Warren Snowdon (Lingiari, Australian Labor Party, Shadow Parliamentary Secretary for External Territories) Share this | Hansard source

This Private Health Insurance Amendment Bill (No. 1) 2014 aims to suspend the indexation of taxable income threshold for the private health insurance rebate and the Medicare levy surcharge for three years. And, as the Bills Digest reminds us, the pausing of the indexation will mean that there are those without private health insurance cover whose incomes are likely to move into the income tier at which they become liable to pay the MLS—subject to the old bracket creep. Others may see the rate of their levy liability increase and, ultimately, the government revenue from the MLS will rise.

As the Bills Digest tells us:

Overall, the effect of pausing indexation is likely to shift the cost of private health insurance away from the Government and onto the consumer. This is proposed at a time when reports show that consumer contributions to the cost of health care continue to grow while government expenditure in real terms is falling. According to the Australian Institute of Health and Welfare, in 2012-13 government funding of health expenditure fell by 0.9 per cent in real terms for the first time this decade, largely as a result of a 2.4 per cent decline in the Australian Government's funding of health care. Meanwhile, out-of-pocket spending by individuals grew by 6.7 per cent over the decade (compared to government expenditure growth of 4.4 per cent) and the proportion individuals contributed to overall health expenditure also grew to a high of 17.8 per cent.

So, what this bill will mean, in short, is more people paying a health insurance rebate and more of those already in a fund effectively paying more as their income rises.

Those who choose not to be part of a private health fund will find themselves effectively paying more under the Medicare levy surcharge as their income rises. Again, just a very sneaky way of shifting costs from the government to the private insurers and, in particular, to people who would have otherwise thought they were safe from any increase in their liability had the indexation arrangements been pursued. So the suspension of the indexation arrangements will have a material and direct impact on many Australian households, and that is something which we all need to be concerned about. It does not surprise us in the context of this government because, as we know, to everyone in this place, even to the government benches, they have made a virtue out of breaking successive promises around commitments they made prior to the election—and here is just another example.

We know that the government believes that the rebate will contribute a total estimated savings of $599.3 million as a result of the pause in indexation. Of course, this saving is not going to go into providing more and better primary health care; it is not going to provide better chronic disease management. It is going to go to the health research fund. We in Labor obviously support health research. We have done so historically and we will continue to do so into the future. But what this government has done during the course of its time in government is to introduce policies that will change the way in which health care is delivered in this country and will move us away from the whole idea of a universal health scheme. At the same time, it will increase the cost to families so that they will bear the burden of the government's decisions. This is just another example of what the government has been doing. It is worthwhile saying to the members opposite that, even though they may not themselves accept liability in terms of a personal responsibility for the decisions which have been taken by the government and principally by the Minister for Health as the portfolio minister, they do have a collective responsibility for all of those decisions because they have supported them. We have now had the election promises broken: no cuts to health, no new taxes and the introduction of a GP tax. As I said, the $599 million will not go to immediately improving health outcomes for people or, in particular, addressing those people most in need in our community. Instead, it will go to this fund: the Medical Research Future Fund.

When the current minister was in opposition he made a number of statements about his support for universal health care. He made a virtue of those statements. Indeed, in his contrition to the debate on the bill to means test the private health insurance rebate in 2012, the then shadow minister for health, now Minister for Health, said:

In our country we have a universal health system. That means that, regardless of whether you earn one dollar or a million dollars a year, if you have a heart attack, are involved in a motor vehicle accident, have a crook hip, need oncology treatment or whatever, you can turn up at a public hospital and demand treatment free of charge. That has been an underlying principle supported by both sides of this parliament for a very long period of time—and long may that be the case. A universal system says to people that, in a country like ours in the 21st century, the best available services will be provided.

How is it that we find ourselves in the position that we are in today? How is it that we find ourselves in a position where the government not only is claiming $599 million worth of savings but also has cut in excess of $57 billion out of public hospitals and at the same time wants to introduce a GP tax which will have a direct and material impact on the universality of health care?

It is hard for me to fathom how anyone in the government could go to their communities with these changes and say that they still believe in universal health care. How can you argue that, as a result of the changes that you are proposing in the health system, people who are currently being bulk-billed will be required to pay a surcharge? And we are told that it is the doctors who will make the decision as to whether or not the surcharge will be paid. Of course, what we are doing is transferring the responsibility of the healthcare system to the patients and to the doctors so that the patients will pay more and the doctors will lose money in every consultation. We now know that as a result of the changes which are being proposed, there will be more than 600,000 fewer medical imaging services in the first year. The reason there will be fewer services is obvious: it is because, according to the Australian Diagnostic Imaging Association, previously bulk-billed patients now face costs of up to $1,263 for a liver cancer diagnosis, $1,326 for a thyroid cancer diagnosis, $2,207 to diagnose liver metastasis and $712 to diagnose breast cancer.

What will that mean? That will inevitably mean that people who should be seeking care and who should be seeking a diagnosis for an ailment will not. Ultimately, it will inevitably lead to people dying earlier than they otherwise should have, people suffering for extended periods for not having their particular ailment properly addressed, people not having the proper drugs or people not having the proper treatment. This seems to not matter a jot to the government or to the members opposite.

I say to members opposite that you have a responsibility in this place. As the governing parties, you have a responsibility to abide by the promises you made prior to the last election, which clearly you do not feel disposed to do. But, most importantly, you have a responsibility to ensure that each and every Australian gets a fair shake. I could not agree more with the statement made by the now Minister for Health in his previous contribution to the debate in this place about the importance of the universality of health care. But what we are seeing now is this government contradicting that commitment, walking away from it very directly, and making certain that, as a result, many Australians will suffer in a range of ways. Not only will they suffer because they do not access treatment but, if they are able to access the treatment in the first instance, they will be required to pay the costs. And that will have an enormous burden on many households.

The people who will be most disadvantaged will not be the people who live in the Prime Minister's electorate. I dare say they will not be the people living in the member for Boothby's electorate. But I know where they will be. There will be some in the member for Gippsland's electorate. There will be a lot of them in the member for Gippsland's electorate. There will be a hell of a lot in my electorate and the member for Rankin will have many in his electorate. These are the people of Australia who can least afford not to access medical care yet what we see is a deliberate attempt of this government to move people out of the health system or away from getting treatment as a result of their ideological commitment to their hideous approach to addressing what they call a budget crisis—which of course there is not.

So it seems to me that members opposite need to counsel the Prime Minister. They certainly need to counsel the Minister for Health because I know, when they go to the election in a couple of years' time, people will mark them down and properly mark them down for their dishonesty, for the way in which they have dealt with the Australian community and, most importantly, for attacking the health system in the way in which they are proposing to do. It is not fair; it is not reasonable.

I talked about communities who would miss out. I need to refer to my own communities in the Northern Territory. The most impoverished Australians live in very remote communities. I mentioned the member for Gippsland but, in regional and remote Australia, the people with the poorest health outcomes in this country will be affected more by the changes being proposed by the government than any other Australians. It is not fair, it is not reasonable and it should not happen.

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