Jan McLucas (Queensland, Australian Labor Party, Shadow Minister for Mental Health) Share this | Link to this | Hansard source

Congratulations, Deputy President Marshall, on your election to that position. I move:

That the Senate take note of the answers given by the Assistant Minister for Health (Senator Nash) and the Minister for Finance (Senator Cormann) to questions without notice asked by Opposition senators today relating to copayments for medical services and to the regulation of financial services.

You would have noticed that Labor senators have been asking Senator Nash questions over many weeks about the impact of the GP tax, the $7 co-payment, and what that means for those using the health system in our country. We will continue to do so because it is important that people understand what this will mean for health consumers in our country. We will also continue to do so because we do not get an explanation or an understanding from either the minister or the government of what this measure will in fact mean. We saw the Treasurer, Mr Hockey, say that the $7 co-payment is just a bit more than the cost of a cup of coffee, a couple of beers. That is not what we are hearing from the health community and health consumers and, again, today we see coverage of the University of Sydney's detailed analysis of what this $7 tax on a GP visit, this $7 tax on diagnostic imaging and this $7 tax on pathology will mean. What will that mean?

That is why I, again, asked a question today: what does it mean for a woman who finds a lump in her breast? She has to go to the doctor. There will be a GP tax on that visit. She will probably need to go to the doctor twice. She will need an ultrasound and a mammogram. She will need to have an ultrasound biopsy, various blood samples and various pathology. It is ascertained that the cost for just finding out what the lump might be is in the vicinity of $90. But, if she then finds out that this is a positive test, there are a range of costs that that woman will have to cover in order to be treated for breast cancer. Minister Nash did not answer those questions. She provided a couple of answers.

First of all, she said that the GP can make the choice. The GP can decide whether or not to pass on those costs. At the Senate Community Affairs References Committee inquiry last Thursday, we asked various witnesses about the likelihood of GPs making decisions not to pass on those costs. I do not recall anyone saying, 'That'll be fine; the GP practice will just cover those costs.' It will mean that, for every item 23 on the MBS, a 20-minute consultation, the doctor would not only receive $5 less but also lose their bulk-billing incentive. The bulk-billing incentive is paid at the rate of $6 for a regular bulk-billed event in a metropolitan area and it is $9 or $10 in rural areas—there was different evidence on this last Thursday. The doctor will not absorb those costs for a 15- or 20-minute consultation. The doctors have said to us very clearly, 'We can't afford to.' So the bulk-billing incentive that is currently in place to encourage people to bulk-bill will now be paid if the doctor does not bulk-bill. The incentive is now applied if the doctor does not bulk-bill the patient. That is, they get the bulk-billing incentive if they actually require the patient to pay the $7 co-payment.

Senator Nash also said that the reason we have to do this is that the health system is unsustainable and that we cannot keep the health system going with the costs it has at the moment. First of all, the AMA, which is fairly well respected in this place, says, 'Frankly, the health system is absolutely sustainable.' Associate Professor Brian Owler, the President of the AMA, has said very clearly that the cost to the health system as a ratio to GDP has not gone up in any way that should be viewed as alarming. It is about the same as it has been over the years. But let us peel back Senator Nash's claim that we have to make the system sustainable.

Any saving as a result of the application of the GP tax does not go back to the health budget. It will not go back into support health service delivery in this country. It is being creamed off and put into the Future Fund that, one day, may or may not do some medical research. So it is not as though the money is going back into better services, more doctors, more nurses; it is being pulled away.

But the more concerning thing is that people might go to the doctors less. That is my real fear: that people will attend the doctor less because they have not got money in their pocket. (Time expired)

Scott Ryan (Victoria, Liberal Party, Parliamentary Secretary to the Minister for Education) Share this | Link to this | Hansard source

Mr Deputy President Marshall, may I join others in congratulating you upon your election. I am now no longer required to refer to you as Mr Acting Deputy President! It is good to see a Victorian in the chair after the earlier comments about Tasmanians, even though we are of different persuasions.

What we have seen today and what Senator McLucas referred to in a series of questions is a contrived and confected scare campaign by an opposition that is desperate to find a cause. As Senator Abetz outlined in an answer to a different question, the Labor Party have misled the Australian people by telling them they terminated the carbon tax, by putting out brochures saying that they removed the carbon tax. They do not want to talk about that. They do everything they can to prevent those matters being brought to a vote in the Senate. They do everything they can to prevent the government implementing its agenda, so they try this confected campaign and this confected outrage about changes to Medicare that were announced in the budget.

What is the truth about Australia's health budget? Ten years ago, we spent $8 billion on the Medicare Benefits Schedule. MBS payments cost about $8 billion. Today they are $19 billion and, in a decade, they will be $34 billion. We all know that, as we get better with medical science and, as over the last 10, 20 and 30 years there have been medical treatments for conditions that were not available, our PBS and our medical system costs more because we are treating conditions we previously could not. But we also know that when something in terms of its spending increases by more than the government revenue base or by more than the annual inflation rate, as health spending has done year on year for as long as I have been in this place and indeed much longer under the previous coalition government, it requires each and every year billions of dollars to be reallocated from one government area to another. Because, if spending on health is growing faster than the government revenue base, you need to reduce spending elsewhere in order to maintain that rate of growth or restrain that rate of growth. Or you do what Labor did, which is simply borrow the money.

Growth in health spending per se is not a problem. For the same reason that the Hawke government introduced a co-payment for pharmaceutical benefits for those who had previously had free and unlimited prescriptions, introducing a small contribution from patients to access a service will actually make the health system more sustainable over time. From the confected outrage of those opposite, you would think we were introducing an American-style system where there were serious barriers to access. We have all had the tragedy of cancer in our families, but there are treatments for that that were not available a decade ago, let alone two or three decades ago. Asking people to make a small contribution to access public subsidies in the order of thousands of dollars that can extend and improve the quality of life is not unreasonable. It is done with safety nets.

I do not understand why it is with this most intimate of things, our own health, this thing that is most important to all of us—and I do believe those opposite share that view, although I do not share their confected outrage at these changes—we should say that we should never ask someone to make a contribution to their own health care. Why is it that when we talk about people going to see a doctor—for example, to access treatment, as in the example earlier of breast cancer—there is moral outrage at a payment to access certain treatments, but when you access pharmaceuticals like Herceptin, if you access life-saving medical treatments, it is okay to ask the patient to make a small payment? Somehow there is moral outrage at a payment for another purpose that will actually treat the same condition.

The Labor Party are in a desperate search for a campaign. All this government are doing is making the system sustainable in the long term. All this government are doing is saying that we think it is reasonable that people make a small, modest contribution to their own health care—after all, like all Australians, we agree it is so important to all of us.

Deborah O'Neill (NSW, Australian Labor Party) Share this | Link to this | Hansard source

Deputy President Marshall, congratulations on your elevation. I rise to take note of the responses of the Assistant Minister for Health to questions asked without notice today. I can inform the Senate, particularly the Assistant Minister for Health, that her response today was once again completely uninformative. The responses we received were once again a repetition of tired and worn-out lines from a minister who seeks to hide from the scrutiny to which this government does not want to be exposed. The assistant minister seems to believe that, if she keeps repeating the same lines over and over, those lines, by the very uttering of them, will somehow protect her from the avalanche of outrage crashing down on this government. But the people of Australia are awake to this government. They have, in the nine months since Mr Abbott assumed the prime ministership, been exposed to the reality of the web of lies that those opposite repeated ad nauseam before the election. Any currency those lines ever had in that election has completely evaporated. Remember, Deputy President, the new Prime Minister Tony Abbott, only 24 hours before the last federal election, on 6 September 2013, said there would be 'no cuts to education, no cuts to health, no change to pensions, no change to the GST and no cuts to the ABC or SBS'.

What we heard in the assistant minister's response was weasel words certainly, but weasel words that reveal a determination to push forward with a budget of broken promises to tax the sick. Why are we being subjected to these weasel words? It is because more experts are coming out against this government's policies, and weasel words are all the government have left to sell. They have nothing substantive to say, as each one of their key platforms is quickly being eroded by expert opinion and public sentiment. They keep on the offensive about the former Labor government, but they fail to realise the pain that they are set to cause everyday Australians. The questions addressed to the Assistant Minister for Health today were on that very topic—the pain they are causing, figuratively and literally in this instance.

What we are already seeing and being told by our local doctors all across this country, and indeed by the AMA, is that people are refusing to seek the medical attention that they may need. The fear of being unable to pay this GP tax has Australians running away from their doctors and doctors worried about their patients. Researchers from the University of Sydney are the most recent experts to come out against this tax. They have answered all the questions that the minister continues to refuse to answer. What do we know now? We know that the average patient with type 2 diabetes will be $121.49 worse off each year with this new tax. Patients with worse cases can expect to fork out an additional $150 per year. We can see these examples in other demographics too.

Some conservative estimates of what average Australian families will have to face include the following. A young family with two parents and two children under 16 years of age will pay $184 more per year on average for care and medications. Today, the minister refused to even acknowledge that fact, simply saying, 'I'm aware there are a range of opinions.' Being aware of a range of opinions does not absolve her of the responsibility for the policies that she wants to implement that are designed to hurt the sickest in our community. Self-funded retirees aged 65-plus years with no Commonwealth concession card will pay an additional $244 per year because of what this government wants to implement. An older couple with concession cards will pay an additional $199 per year on average. The minister might call this a modest contribution, but to the people of New South Wales and in the region where I live that is no modest contribution, and it is a disincentive to seek health care.

This is not just a single hit on the sick but a sick tax, literally taxing the sickest people in our community every time they need to seek medical care, every time they have a blood test, every time they need some pathology test, every time they need an X-ray or every time they need any other form of diagnostic imaging. Breast cancer fears will be put aside by mothers trying to look after their kids and putting their needs first and the costs of their families ahead of their own care. The chronically ill must be feeling even worse now than they might expect from their illness, as they are subject to the punishments of this bruising and cruel government, punishing them for being sick, punishing them for having an illnesses, punishing them every time they seek health care or diagnosis, punishing them for acquiring a chronic disease or for failing to be born or remain healthy enough and perfect enough to avoid the need to go to the doctor. This is a sick government. It is a sick tax that they are proposing and Labor will be fighting it all the way, to preserve access to Medicare. That is part of the fabric of this country.

Zed Seselja (ACT, Liberal Party) Share this | Link to this | Hansard source

The fundamental question when we debate the GP co-payment, as we are this afternoon, is whether we want Medicare to be sustainable. Fundamentally, the contribution from those opposite, the modern Labor Party, is that they do not want Medicare to be sustainable. All of those who have looked at this in detail over the years, on both sides of politics, and taken the view that we need to make Medicare sustainable have come to the same conclusion. Bob Hawke wanted to make Medicare sustainable, Dr Andrew Leigh wanted to make Medicare sustainable and the coalition government wants to make Medicare sustainable.

We have heard from Senator Ryan and others about the massive blow-out in costs from 2004 to 2014 and the projected blow-out in costs in another decade from $8 billion to $19 billion to $34 billion. When Andrew Leigh made his comments we were spending around $8 billion. In 2003, he said:

As health researchers have shown, cost-less medical care means that people go to the doctor even when they don't need to, driving up the cost for all of us.

That was Dr Andrew Leigh's position when we were spending less than $8 billion. Dr Leigh had a prescription, and it was the right one. We wouldn't often say that about Dr Leigh, but on this he was correct. He was correct when he came to that conclusion, as was Bob Hawke. So, well before it was blowing out, Bob Hawke and his government identified that they needed to make Medicare sustainable.

The modern Labor Party are now arguing that in fact Bob Hawke did not support Medicare and they are not prepared to accept that he was trying to save Medicare. He was trying to improve Medicare. He was trying to ensure that the position that Andrew Leigh put—that all of us end up paying more and it becomes unsustainable—was the correct one.

Well before we saw these kinds of costs, Bob Hawke said: 'It is quite clear, and I understand there is a very significant blow-out with regard to the Medicare situation in terms of servicing. What needs to be done of course is to ensure that both on the supply side and the demand side that there be some restraint imposed because you can't have a situation, Ray, where you are just going have outlays growing as in the rate that they were.' That was true then and it is truer now. What we have seen since then is massive blow-outs in cost—massive blow-outs when Dr Andrew Leigh said it in 2003 and came up with his prescription; and massive blow-outs since then: $8 billion in 2004, $19 billion now and $34 billion projected in 10 years time.

We hear those opposite, Labor senators, claiming that they support Medicare. That position is not sustainable if you do not have a way to make it financially sustainable. If you do not accept people being asked to make a small contribution to their own health care, with safeguards in place for the most vulnerable to a maximum of $70 per year, then you need an alternative prescription.

As Senator Ryan so eloquently put it, when these costs grow well above inflation and government revenue, then the money has to come from elsewhere, and you cannot just keep borrowing it. Eventually you will have to pay it back. So those of us who believe not in a sustainable budget for its own sake but in a budget that can deliver a sustainable Medicare system, a sustainable NDIS, a sustainable pension system and fund the infrastructure of the 21st century need to come up with ideas of how to fund these things and make them sustainable, and that is what the coalition has done.

Bob Hawke knew it to be true but eventually got rolled by his own party. Andrew Leigh knows it to be true but he has now had to pretend that he has had a lobotomy since coming into parliament and he no longer believes what he knew to be true just a few years ago. The position put by the Labor Party has no substance. It needs to be rejected. That is why things like a co-payment are important. (Time expired)

Sam Dastyari (NSW, Australian Labor Party) Share this | Link to this | Hansard source

I rise to take note of answers given by Senator Cormann during question time today—and what a day it has been! With apologies to President Obama, today we have seen the government in the Senate acting with the audacity of hope. Over the past few hours we have witnessed the government's audacity in trying to ram through the repeal of the carbon tax legislation without debate. During question time, we finally got to hear the Minister for Finance, Senator Cormann—the still acting Assistant Treasurer—admit that the government has audaciously introduced changes to Labor's Future of Financial Advice reforms to remove basic consumer protections, in the dead of the night, at the eleventh hour, in an audacious attempt to subvert the parliamentary process and avoid the scrutiny of the Senate. There has been an attempt to ram through changes making it easier for the likes of Storm, Trio, Timbercorp, Great Southern and—as we heard again just 10 days ago—the Commonwealth Bank's shonky financial planning arm to rip off ordinary Australians. The government has the audacity to hope that they are going to get away with it. On 30 June, hours before their own 1 July deadline, they promised the big banks, AMP and a handful of dodgy financial planners that give the good financial planners a bad name, that they would keep their promise to them. While they were prepared to break promises to working Australians—promises about the ABC, promises about Medicare and promises about SBS—they insisted that they needed to keep a promise to the big banks and to a handful of dodgy financial planners and audaciously introduced these changes by regulation, without the confidence or the guts to bring proper legislation into this place.

In today's Financial Review,Phil Coorey asked Mr Clive Palmer, the member for Fairfax, what he thought about Mr Cormann's audacious act. For the benefit of those opposite, I will quote the response the member for Fairfax gave Mr Coorey. The member for Fairfax said:

They can stick it up their arse—and you can quote me on that.

How can you have advisers not acting in people's best interests?

Gavin Marshall (Victoria, Deputy-President) Share this | Link to this | Hansard source

Simply quoting unparliamentary language does not make it parliamentary, and I would ask you to withdraw. I would also ask you to be mindful of the standing orders.

Sam Dastyari (NSW, Australian Labor Party) Share this | Link to this | Hansard source

I withdraw. I was of the opinion that I was quoting a member of the other place. But I could not agree more with the sentiment that was expressed earlier today by Mr Palmer, the member for Fairfax. I think he captured the sentiments of people who had been fleeced, who had been mugged and who had been ripped off before the FoFA changes were introduced.

Senator Cormann's audacious act in the dead of night will take Australia back to the bad old days. He has removed the best interests duty by removing the list of the steps a planner must take to legally meet the best interests duty. He has introduced new exemptions allowing for conflicted remuneration—allowing payment of conflicted remuneration and commissions for advice on complex products. These exemptions will see a return to the sales culture—and those across the chamber know it. These exemptions will see the return of conflicted remuneration, allowing payment of unlimited incentives and bonuses based on sales and revenue targets and removing any requirement to disclose these incentives.

Senator Cormann's reforms will allow commissions on execution services, extend grandfathering provisions so that these commissions can be traded, extend the already broad exemption for basic banking products so that it applies to all staff and remove the opt-in requirement, bringing back trailing fees. We will not allow Senator Cormann's audacity to roll back basic protections for Australian consumers, and nor should this Senate.

Question agreed to.