based program, with its guarantees of the right choice, of quality and of personal privacy, will be a very great improvement on the present system. I point out to the House that I asked a question on this very subject this morning in the House and I was told how much privacy people have now. The falsity of most of the criticisms of it and the ferocity with which they have been pursued reveal the self-interest of those behind them and their determination that the privileges of the few should be maintained at the expense of the rights of the majority. Well, the game is up. The public has seen through the smokescreen that has been thrown up and this Government will not let its objectives be frustrated by cliques of socially selfish people. I ask the House to carry these Bills. I believe that the Australian public wants them; the Australian public needs them.

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