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Wednesday, 11 December 1974
Page: 3385

Senator WRIEDT (Tasmania) (Minister for Agriculture) - in reply- As has been said during the course of the debate, this legislation has been debated in the Parliament for quite some time. It is quite apparent that the members of the Liberal and Australian Country Parties have no intention of supporting the Government's legislation. Without dragging out the points any more than is necessary, three or four comments were made to which I feel I should reply. To close my remarks I shall restate the advantages of this system which the Government has been trying to introduce for the past few months. Senator Guilfoyle, who led for the Opposition, talked of the higher taxes people would have to pay to finance the Government's health scheme. On this very point the Minister for Social Security, Mr Hayden, in answer to a question in the House of Representatives not so long ago, pointed out that people would not be required to pay higher taxes.

People now pay contributions to private health insurance organisations. That in itself is a tax. It is quite wrong to talk about a voluntary tax. If a person wants to cover himself for health insurance purposes he has no choice other than to pay. What is important is that under the Government's proposed scheme one will pay according to one's ability to pay. Under the present scheme the higher one's income, the less one pays after one claims a tax deduction. The more one has need of subsidisation from public support programs, the less one gets under the present scheme. These are the types of anomalies which the Government would try to remove under the proposed medical scheme. Senator Guilfoyle also talked of the administrative costs of the Government's scheme. Actually, the Government's scheme will be more efficient than the present one. The levy will be collected along with income tax by the Taxation Office. In the case of employees it will be deducted from their pay along with income tax instalments and be remitted to the Taxation Office. I ask honourable senators to compare this scheme with the present scheme under which large numbers are required to attend and make their payments at the funds' offices or at the agents' offices. It is apparent that the proposed system would be a more streamlined system of collection. Some comments were made about the cost to the individual. During the past 4 years, contributions to hospital and medical benefits funds under the present scheme have approximately doubled. All indications are that they will continue to rise. The medical profession has announced large increases. At present an inquiry is being held to determine medical fees for benefit purposes. Hospital costs continue to rise and, if the present scheme continues, public hospital fees must be expected to increase. Contribution levels under the present scheme must be approaching- if they have not already reached- levels where many people will experience real difficulty in maintaining health insurance under the present inequitable contribution arrangements. The collection of individual contributions through the proposed levy on taxable incomes will mean that payment of the contributions will be directly related to ability to pay. This will ensure that no members of the population are unable to avail themselves of medical or hospital treatment because of inability to pay for the treatment.

Before I restate the Government's position on the whole medical scheme I want to touch briefly on the point raised by Senator Hall. I do not think there is great validity in it. Naturally, in the light of the obstruction in the Senate, the Government will have to reconsider the position. I am unable to state precisely what the Minister for Social Security would do, but I have no doubt that in the light of the rejection of this legislation he will be compelled to give further consideration to what the Government will do in pursuance of the financing of the scheme. Let me state briefly what the Medibank program will mean for individual citizens. I make it quite clear that these are the essential points of the national health scheme that this Government has been endeavouring to implement to protect all the citizens of this country. For individual citizens, the program will mean automatic health insurance coverage based on a more equitable system of payment, freedom of choice of doctor and the type of hospital care. Patients will be perfectly free, just as they are at present, to choose their own family doctor. They will also be able to be referred to any specialist in private practice. In fact, there will be an extension of freedom of choice of doctors in that in public hospitals patients, regardless of means, will be able to elect to be treated by a salaried doctor. Individual citizens will be able to receive free standard bed hospital treatment without means test. They will also be able to insure with private health funds against charges raised by public hospitals for intermediate and private ward care and for treatment in private hospitals.

For existing pensioner medical service pensioners, the program will mean access to the full range of medical and hospital services on the same basis as all other members of the community. For privately practising doctors it will mean that the existing system of medical care and the doctor-patient relationship will be maintained. Doctors will continue to charge a fee for each service provided and will have a choice in the way they are remunerated through the health insurance system.

For State governments the program will mean a considerable increase in the funds provided by the Australian Government for hospital services under agreements to be negotiated. These agreements will specify that the Australian Government will provide up to 50 per cent of the net operating costs of public hospitals. For private hospitals it will mean an increase in the daily bed subsidy from $2 to $ 16 and a guarantee of managerial autonomy. For religious, charitable and community hospitals volunteering to provide free standard ward treatment the program will mean the payment of a supplementary daily bed payment on top of the basic $ 1 6 a day subsidy.

For the community generally the program will mean a more efficient system of health care financing and, in addition, assistance by way of health program grants for approved organisations providing particular types of health services which are not otherwise covered under health insurance arrangements. I believe that it is a great tragedy for the Australian people that this legislation is to be rejected. Such rejection thwarts the Government in its stated aim to introduce a health scheme of this nature, one which has been stated clearly by the Government in 1972 and again in 1974. It is true that there are sectional interests within the medical profession in Australia which have used every possible means available to them to prevent the introduction of this legislation. As has been pointed out earlier in the debate, which countries would now opt out of a national health scheme? Would the Swedish people say that they no longer want such a scheme? Would the New Zealanders say this? Of course it is necessary to bring in a system which is efficient and which is equitable and which provides for the necessary things that we need in our health and medical services. This effort is being thwarted today by this Senate. It is being opposed by the Liberal Party and Country Party senators in this chamber, and history will prove that one way or the other the Australian people will eventually get the sort of national health services that they deserve and that they want.

Question put:

That the Bill be now read a second time.

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