Simon Crean (Hotham, Australian Labor Party, Shadow Minister for Regional Development) Share this | Hansard source

I, together with the member for Werriwa, oppose the Medibank Private Sale Bill 2006. It will put into the health system increased costs that will fall on individuals, and that can only be bad for people struggling to meet health costs. The fact is that Medicare has been and can be a world-class universal healthcare system, providing affordable health care to all Australians—a system whereby what gets you that affordable health care is your Medicare card, not your credit card.

But let us be clear at the outset as to who in this parliament is really committed to Medicare. Labor created Medicare under the Whitlam government; the Liberals under the Fraser government wrecked it. It was recreated again under the Hawke Labor government; the Howard government, when it came to office, wanted to wreck it again. They could not because, by that stage, it had been so entrenched and universally accepted, so what they did was undermine the system and starve it of funds. They ran down bulk-billing and increased patient out-of-pocket expenses. They forced a position in which people who got sick could not go to a doctor but turned up at the emergency wards of public hospitals, adding to the waiting lists. This was cost shifting of the worst order. They forced more and more people into the private system and diverted resources into that system to drive private health insurance, forcing more people onto it. It was another way, if you like, of forcing people to pay more for their health care—shifting the cost from the public to the private.

Interestingly, it is worthwhile reminding the House that the way they paid for the private health rebate was not new money; it was money diverted by their scrapping of the co-contributions system for superannuation—a system that Labor had developed, which the Howard government promised to keep before the 1996 elections, but, when they came to office, they abolished it. They used the savings from that to fund the injection into the private health rebate. In other words, they took a benefit from all of the workforce—superannuation—and redistributed it to private health insurance, covering just half the population.

Also prior to the 2001 election, they promised to keep private health insurance premiums down. I even remember the Prime Minister offering personally to intervene to stop increases in private health insurance. Since then, private health insurance went up each year: in 2002 by seven per cent; in 2003, another 7.4 per cent; in 2004, 7.6 per cent; in 2005, eight per cent; and in 2006, 5.7 per cent. No intervention as promised by the Prime Minister. Another broken promise. End result? People forced to pay more for their health. Honest John indeed!

Under the bill before us, Medibank Private is now to be sold. Instead of a not-for-profit organisation, it will become a for-profit organisation. As the member for Werriwa said, does anyone really believe that that will do other than force private health insurance premiums up even further? If the government would not exercise control over costs and now it is selling the remaining mechanism by which downward pressure on healthcare costs could be affected, does anyone seriously suggest that the hike in private insurance premiums that we have seen under this government will not just continue upwards? The Prime Minister and the Minister for Health and Ageing parrot the Goebbels chant. You heard it again today in question time when the minister said that this government is the best friend Medicare has ever had. But, like so much of their mantra, the facts are different.

The government, of course, know they are hugely vulnerable on the claim about their support for Medicare. It is, in fact, a huge lie to say that they are the best friends of Medicare. The truth of it is they cannot win free-to-air publicity on their claim, so they buy time: paid advertising to reinforce the chant, money spent—some $100 million of it just on advertising alone for this system—not to improve the system, not to tell people how to better access it, not to help people get their costs down but simply an advertising campaign to identify themselves with the Medicare brand name.

Let us just look at the facts, because I think it is instructive. I sought leave from the minister at the table before—and I hope he has passed it onto the current minister, the Minister for Community Services—to incorporate in Hansard this table which shows the national bulk-billing rate since 1984-85.

Leave granted.

The graph read as follows—

This is a very interesting graph because it shows, in the columns that are red in colour in the original and extend from 1984-85 up to and including 1996-97—essentially when Labor was in office and was committed to rebuilding Medicare, which had been trashed by the Fraser government—that in each of the years, because of Labor’s commitment, we saw an increasingly steady trend to increases in bulk-billing, and so much so that we peaked with an over 80 per cent national bulk-billing rate in 1995-96. There was a continuous upwards trend in all the years because Labor was committed to Medicare.

When the government came to office, withdrew the funds and did not maintain the commitment to Medicare, we saw a steady decline until 2003. Why do we start to see the pick-up after that? Because in 2002-03 Labor hammered the government on this issue. We developed a policy in opposition to repair the system. Labor set about providing the means by which we could rebuild the system—as opposed to wrecking it. We proposed measures to increase the rebate for all bulk-billed patients. In addition, we provided targeted incentives to reward doctors in disadvantaged regions. It was a bold response to restore the universality and affordability of the system. It was costed and funded—it was affordable. So effective was the campaign that the government panicked. You might remember that they changed ministers. They also had to pump money in because they were losing ground in the polls. They increased the rebate, but effectively they only increased it for the aged and children in families. In other words, they embraced the direction of Labor’s solution but nowhere near comprehensively enough.

It is true that the bulk-billing rate has increased since then, but that simply confirms the direction of the policy that Labor was advocating: start fixing the rebate and you will see an increase in bulk-billing rates. But, even with the half-hearted approach that the government has made, bulk-billing rates are not even back to where they had fallen to in 2001-02. They are about 75 per cent, well under the over 80 per cent that they peaked at when Labor was in office.

The system can be repaired, but it requires a belief in it and a commitment from government to repair the rebate system. It is a commitment this government will not make. It is now resting on its laurels thinking that the heat has gone out of this debate, but it will not go out of this debate.

I remind the House of the government’s performance on health care. They gave an ironclad guarantee shortly before the last election was called. In fact, on 6 September 2004 the Minister for Health and Ageing committed to keeping the Medicare safety net at its existing level, only to have the Prime Minister and the Treasurer humiliate him by repudiating that ‘ironclad’ commitment once the election was over. The government say whatever it takes to get elected. Do not believe them. They are not sincere.

But the message from all of this is clear: if you want Medicare as a universal system of affordable care, only Labor—the creators of it, the believers in it, those committed to strengthening it—can deliver that. And strengthened it must be. As we have an ageing population—with medical science driving longevity—health care and aged care, together with superannuation, are the generational challenges of our time. The government pretended to support Medicare—they had advertisements to say that they supported Medicare—but they do not have the commitment. Beyond the deceitful and costly advertising, theirs is a two-pronged solution, forcing Australians to pay more for their health and blaming the states.

Instead of blaming the states, this country needs a federal government committed to funding Medicare and aged care, thereby taking pressure off the hospital system, and using that commitment to forge a new health partnership with the states. Only Labor will make such a commitment.

The government’s position, bad as it is, only gets worse under this bill. Now they want to sell Medibank Private. They say that it will produce efficiencies on the basis of some scoping study from Carnegie Wylie and Co. but they will not produce the study to show how those efficiencies will materialise. I call on the min-ister to produce that study, to show the public and this House the evidence. Do not just make the assertion; give us the material upon which you base that assertion.

It goes further because there is a real issue concerning where the proceeds of the sale will go. When the government first announced its intention to sell Medibank Private in April, the Parliamentary Library produced a report on the consequences of that sale. One of their conclusions was that members of the Medibank Private fund had rights in the sale. The argument goes—and I commend this research briefing to the House—that, essentially, unlike other funds, where members make contributions, private health funds are subject to community rating and members, despite what the rules of the fund might say about the ability of the fund to cancel their membership, cannot have their membership cancelled if it involves discrimination. There is a fairly lengthy list of things for which you cannot be discriminated against. They cannot discriminate, for example, if you are chronically ill or on the basis of your sex or race. They cannot discriminate and force you out on the basis of your age. Essentially, under legislation that governs private health funds, members are entitled to retain membership as long as they continue paying.

A not-for-profit organisation, by its very nature, cannot distribute profits but has to manage its assets in the interests of members. In other words, it cannot simply go about and fundamentally change its status without having regard to the members’ interests. The research paper from the Parliamentary Library is quite categorical: members have rights over the existing assets of the fund. This in turn suggests that members could have a right to compensation if the government sold it.

What do the government say? They categorically deny that members have those rights. They say they do not have to pay compensation, even though there are some interesting adjustments now in the bill that suggest they might recognise that there is a compensation liability there. They essentially say that the Parliamentary Library is wrong. They hastily commissioned Blake Dawson Waldron, their law firm of choice, to confirm their view. The Parliamentary Library responded by categorically rebutting aspects of that part of the BDW—Blake Dawson Waldron—analysis that sought to counter the Parliamentary Library’s assertions.

This is a government not known for being open with its information. It is a government known, in fact, for its avoidance of scrutiny. It rushes legislation in when it suits to deny not only proper debate but informed analysis. I commend the Parliamentary Library not only for the rigour of the work but for the way in which they have been able to respond so expeditiously to the Blake Dawson Waldron legal opinion, because this was material that only came to us in the opposition the very day this legislation was being debated in the parliament. The Parliamentary Library’s work is comprehensive. I commend it to all members of the House. It gives, on the face of it, a significant rebuttal of the legal advice that the government relies upon.

Here we have the circumstances of the government paying for its propaganda defence. I pay tribute to the library, in particular the authors, Luke Buckmaster and Jerome Davidson, for the way in which they have been able to analyse this in the public interest. I do not just urge members of parliament to read this to reject the proposal we have before us; I urge the public, in particular members of Medibank Private, to read the analysis.

What we have is the hired legal mouthpiece versus the independent and first-rate parliamentary research facility. And if anyone doubts that tag, I remind the House that a couple of days ago that is exactly what the minister for health acknowledged they were. This is not just a mere difference of opinion; the Parliamentary Library research conclusion is damning of the Blake Dawson Waldron advice. The government was forced to provide that legal advice because of analysis previously done by the library that the government claimed was wrong.

I made the point before that the government will not release the scoping study from Carnegie Wylie. It is that study upon which they rely to assert that there are efficiencies to be gained from selling Medibank Private. How does the public know? The parliament cannot know, because the government will not release the details of the scoping study. One can only ask the question: will that advice stack up to scrutiny when it is released—if it ever will be released?

The conclusion one comes to is that there is too much uncertainty associated with the bill before the House. Our suggestion to the government is: withdraw the bill. Withdraw it until you release the Carnegie Wylie advice and until you respond to the Parliamentary Library more effectively than simply by saying your preference is to rely on Blake Dawson Waldron. That is not an answer. It is not rigour. It is poor public policy and, if it proceeds, the public will pay again.

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