House debates

Monday, 23 June 2014

Bills

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

5:30 pm

Photo of Jill HallJill Hall (Shortland, Australian Labor Party) Share this | Hansard source

This bill increases the general extended Medicare safety net from $1,248.70 to $2,000. It is what the government reports as a savings measure and will save $105.6 million over four years. It is included in the forward estimates from January 2015.

The fact it is reported as a savings measure says a lot about this government's approach to health care and Medicare. Its approach is to save money. It is not an approach of delivering quality health care to Australian people. It is not about putting in place the best health system we could possibly have in this country. It is not about saving health dollars by putting in place a strong preventative health program. It is not about designing a health workforce that will be there to cope with the needs of Australians into the future. Rather, it is about saving money. It is about cutting costs. It is about the budget bottom line and it is very short-sighted.

Often, cuts lead to poor health outcomes. I think the government will be surprised at the poor health outcomes that come from their GP tax, for instance. That $7 GP tax is going to act as a disincentive for Australians to attend their doctor—to go along and see their doctor when they are sick—as it is well noted that price is a determining factor in whether or not a person attends their GP. When this threshold is lifted, it means people will incur a greater out-of-pocket expense before they can get assistance.

This government does not understand how hard it is for families, pensioners, students and all those young people out there just getting started to make ends meet. It is only once that gap in expenditure exceeds $2,000 that a person will be able to make a claim. If you are a pensioner, it is at a lower level, but currently you still need to have an out-of-pocket expense of $624.10—and that will also be increasing. That is a significant amount of money for a pensioner to have to pay; and $2,000 is certainly a significant amount of money for a person who has young children, and is struggling to make ends meet, to pay.

On Saturday I held a Medicare rally in Shortland electorate. I was supported by the member for Newcastle, the member for Charlton and a surprise attendee, the state member for Swansea, who subsequently put out a media release saying that the GP tax was bad policy. He is a Liberal member and he condemned the Abbott government. He says the NSW government opposes this move because it is bad health policy. It means that people will have a greater out-of-pocket expense and instead of going to the doctor, they will get sick and not take their medications.

There have been studies undertaken in relation to the impact of out-of-pocket expenses. A recent report from the New South Wales Department of Health indicated that 15 per cent of people in New South Wales skipped a medical appointment, tests or medication due to cost, and 23 per cent reported spending more than $1,000 a year on health care out-of-pocket expenses. It is important to note that internationally Australia ranks fifth highest for out-of-pocket healthcare expenses among OECD countries. The highest out-of-pocket expenses are pharmaceutical, followed by dental and then doctor attendance—in the order of just over $2 billion.

It is bad policy to put in place a measure that is going to lead to Australians not attending the doctor because one of the best ways to manage healthcare costs in Australia is to keep Australians healthy. In an era when we have increased obesity and a rise in diabetes, and new approaches to treating cardiovascular disease and cancers, it is important that people undertake treatments early and in a sustained manner. If a person fails to undertake the treatment that they need, then they will become sicker, and lifting the threshold is going to increase the costs to individuals. That means a family will incur an extra $751.30 out-of-pocket expenses before they are eligible to claim on the EMSN.

Deputy Speaker Jones, I do not know about your electorate or those of members on the other side of this parliament, but I know that we on this side of the parliament have been lobbying vigorously. In addition to the GP tax and other aspects of this budget, over a long period of time one of the most common issues raised with me by my constituents in relation to health is out-of-pocket expenses. What we are saying to them is, 'You have to pay more. Your out-of­- pocket expenses have to be even greater before you get any assistance from the government.' In actual fact, as well as lifting the safety net, the government is requiring—is set to legislate—to have doctors charge a $7 GP tax each and every time a person visits them and that is going to increase the out-of-pocket expenses. That is going to make it harder for people to attend the doctor.

The rally that was held on the weekend—and I have mentioned this a couple of times already in the parliament today—was attended by 500 people. The thing I found most overwhelming was when the Assistant Minister for Health asked, 'Who in this crowd has never been to a rally before?' and 80 per cent of the people raised their hands.

I was particularly moved when an 87-year-old lady came up to me at the start of the rally and said, 'I have never been to a rally in my entire life. This is a first for me. But I feel so strongly about having to pay more for medical expenses. I feel that, if I go to the doctor and I have to pay this GP tax on top of all the other things that I have to pay, including my medication, I'm just not going to be able to cope financially.' She was a sprightly 87-year-old with one of her friends from the retirement village she comes from. Just as I was leaving the shopping centre at the front of the Belmont Medicare office, which the Labor government reopened after the Howard government closed it, a gentlemen came up to me who was 92 years old. He had never been to a rally before in his life. I will have to well and truly admit that the 96-year-old who came up to me on the foreshore had been to many a rally in his lifetime. He was there being as active as he always was, saying no to the Medicare tax.

What I am trying to do here is create a picture of people in my electorate—and it is an older electorate—who feel so strongly about out-of-pocket expenses and the impact that will have on their lives and on their health. People like that man and that woman are prepared to come out. As well as having elderly people attend the rally, we had families and young people. A really broad cross-section of society attended our rally and march on Saturday.

The march went from the shopping centre where the Medicare office is and around the corner to a set of lights. I was at a function on Saturday night and one of the business owners said to me that she could not believe the number of people who had turned up. This was just in the suburb of Belmont in the Shortland electorate. People had come from other areas within the Hunter and the northern part of the Central Coast, because they were so concerned about the increase in out-of-pocket medical expenses. That is what this legislation is about: increased out-of-pocket expenses.

Another interesting speaker that we had at the rally was an accident and emergency nurse from Belmont Hospital. He stood up and expressed his concern about the fact that the GP tax, the extra out-of-pocket expense that people would pay in the community that he works in—the community that I represent—would lead to an increased number of people presenting at the accident and emergency department at Belmont Hospital. I believe that is a real concern. It will lead to the system being clogged. It will lead to people having to wait a very long period of time if they are going to access the services of the accident and emergency department. There has also been talk that the government is thinking about a hospital tax—charging $5 for a person to attend the accident and emergency department.

This is really difficult for people to come to terms with in the area I represent. I see the member for Paterson joining us here. I say to him that I had one of his constituents travel over two hours by public transport to visit me to raise issues around the increase in health costs—he is on a disability support pension, his wife is on a disability support pension and their daughter has been seeking medical assistance at the John Harper hospital. They came to see me because they are so concerned about the impact the out-of-pocket expenses will have on them. To be prepared to travel for two hours via a public or private bus company, as these people did, shows what a concern the increases in medical expenses are to people in the community.

I say to the government members here in the chamber that you might think I am just a member of the opposition standing up and rabbiting on about the impact of this $7 GP tax. But, believe me, they are real people out in the community that are going to be hurt by it. They are real people that cannot afford to pay this. This is going to have an adverse health impact on our community. Please, stand up in your party room, talk out against it and support the people that you have been elected to represent in this parliament.

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