House debates

Monday, 23 June 2014

Bills

Health Insurance Amendment (Extended Medicare Safety Net) Bill 2014; Second Reading

4:51 pm

Photo of Ian GoodenoughIan Goodenough (Moore, Liberal Party) Share this | Hansard source

I speak in support of the Health Insurance Amendment (Extended Medicare Safety Net) Bill 2014, which amends the Health Insurance Act 1973 to set the general extended Medicare safety net threshold at $2,000 for individuals and families, from 1 January 2015.

The bill also makes some administrative changes, allowing the chief executive of Medicare greater flexibility in determining family composition for the purpose of paying benefits by permitting that the use of forms of communication, other than written correspondence, such as telephone contact.

By way of background, the EMSN was introduced by the Howard government in 2004. It provides an additional rebate for out-of-hospital Medicare services after an annual threshold in out-of-pocket costs for out-of-hospital Medicare services is reached.

There are two thresholds, namely, concessional and general. The EMSN concessional threshold is for concession card holders and families eligible for family tax benefit part A. It pays 80 per cent of the out-of-pocket costs or the EMSN benefit cap, whichever is the lower amount, for out-of-hospital Medicare Benefit Schedule services, after a threshold of $624.10 per family or individual per calendar year is reached.

It is important that this bill does not make changes to this arrangement and that the threshold continue to be indexed according to the consumer price index. This ensures that those in most need in our community continue to be heavily subsidised. Those eligible for the concessional threshold include holders of Commonwealth seniors health cards, veterans healthcare cards and pensioner cards.

On the other hand, the EMSN general threshold is for non-concessional card holders and it provides for 80 per cent of the out-of-pocket costs or the benefit cap, whichever is the lower amount, for out-of-hospital Medicare Benefit Schedule services, after the current threshold of $1,248.70 per family or individual per calendar year is reached. Both EMSN thresholds are indexed annually by CPI, as specified in the Health Insurance Act 1973.

The bill's administrative changes are centred around the expanded scope for the chief executive of Medicare to confirm family composition when a family has or is about to reach the extended Medicare safety net threshold. This part of the bill removes an unnecessary administrative requirement, enabling more timely payments of EMSN benefits to entitled recipients.

Currently, the Department of Human Services can only make a request to a person in writing for them to confirm their EMSN family status. This part of the bill removes the request by Medicare to be only in writing, allowing the chief executive of Medicare to confirm the claimant's family status at the time by other means, such as telephone contact. This allows Medicare EMSM payments to be made in a more timely manner.

This bill is projected to save the budget $105.6 million and is included in the forward estimates. In effect, this implements a decision taken in the 2013-14 budget by the previous government, so it is not new. The cost of health care is rising due to advances in medical treatment and care as well as an ageing population with greater longevity and lifestyle factors. The recent Commission of Audit report has projected that over the next decade Pharmaceutical Benefits Scheme costs will grow by 5.4 per cent per year; Medicare Benefits Schedule costs will grow by 7.1 per cent per year; and hospital costs will grow by 10.4 per cent per year. It is therefore important that the government ensures that the public health system is sustainable in the long term. Unfortunately, government resources only stretch so far, and the public health system is under a great deal of cost pressure. Therefore, it is essential to take responsible measures to keep the health system sustainable.

My predecessor, Dr Mal Washer, took an active interest in health related issues and worked very hard during his 15 years in this parliament to advocate for improvements in the medical facilities available within the electorate. As a result of his dedicated work, the people of Moore now have access to state-of-the-art health services available locally. The centrepiece of health and medical care in my electorate is the Joondalup Health Campus. With approximately 650 beds, it represents the largest health care facility in Perth's northern suburbs. Of these, 498 beds are provided for public patients and 145 beds for private patients. The hospital provides 24-hour acute care from an integrated public and private campus, which includes an emergency department, an after-hours GP clinic, and a day procedure unit. Specialist services include paediatrics, orthopaedics, renal, oncology, obstetrics, gynaecology and ophthalmology, to name just a few. In March 2012 the theatre block was officially opened, which includes 12 operating theatres, twice as many as before; a nine-bed intensive care unit; a six-bed high-dependency unit; and a 10-bed coronary care unit. The new operating theatres are among the most advanced in Australia. They include four state-of-the-art iSuites with video and touch screen technology to enable surgeons to view and capture images from inside the body while they operate.

People living in Perth's rapidly growing northern corridor will be able to receive all the health care they need at the Joondalup Health Campus, which provides an extensive range of in-patient, outpatient and emergency services. A comprehensive range of medical, surgical and maternity services is available on the campus, including cardiology; ear, nose and throat; gastroenterology; obstetrics; orthopaedics; palliative care; and urology. A complete range of diagnostic health care facilities is available on site, along with comprehensive pathology, radiology, pharmacy and allied health services. The emergency department is operated by qualified staff 24 hours a day, seven days a week, with extensive critical care facilities including intensive care and coronary care units which are staffed by an experienced team of nurses and medical practitioners. Other on-site facilities and services include a purpose-built mental health unit, including secure accommodation; dedicated day surgery and endoscopy units; and a renal dialysis service.

A second integrated state-of-the-art $20 million regional healthcare facility opened its doors in 2013, Shenton House. Centrally located directly opposite the Joondalup Health Campus on Shenton Avenue, it provides the first cancer care treatment centre in Perth's northern corridor, with services including on-site radiation and medical oncology treatment as well as cardiology care and sleep studies provided by GenesisCare. The facility was developed as a joint venture between the Anglican Diocese of Perth, which originally owned the land, and Perth Radiological Clinic. Shenton House is licensed as a day hospital by the health department, with GenesisCare the only approved provider for a specialist medical centre in an area of need in Joondalup, introducing treatment options not previously available.

Perth Radiological Clinic operates an imaging department which occupies the entire first floor. It includes a start-of-the-art magnetic resonance imaging scanner, a cutting-edge low-radiation dose computed tomography scanner, a wing of ultrasound rooms, and a dedicated mammogram imaging suite. Cancer patients living in Perth's northern suburbs will benefit from the new PET-CT scanner, which stands for positron emission tomography—computed tomography. The new state-of-the-art PET-CT scanner is a very important tool for the diagnosis and management of many forms of cancer, especially lymphoma, melanoma and colorectal cancer. It is the first scanner of its type in Perth's northern suburbs and allows patients to have their scan done closer to where they live instead of travelling to Perth. Scans covered under Medicare will be bulk billed whilst scans not covered by Medicare will be performed at a discounted fee.

GenesisCare has invested more than $10 million on its premises, offering cancer care, cardiology services and the area's first in-patient sleep lab. The linear accelerator and allied equipment, which produces X-rays directed only at the cancer cells, represent an investment of approximately $4 million. A second machine is due and there is room for a third. About 300 patients a day will use the cancer and cardiology services. It is estimated that one-in-three Australians will contract cancer at some stage in their lives. Improved access for cancer patients needing radiotherapy and cancer treatments will contribute to higher survival rates. The provision of radiotherapy services in Joondalup means patients will avoid having to travel about 60 kilometres to Sir Charles Gairdner Hospital several times a week.

Advances in medical technology add to the quality of life of patients. However, there are significant costs added to the health budget by new treatments. The Medicare Safety Net ensures that individuals who reach the safety net threshold amount are paid an 80 per cent subsidy to minimise the financial burden and hardship. This is world-class in terms of granting public access to quality medical services at a heavily subsidised price.

In my home state of Western Australia, the state government is investing heavily in health care. Between 2008 and 2018, the Department of Health of WA is investing more than $7 billion in building new hospitals and improving existing health facilities, with support from the Commonwealth government and other partners. The flagship Fiona Stanley Hospital, which cost approximately $2 billion to build, is expected to be operational later this year. In addition, the $1.2 billion Perth Children's Hospital is currently being built on the Queen Elizabeth II Medical Centre site in Nedlands and will replace Princess Margaret Hospital as the state's dedicated children's hospital. The hospital will provide the best possible clinical care for future generations and will be the base for continuing WA's outstanding paediatric research.

In summary, the standard and quality of healthcare facilities available to the community has greatly improved over the years through new medical facilities being built, the advancement of scientific technology and breakthroughs in medical research. The cost of health care has also increased at a rapid rate as new revolutionary treatments are introduced and subsidised by the taxpayer. Faced with these considerations and an ageing demographic, it is the responsibility of government to ensure that the Medicare system remains affordable and sustainable for the long term. This bill is projected to save the budget $105.6 million and is included in the forward estimates, effectively implementing a decision taken in the 2013-14 budget by the previous government. I commend the bill to the chamber.

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