House debates
Thursday, 25 June 2009
Private Health Insurance Legislation Amendment Bill 2009
Second Reading
Debate resumed from 3 June, on motion by Ms Roxon:
That this bill be now read a second time.
10:53 am
Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source
The Private Health Insurance Legislation Amendment Bill 2009 is a distinct change from recent legislation brought before this House by the Minister for Health and Ageing. Several measures brought before this House in recent weeks will have the effect of driving people out of private health insurance in this country. Measures such as the Fairer Private Health Insurance Incentives Bill 2009 will be a detriment to private health insurance and will cause further harm to the already stressed public health system in our country. They were desperately created by this government to pay for its reckless cash splashes and the mountain of debt that it is now saddling the nation with for many years to come. On the other hand, this legislation actually seeks to encourage people to take out and keep private health insurance with all the attendant benefits that it brings to the nation’s health system.
The bill will add a new category to the insured groups to which private health insurance can offer insurance policies. Currently the Private Health Insurance Act requires that insurers only be allowed to offer policies to particular insured groups, namely singles, couples and families with dependent children. Since late 2007 the rules have been changed to include another extended family category, ‘dependent children non-student’. At this point I would like to take this opportunity to recognise the work of former Health Minister Tony Abbott and the way in which he was able to work with the private health insurers and also recognise the private health insurers for their efforts in maintaining a situation where more people could potentially come into the privately insured pool in this country. This category allowed family policies to cover people between the ages of 18 and 24 who were single and not in full-time education. The category was developed by health insurers to encourage young adults to maintain health insurance cover into adulthood. The arrangements, however, have been temporary. This bill proposes amendments to insert the category ‘dependent child non-student’ in the Private Health Insurance Act and will enable insurers to offer policies to this group on a permanent basis. Health insurers will be able to charge a higher premium for these extended family policies than for others. But that premium is expected to be less than that charged to a young single individual.
With the percentage of people in the 20- to 24-year age group covered by private health insurance in decline, down to 3.9 per cent in 2008, this measure will hopefully make insurance under a family policy umbrella more attractive and see younger people remain covered by insurance. We will have to wait and see though because the government’s other actions will make the price of insurance that much more expensive for many Australians. Insurance premiums will rise for 2.3 million people by between 14.3 per cent and a staggering 66.7 per cent as a direct result of the Rudd government’s decision to make changes to the health insurance rebates put in place by the coalition to actually boost private health membership. I remind the House that the government promised over and over again it would not make those changes—just one of the many broken promises as to health. I think that shows that this government does not have a proper direction as to the way in which it is taking health in this country. Pressure for premiums to rise even further will flow from the rebate changes which the government now admits could see 40,000 people drop out of insurance altogether. That is the Treasury’s conservative estimate, I might add. Others, including the respected firm Access Economics, estimate the rebate changes could force 100,000 people out of private health insurance. That is on top of the 492,000 that the government still expects to quit insurance over last year’s decision to change the Medicare levy surcharge thresholds.
So we have a series of measures that are sure to have substantial negative impacts on private health insurance. Those impacts will flow on to all Australians including those who rely on the public hospital system. Fewer people with insurance means more people waiting for treatment in hospitals, longer queues and, under the Rudd government, longer waiting times. That from a government that promised to fix those very same hospitals by the end of this month! That is only a matter of days away. Clearly, the Rudd government cannot claim that it has fixed Australia’s 750 public hospitals. No doubt the Prime Minister and the minister for health are already drawing up their spin to tell Australians they have fixed Australia’s public hospitals when every piece of evidence is to the contrary—and every Australian knows that. The coalition in government worked hard to reverse declines in health insurance membership. Under the Keating Labor government insurance membership had plunged to just 30 per cent of the population. Through the rebates and other measures it took, the Howard government reversed that trend and more than 44 per cent of Australians are covered. But now we have another Labor government and the message is clear: private health insurance is under attack once again. We will hold this government to account for its claim that it will fix public hospitals by the middle of this year. Its blatant attack on private health insurance over the last 18 months has been quite remarkable, almost without precedent. You would have to look back to the Hawke-Keating years to recognise a similar attack on people with private health insurance.
We should be holding up people in this country who have private health insurance as heroes of our nation who share some of the burden of the health system. People who insure for themselves—who have a capacity to do so—relieve some of the pressure on the public hospitals in the services that they, quite rightly, provide to people who are more needy and do not have the capacity to provide support or insurance for themselves. This country should always maintain a health system that protects those who are most vulnerable, but we should also put in place incentives—a system that provides benefits to those who are able to self-insure and defray some of the costs that otherwise would have to be met by the Australian taxpayer. We should recognise and start a debate in this country to recognise that these people should be embraced and should not be excluded from holding private health insurance, because, ultimately, under a Labor government or a Liberal government, regardless of what colour of government you have in this country, there will always be a system that provides for those Australians who cannot provide for themselves; there will always be universality, and that should always be the case.
But if you have a case, such as we have with this government at the moment, where they seem completely determined to drive private health insurance into the ground yet again, then the pressures on the public system will again become unbearable. I know that the member for Herbert, who is in the chamber today, has been a great champion for health services in Townsville and the surrounding region in his electorate and he would be horrified to hear a suggestion by the Rudd government that they had fixed public hospitals, not just in Queensland but around the country. It is a remarkable claim that they have made and of course they have said nothing about it in the intervening period. We are approaching the 30 June deadline for the Rudd government to meet their obligation—their election commitment to fix public hospitals—and yet they still have not detailed one criterion or suggested one benchmark that will be the benchmark against which they are determining whether or not they have fixed public hospitals. It is a remarkable situation and all Australians would know that Mr Rudd cannot claim that he has fixed public hospitals. He cannot suggest that there is no more work to be done. He made a commitment: he said to people that he would fix public hospitals, he would end the blame game and he would somehow—somehow!—fix public hospitals by 30 June. He has only a week to go and there is nothing on the table from this government that would suggest that they are even serious about meeting this obligation. With their claims that they have fixed public hospitals, Australians must really wonder, in the face of all of the evidence, what is going on with this government, particularly in the area of health policy.
We hope that measures in this bill will make it somewhat easier for families with young adults to keep the young adults covered by private insurance. That is why when we were in government we put in place this framework—we allowed this framework to take place—to work with the private health insurers to encourage young people to take up private health insurance and to stay on their parents’ cover as an incentive for them to remain in private health insurance when they go onto their own policy and relieve some of the pressure, and this is incredibly important, particularly when you look at waiting lists around the country. People in this country would be amazed to hear that if they lived in Townsville, as the member for Herbert does, there is now in Townsville Hospital a waiting list to get on a waiting list; it is quite amazing—
Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source
Mr Deputy Speaker, I rise on a point of order. I have been quite indulgent in not standing up before and bringing the member back to the debate—
Sid Sidebottom (Braddon, Australian Labor Party) Share this | Link to this | Hansard source
What is the point of order?
Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source
The member is not speaking to the legislation before the House.
Ms Anna Burke (Chisholm, Deputy-Speaker) Share this | Link to this | Hansard source
I remind the speaker that the legislation is the Private Health Insurance Legislation Amendment Bill and I would ask the speaker to be relevant to the legislation.
Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source
My old sparring partner, the honourable member who interjected, always engages in these debates. Her contributions are always worthy. I always enjoy reading Hansard as it is a much clearer way of understanding the argument that she puts than being here at the time!
There is a reason I raised this very important waiting list issue. If we return to the basics, the reason we have private health insurance in this country—for the benefit of the member who interjects—is that if we stop private health insurance, if we push those 10 or 11 million Australians out of private health insurance into the public system, then we would have no capacity whatsoever—
Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source
I raise the same point of order, Mr Deputy Speaker.
Ms Anna Burke (Chisholm, Deputy-Speaker) Share this | Link to this | Hansard source
I have made it clear to the speaker that I wish him to speak on the Private Health Insurance Legislation Amendment Bill and the speaker was mentioning private health insurance in his comments. But I am listening very carefully to make sure that he returns to it.
Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source
As I said, for the benefit of the member who interjects trying to comprehend the correlation between hospitals, waiting lists and public policy in relation to health and private health insurance, I will slow the message down.
Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source
Mr Deputy Speaker—
Ms Anna Burke (Chisholm, Deputy-Speaker) Share this | Link to this | Hansard source
Both members will resume their seats. The member is speaking about the Private Health Insurance Legislation Amendment Bill. He is mentioning private health insurance—
Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source
It has got nothing to do—
Ms Anna Burke (Chisholm, Deputy-Speaker) Share this | Link to this | Hansard source
Thank you, I am speaking. I will ask the member, as the shadow minister in charge of this area of legislation for his side, to return to the legislation.
Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source
As I was saying, in relation to this bill, and for the benefit of the member, the reason that we have private health insurance in this country is that if we force people out of private health insurance by not bringing measures like this into the parliament then our public system would collapse. The difficulty is that this government seems wont to crash the private health insurance market in this country. If the government puts these bills up as a genuine attempt to try to help people stay in private health insurance, then they provide ways in which we can manage our health system into the future for this country.
If the honourable member opposite seriously believes that we should not be supporting the 11 million Australians in private health insurance—if the Labor Party believes that we should be crashing the private health insurance market—that would be a devastating day for the health system in this country. The previous government was able to increase coverage of people with health insurance and therefore relieve some of that pressure experienced by our public hospitals. This is a concept that clearly escapes the honourable member opposite, as she flees the chamber to get an additional briefing before she speaks so that she can at least give some semblance of a contribution to this debate.
The important point is that waiting lists are crushing older Australians in particular around this country. If we force people out of private health insurance and into the public system, it will only make for a more devastating situation. People who are now waiting years for treatment in the public system will wait years longer if people are not taking out private health insurance and sharing some of the burden into the future. It would be an amazing situation to see this Rudd Labor government return to the devastating days in the private health insurance market that we saw in the Hawke-Keating years, when Labor really was determined to crush private health insurance in this country.
About one million Australians on incomes of $26,000 a year or less have private health insurance in this country. They will be impacted directly by the Rudd government’s decision. The government projects that the changes it has made to private health insurance will raise about $1.9 billion over four years, which will make private health insurance premiums higher for all Australians. I mentioned earlier in my speech on this debate that the government, on its own figures, projects that about 40,000 people will drop out of private health insurance, but at the same time the government claims that it will raise about $1.9 billion in revenue over four years, or about $500 million per annum. How is it that $500 million is going to be obtained from 40,000 people dropping out of private health insurance? It is a nonsense. Hundreds of thousands of Australians will grin and bear the extra premiums, but they will remain in private health insurance. They might be older Australians, and pensioners in particular, who are concerned about the deterioration of their health and the conditions and complications that might approach as they age. They might be people who are planning to start a family and want to have cover. It may be that many families around the country, regardless of their financial status, are scared about the situation in our hospitals and that is the reason they maintain their private health insurance. Whatever the reason, we should be encouraging people into private health insurance because it offsets the debt that would otherwise be ultimately incurred by the taxpayer.
That is why I say, particularly for the benefit of the member for Shortland, that it is good to have people offsetting some of their own costs in relation to health. If people pulled out of private health insurance today and went into the public health system, it would collapse overnight. This government’s intention to wreck the system is unsustainable and it is un-Australian. We need to make sure that we take the fight up to the government.
I say to those 11 million Australians who are going to face higher health insurance premiums into the future: write to your local member of parliament and make sure your voice is heard. It is very difficult indeed for young families, for older Australians and for people on low and middle incomes to maintain private health insurance cover at a time of economic difficulty, not just in this country but in other parts of the world, even without the additional burden of extra and higher insurance premiums. This will make it more difficult for people to balance their budgets, and ultimately a crunch point will come. When that crunch point comes, if people drop out of private health insurance, with the Prime Minister not having lived up to his promise to fix public hospitals, that will put even greater strain on those wonderful people—the doctors and nurses and other allied health professionals—who on a daily basis perform in an environment which for many of them remains completely intolerable. Many of the doctors and nurses that I have spoken to around the country are devastated by the conditions in which they are expected to work.
This is a country which should be providing better health outcomes to the Australian public. The government should acknowledge that it would be much preferable if we had better hospital environments in particular for people to work in. On that basis, the coalition supports the bill.
11:12 am
Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source
My contribution to this debate will be very brief. The Private Health Insurance Legislation Amendment Bill 2009 is a very narrow piece of legislation that relates to one very small aspect of private health insurance. It does not relate to the $1 billion that the previous government ripped out of public hospitals. It does not relate to the private health insurance rebate. Rather this bill allows insurers to offer extended family policies that cover adult children aged between 18 and 24 inclusively who do not have a partner, are not receiving full-time education at school, college or university and are included in the insurer’s fund rules. The premium rate offered for policies covering these adult children may be higher than ordinary premiums charged for dependent children for that product, but it is expected to be lower than the premium charged for separate policies covering young adults.
This legislation shows that we on this side of the House are friends of the private health insurance industry. It shows that we support private health insurance. It shows that we want to encourage as many young people as possible to take out health insurance. The bill provides that adult children who do not live at home and are not students can be covered by their families’ health insurance premiums, which demonstrates to the parliament how committed the government is to ensuring the ongoing viability of private health insurance. The bill is not about any of the issues that the previous speaker mentioned. The contribution of the shadow minister for health and ageing demonstrated to this House that he is incapable of speaking to a piece of legislation. He uses every opportunity to go off on a tangent and try to frighten the people of Australia.
I commend the bill to the House and I have great delight in supporting it.
11:14 am
Brendan Nelson (Bradfield, Liberal Party) Share this | Link to this | Hansard source
I wish to take the opportunity in the debate on this Private Health Insurance Legislation Amendment Bill 2009 to speak to two issues: the first is private health insurance, and hospital care in particular; the second is to discuss issues in relation to deafness in newborns and infants in particular. The editor of the Medical Journal of Australia, Martin Van Der Weyden, introduced his early-December 2008 editorial with the following anecdote to illustrate the circumstances that we face in Australia in relation to health care, and hospital care in particular. The anecdote in many ways reflects the paradox for many Australians, which is the delivery of health care in this country. It went like this: two patients present to two clinics in Australia on the same day. Both have a limp. The first is seen the day that he seeks to have an appointment. He is X-rayed that same day and is booked in for a hip replacement the following week. The second patient waits three weeks to get an appointment to see his GP. He consults the GP and waits a week for the X-ray of the hip to be reported. He waits eight weeks to see an orthopaedic surgeon and then waits another month to have a hip replacement. The editor asked: what is the difference between the two patients? The answer is that the first is a golden retriever; the second is his aged owner. While there is some flippant humour in the paradox that is presented, that is the paradox of modern health care in this country.
We live in a country where almost every day, in any newspaper, television bulletin or radio report about health care, in the space of the one bulletin we will be presented with the latest technological advance in medicine. Only last week, for example, we had one television news report which reported the successful insertion of a cardiovascular pacemaker into a premature baby. The same news bulletin reported a woman suffering because of the lack of something as basic as a cardiac monitor. And so, too, every day we see examples on the one hand of extraordinary advances in medicine, but on the other a New South Wales hospital not being able to provide meat for its patients because the butchers’ bills have not been paid for six months.
One of the things that is constantly put in the debate about hospitals is lack of money. It is understandable that many Australians would think that to be the case. The truth of it is that in real terms on a per capita basis since 1960 health care funding in Australia by government has increased by 1,150 per cent—11½ times in real terms per capita. That is after adjusting for inflation. In fact, since 1995 it has increased 50 per cent in real terms. Public hospital expenditure similarly has also increased in real terms over that period of time. In fact, as a proportion of GDP, public hospital expenditure in 1960 was 1.3 per cent of Australia’s gross domestic product; it has increased now to 2½ per cent of Australia’s GDP. By any standard, Australia’s investment, both public and private, and in fact from all sources in health care and hospital care in particular, has increased.
Yet, at the same time, over the last 20 years there has been a 67 per cent reduction in the capacity of Australia’s public hospitals according to the audit conducted and released by the Australian Medical Association late in 2008. In fact, the AMA estimates the deficit of public hospital beds to be in the order of 3,750. Whatever figure one chooses to accept, by any standard for everyday Australians there is undoubtedly a shortage of public hospital beds. Public hospitals at the moment are running in excess of 85 per cent occupancy, which is cited as the ceiling of safety by the Australian College for Emergency Medicine. Even more disturbing is that our major teaching hospitals—for example, the Flinders Medical Centre in Adelaide, the Austin in Melbourne, Westmead and the Royal North Shore in Sydney—are running at an occupancy rate in excess of 95 per cent.
One of the initiatives undertaken by the current government purportedly to deal with this is to establish GP superclinics. The purported or stated intention is to reduce the load on our emergency departments and so on. It is worth noting for the purpose of considering this debate that the Australian College for Emergency Medicine estimates that only one in 10 presentations to emergency departments and public hospitals are cases that could be handled by a general practitioner and that only one per cent of emergency department resources are actually consumed by such presentations. In other words: whatever the motives for building GP superclinics and whatever the benefits of them may be, it should not include substantially reducing the demand on overstretched public hospitals.
There are three reasons why health care costs in Australia are increasing in spite of major increases through successive governments—Labor governments and coalition governments—in funding and the fact that there is still clearly unmet demand and certainly serious mismanagement of public hospitals. The first is the ageing of the population. The Productivity Commission, in its 2005 report on the impacts of technology on health costs, estimated that the per capita annual increase attributed to ageing is in the order of 15 per cent. And we know from the Intergenerational reportfirst initiated by the then Treasurer, Peter Costello, in 2002 with a second report in 2007—which forecasts economic and demographic impacts 40 years out, that the proportion of the population of a working age that supports those who are not will decline over the next 40 years from five people to 2.4 people.
The second impact of those costs is the increasing affluence of the Australian population, to which the Productivity Commission attributes 37 per cent per capita costs annually. But the largest contributor to increased costs is technology, at 47 per cent. In my view, our country faces some quite significant challenges in health care. The first is that there is going to have to be a significant recalibration of the expectations of Australians about what the health care system is going to deliver. As I said in my earlier remarks, we are presented each day with evidence of the latest technology which is available or which may become available or that Australians expect to become available to them. At the same time there is hot bedding of patients, ramping of ambulances, people being put into storerooms and cupboards in waiting rooms because there is nowhere else to put them, the emotional agony and indignity of a woman having a miscarriage at 14 weeks gestation in the toilet of the waiting room of a public hospital and an elderly women being put into a storeroom because there was nowhere else to put her while she was waiting for a bed to be found somewhere in the hospital.
Then there are elective waiting lists, which, as the Australian Institute of Health and Welfare reminded us in their most recent report, have further increased again in terms of average days that Australians are waiting. Something is going to have to give. I noticed recently that the New South Wales Director-General of Health foreshadowed—on behalf, presumably, of the New South Wales state Labor government—that Australians could no longer expect to see universally free health care being provided. She expected that it would not last more than another five years.
The second thing that is required in my view is serious reform to the entire dysfunctional nature of the relationship between the Commonwealth and the states. That is obviously needed. The biggest constitutional issue and question which faces this country is not whether we are a republic or not, as important as that question may be to many Australians; it is instead how we best manage the relationship of a federation in a country which is vastly different to that of Henry Parkes. You need to look no further than the administration and funding of Australia’s health care, and hospitals in particular, to appreciate why we need reform.
I am very strongly of the view that handing over responsibility for Australia’s public hospitals to the Commonwealth would create far more problems than it would ever solve. Anyone who thinks that we will get public hospital services from having Canberra control their administration is frankly delusional. However, I strongly believe that, as long as we continue to have states, the Commonwealth should be the sole funder of almost all of Australia’s health care system, leaving aside the contribution made by people at a private level. The Commonwealth should be the single funder which sets and mandates, in consultation with health care professionals, the standards that we expect. The states should then be responsible for delivery. I would encourage the government very much to move in that direction.
It is 25 years since I worked in a major public hospital, a teaching hospital. But it has been extraordinary to see the changes that have happened and the demoralisation of Australia’s professional medical workforce in its teaching hospitals. Imagine working in an institution where the people who purportedly run the institution have no responsibility for the decisions that are made within it and cannot be advocates for the institution without the risk of losing their jobs. My very strong view is that the management of the hospitals—of which there are around 750—needs to return to a local management model and perhaps even in many cases management via boards.
There was a time when a board ran a hospital. The board then asked of its medical and nursing staff what was required to deliver services to the community for which it had responsibility. It would test that information and then it would be the advocate for the institution in seeing that the necessary resources were available to deliver those clinical outcomes. While you would not in the 21st century necessarily return entirely to that particular model, we are now in an environment where we have a clipboard carrying bureaucrat who turns up at a hospital and tells the hospital what will be delivered within a particular budget and then if anyone does not like that they can go and look for alternative employment—which, sadly, is what most of Australia’s professional health care workers, particularly specialists, have done. It is completely demoralising to work within a system which you no longer believe in.
As far as Australia’s future funding of health care is concerned, in my view it is about the money, the management model and the model for funding that ultimately delivers the services to the system. That is what this debate about private health insurance is really about. We are now in a situation where about 46 per cent of the population has private health insurance. That is up from 34 per cent in 1995 because the previous government introduced this 30 per cent rebate, which was not means tested. It introduced Lifetime Health Cover to provide a penalty for those who did not join private health insurance at a young age. It also provided very strong political support to private health insurance.
In 1995, we had a Prime Minister, Mr Keating, who, rather memorably, from the Royal Adelaide Hospital said: ‘Australians don’t need private health insurance. They can rely on Medicare.’ If I had been worth $5 million at the time, I might have been tempted to say that sort of thing. But all members here need to be reminded that there are one million Australians living on less than $26,000 a year who have private health insurance. That is less than the electorate allowance that we get, and these people are living on that and they have private health insurance. A wonderful woman, Ethel Guy—she was President of the Tasmanian Pensioners Union—once said to me in the early 1990s: ‘Brendan, a lot of my members go without food to pay for it.’ That is the situation that we are in.
There is a view deeply rooted in the Labor Party that is hostile to the basic concept of private health care. There is now a view that the private health rebate can be means tested and that that will not make any difference. It is not said publicly, but they think that the so-called rich people should pay more for their private health insurance. The people who will suffer from that the most are actually the most vulnerable people, the low-income people, who have private health insurance. There are 202,000 people over the age of 65 living on less than $20,000 a year who have private health insurance; there are another 160,000 earning between $20,000 and $30,000 a year over the age of 65 who have private health insurance. These are people who think that they are going to need it. They are not just financially unfit; they are also people who think that they are going to need their private health insurance. The fewer people you have in it who are financially fit and also physically fit, the higher the risk that you have in the pool. That turbo charges premiums.
So we will go through the charade again of the minister at some point having to agonise over claims for private health insurance premium increases from the private health insurance sector to fund and support services in the private hospital system. When that time inevitably comes it should be remembered that in its first two successive budgets the government has done two things which are hostile to the interests of keeping deflationary pressure on private health insurance premiums. I also remind the House that in the decade to 2006 there were 1.2 million separations from private hospitals—a 47 per cent increase in separations. I just ask the House to think what would have happened if all of those had had to go through the public hospital system.
In concluding, there is just one other issue that I would like to raise and that is the issue of newborn deafness. A great friend and mentor of mine, Dr Bruce Shepherd, has given me a lot of advice throughout my life—most of which, fortunately, I have not taken. In 1962 he took his newborn first child, Penny, to get the best medical advice he could get in Great Ormond Street Hospital in London because he suspected she was deaf, and he was told, ‘I don’t know whether your daughter is deaf but she is definitely mentally retarded.’ That is the way that many parents encountered deafness in their children in the 1960s. We are living in a country today—because Bruce Shepherd did not listen to a lot of people who told him he could not do it—where, if we could screen every child at birth for and detect deafness and get them into an effective program with a cochlear implant where it is medically indicated before 12 months of age and get them into an auditory-visual therapy program, as it is called—run by the Cora Barclay Centre in Adelaide, the Shepherd centres in New South Wales and Canberra, Hear and Say in Queensland and Murdoch in Western Australia—which is relatively inexpensive, by the age of five you would not know they were deaf. They could be fully integrated not only into school but into society. In Western Australia we still do not have 100 per cent coverage for screening—it is 46 per cent. Despite stated intentions of state-wide screening by next year, in Victoria we are still running at only 55 per cent. The Northern Territory is a basket case. The Royal Darwin Hospital screens just over half of its newborns; and as a consequence of the intervention we are now screening many—but certainly not all—Aboriginal children.
We could live in a country where we could proudly boast that every child will be screened at birth for deafness. There are about 500 children born in Australia each year who are profoundly deaf and most of them will require a cochlear implant. It is a relatively small sum of money. An implant could be demand funded and provided to those children. We could then get them into an auditory-visual program and by the age of five we would not know they had even been deaf. The evidence emerging from the National Acoustic Laboratories is that by the age of 3½ these children have receptive and expressive language that is only six months behind normal children. It is not an issue of partisan politics. It is something that we can actually achieve with a relatively small amount of money and political will. I commend the House and the government to do whatever they can to see that the states get up to speed with this. I am ashamed that in the state of Western Australia there are only six publicly funded cochlear implants for children who are born profoundly deaf in that state. I urge and encourage Colin Barnett and the Western Australian government to damn well do something about it.
11:34 am
Darren Cheeseman (Corangamite, Australian Labor Party) Share this | Link to this | Hansard source
The Private Health Insurance Legislation Amendment Bill 2009 is another important piece of legislation that will strengthen the opportunity for 18- to 24-year-olds to be able to access private health insurance via their families. This is significantly important, particularly because many people in that age bracket are putting themselves through education and training with the costs associated with that. Extending the private health insurance coverage of their families to this generation is a very significant reform. It speaks volumes about the commitment of the federal Minister for Health and Ageing, Nicola Roxon, to having a very strong public healthcare system that is supported by a strong and viable private healthcare system. I commend the work of the minister and recommend that the parliament support the bill.
11:35 am
Mark Coulton (Parkes, National Party, Shadow Parliamentary Secretary for Water Resources and Conservation) Share this | Link to this | Hansard source
The Private Health Insurance Legislation Amendment Bill 2009 breaks an emphatic promise which was made at the time of the election but which was shattered in the budget—the plan to dismantle the 30 per cent rebate on private health insurance premiums. There are 43,170 people in the Parkes electorate who are covered by private health insurance. The government’s move away from private health insurance to encouraging more people into Medicare and onto the public hospital lists will have a negative effect on the people in my electorate. It is five days now until the date on which the Prime Minister promised that he would have fixed up the health system in Australia. He said on the issue of health, ‘The buck stops with me.’ The people in my electorate are waiting to see what is going to happen in the next five days to change that.
The health system in western New South Wales is at a very critical level. The issues with Dubbo Base Hospital have been well documented over the last 12 months. To be honest, it is the dedication of the medical staff and the medical professions in western New South Wales who are keeping it all together. As a nation we need to look at how we are going to manage and fund health in the future because, quite frankly, it is the largest issue that my electorate is dealing with at the moment. I find it quite amazing that none of the money in the stimulus package went into the health system to overcome a lot of the service problems that we have at the moment. I will not dwell on this today, but in conclusion I would like to say that the health service and the people in western New South Wales, including in the Parkes electorate, are waiting for a change in the health service. They are looking for some leadership in this.
On indulgence, I would like to highlight something that has happened this week. I do not intend to make a political point but I would like to seek indulgence to mention this in the House. On Monday afternoon, a Sri Lankan born paediatric registrar Dr Ruban Arumugam was tragically killed on the Castlereagh Highway near Mudgee in New South Wales. Reuben, as he was known to his colleagues, came to Australia in the early nineties, was educated at the University of New South Wales and has been working in Dubbo, in western New South Wales as a paediatric registrar. He had had a very busy weekend. He was actively involved in saving the life of a child that was born 13 weeks premature. It was particularly difficult because, due to the inclement weather, the aerial retrieval services that normally provide backup could not go to Dubbo. Dr Arumugam had a very torrid time saving that child. Also, on the weekend he dealt with a young child that had been diagnosed as having leukaemia.
After a busy week of shifts at Dubbo Base Hospital he was heading home to his wife who lives in Western Sydney when he was, unfortunately, killed in a car accident. I would like to place on record here my condolences to Reuben’s family, to his colleagues at Dubbo Base Hospital—I know they are mourning at the moment—and to his mother and father, who at the moment are working through Immigration to try and get temporary visas to be here for his funeral. We are having a few problems with that but I am assured that Senator Evans’s office is working very hard to overcome them.
In closing, I would like to acknowledge the contribution that Dr Arumugam made to the people of western New South Wales. I would like to acknowledge my sadness for his wife and his parents, and his brother who lives, I think, in America. His death highlights the dedication and the extreme pressure that people who work in health in western New South Wales are under. I know he will be sadly missed.
11:42 am
Mark Butler (Port Adelaide, Australian Labor Party, Parliamentary Secretary for Health) Share this | Link to this | Hansard source
On indulgence, I would like to joint the previous member in expressing the government’s condolences to the family of the doctor that he spoke of. We know that medical professionals all around the country do extraordinary work and often work very long hours, drive long distances and put themselves in danger in helping others maintain their health and wellbeing.
I thank members for their contributions to this debate. Though I note the opposition’s support for this bill I also note that the member for Dickson continued to exhibit an incapacity to stay on the topic. The fact is that the industry are great advocates of this measure and it is important that all members of the House are very clear about that fact. The Private Health Insurance Legislation Amendment Bill 2009 will amend the Private Health Insurance Act 2007 and the Age Discrimination Act 2004. The amendments will permanently allow private health insurers to offer extended family policies that cover people aged 18 to 24 inclusive; who do not have a partner; are not studying full time at a school, college or university; and where the fund rules of the private health insurer provide for this group.
Private health insurers developed extended family policies to encourage 18- to 24-year-olds to continue their health cover into adulthood. Under the Private Health Insurance (Complying Product) Rules 2008 No. 3, transitional arrangements were made to allow these extended family policies to continue until the end of this year—31 December 2009. The bill will allow the Private Health Insurance Act 2007 to allow insurers to permanently offer extended family insurance policies. In essence, this measure will enable private health insurers to continue to provide a type of product which will encourage younger people and their families to maintain private health coverage.
This government has consulted health funds, and I would like to thank all of those who have offered their input. I note that in its submissions the Health Insurance Restricted Membership Association of Australia has been constructive and supportive in moving this proposal to fruition. I note in particular that that association has stated that it welcomed the proposed amendments. HIRMAA’s support is particularly important due to its unique historical and contemporary links to various professions, trades, industries, unions, employers and geographic regions, and I thank the association and its members for its valuable input.
The Australian Health Insurance Association has also expressed its open support for the proposal, which only goes to show that, while we may disagree from time to time, we do continue to work together where we can. I am pleased that the AHIA:
… endorses the proposed legislation and congratulates the Australian Government on the policy initiative.
It goes on to say:
This important policy change will allow funds to continue to support the health care needs of younger Australians.
I welcome the broad support of the insurance sector and anticipate that this measure will assist in providing downward pressures in premiums, which is especially important in times of economic uncertainty like these.
The bill also amends the Age Discrimination Act 2004 to provide an exemption from any unlawful age discrimination under that act which may arise from allowing a higher premium to be set for extended family policies. The bill also includes consequential amendments to the Private Health Insurance Act 2007 consistent with the introduction of the Private Health Insurance (National Joint Replacement Register Levy) Bill 2009, which imposes a levy upon sponsors of joint replacement prostheses in order to recover the costs of maintaining the National Joint Replacement Registry.
Question agreed to.
Bill read a second time.
Message from the Governor-General recommending appropriation announced.