Kay Hull (Riverina, National Party) Share this | Hansard source

I rise with great pleasure to the support the legislation that we have in front of us today. Before I commence outlining the reasons why I support the Private Health Insurance Bill 2006 and related bills, I will refer to the speech by the member for Newcastle. I feel it is imperative and incumbent upon me to assure Australians that it is absolutely not a crime to have private health insurance. The member for Newcastle would have you believe—if you listened to her speech and the assertions she made within it—that it is. She has not represented those in her Newcastle electorate who would dare to have such a thing as private health insurance. Given the statements that she made in the House today, she has clearly told the electors of Newcastle that if you have private health insurance then your interests will not be represented by your member. Far from paying out on members of The Nationals, she should note this. The one thing that you can be assured of about National coalition members is that they will represent all constituents equally. There is no discrimination in the way in which we voice the concerns of the constituents. Regardless of whether we agree with them or not, the voices of the constituents can be heard, and they will get representation. That is certainly what people have been told by the member for Newcastle they will not have if they have private health insurance.

I will now move on to the reasons why I support this bill. The particular area of the bill that I want to mention concerns the broader health cover that has been sought for so long by my electorate. When this is introduced, it will mean insurers will be able to pay benefits for medical services that are provided outside a hospital. What a very sensible decision to make! While private health insurers must offer a product that covers hospital treatment, they will now be able to develop a health insurance policy that can pay benefits for hospital services that can be safely delivered outside a hospital environment and setting. This allows for the best care to be provided in the most suitable location for the person who has taken out private health insurance. Who knows: it could move on to the public health system as well and enable pressure to be taken off that system as people who have private health insurance take that action, so that more public patients who are unable to have private health insurance can access treatment.

They probably cannot if they live in the electorate of Riverina, which is under the Greater Southern Area Health Service run by the New South Wales state Labor government of Premier Iemma. It is not easy to access any service, whether it be inside or outside a hospital. You have got a significant waiting list. I was told recently of a man with an injury who does not have private health insurance. The fact is he was told he would have to wait three years before he could even have a remote chance of being put on the list to have his bicep repaired. That is what we have to bear in New South Wales under the Iemma Labor government.

Once the Private Health Insurance Bill goes through, it will enable patients to receive benefits for services which do not require admission to a hospital. Take someone with cataracts. Having cataracts is a common reason why an elderly patient or a not so elderly patient has to be admitted to hospital, although now they could have their procedure done safely and effectively in a very low-acuity setting. The second most common reason for admission to hospital is chemotherapy. We all know people who are in the unfortunate circumstances of suffering from cancer and requiring admission for chemotherapy. But this chemotherapy can be provided just as conveniently and safely in a community setting, either in a person’s home or in a low-acuity health facility. You should be able to access this treatment under your private health insurance and you should not have to be forced into hospital.

The changes will mean that pressure is taken off our health system, as I have indicated, through fewer people being admitted to hospital and these additional hospital costs being avoided. The idea is that, when you factor in the high cost of providing health care in a hospital setting with nurses, the overheads and all of the issues that go into making up a day charge for a hospital, you will be able to stop premiums from rising to account for the additional costs of providing medical treatments or services to those in hospital who simply may not need to be there because those types of services could be delivered elsewhere. Broader health cover will also allow health insurers to work with a wide range of service providers to develop more flexible and innovative products that reflect our modern clinical practices and our consumer expectation. Again, these are things that are so beneficial for somebody recovering from an illness or needing the appropriate and adequate treatment for an illness that could be available outside the system rather than within the hospital system itself. Health insurers will be better able to assist consumers to manage and prevent acute and chronic conditions. Many people could benefit from tailored programs that support and sustain a healthy lifestyle, such as a personalised health check, dietary guidance, exercise supervision and support to quit smoking. All of these things can now be taken into consideration in the way in which private health insurance is paid for.

Broader health cover is set to come into effect on 1 April 2007, and it will include: outpatient and day services; in-home services such as dialysis and post-discharge care; and condition management, wellness and prevention services. The previous speaker outlined that she thought many of the people in her electorate would love to be able to get dialysis at home and be able to claim it. Yes, that is the case, but many of the people who need dialysis want to take comfort in the public hospital system. If you take the pressure off dialysis units in the public hospital system by enabling people to utilise their health benefits and set up dialysis at home, it has to be better in the long term for access for public patients. We have a whole suite of options that can come into play to give everybody better opportunities to access the treatments they require.

There are also dental and optical services, out-of-hospital chemotherapy, nursing, dietitians, domestic assistance, ambulances, hearing services, theatre fees, physiotherapy and podiatry. All of these will be eligible for the 30 per cent and over-65 higher PHI rebates plus public health insurance rates. Nothing will stop private patients being treated in public hospitals, but this will encourage private-insured wellness, prevention and early intervention for fund members, which could prevent or minimise expensive hospitalisation. That is the priority of the government, and it should be. We need to offer a suite of services and choices and try to minimise the cost overall by always being innovative and enabling new practices to come into play that can reduce or contain costs in an ever-burgeoning health world where many of our health treatments are so expensive and sometimes cannot be avoided. I think that it will greatly appeal to younger and healthier people who currently feel that hospital cover is not relevant to them. In some circumstances these services may be more suitable, safer and more cost-effective for members. Health funds, as I have mentioned, may also offer to cover preventative services which, in helping people to better manage their health, may place downward pressure on premiums over the long term. That is all that we can hope for. We need to start putting into practice policies to put downward pressure on premium hikes and prices.

Individual funds will decide what services they include in the private health insurance product. I would encourage them to be expansive, and innovative and to explore any and all options that can contain health costs over time. In my electorate of Riverina there is only one private hospital to cater to the entire electorate, so it is under enormous pressure. If I had a hip replacement, I could decide to go into the private hospital, as I have private health insurance, in order to free up one extra space in the public hospital for somebody else who will hopefully come off the three- to four-year waiting list—and sometimes longer—for the same type of procedure. If I go into a private hospital to have my operation and then am very well, I will still need some physio and somebody to occasionally check on my wound. For me to be in a position where I am going to run up the cost of all of the nursing and health services provided in the hospital that come into the costing of that bed seems quite ridiculous to me. It seems to me that I should be able to go home and have somebody come in and dress my wound and still claim that on my medical insurance. It would be much better and healthier for me as the patient, it would establish an external practice that is able to accommodate and assist those services and, at the same time, it would take the pressure off the hospital system and not be so costly for the private health insurance fund that it has to continue to raise its premiums. I think it is such a sensible idea to be able to have these options.

In rural and regional areas it is often easier to have treatments for a serious illness in a more comfortable setting, such as home environments, due to isolation and lack of beds. This legislation can assist in these situations for those people who have committed no crime. They have private health insurance; that is simply not the crime that previous speakers in this debate would have people in this House believe. If people are prepared and willing to do that to take the pressure off the public hospital system then this is what we should have, but it should have a multiple choice factor.

The fact that these changes can, as I say, lead to lower premiums for residents is welcome, especially for those rural people who outlay an enormous amount in travel costs in order to be treated. Serious illness is very difficult for people in rural areas. They travel to hospital because they are not covered for that treatment at home or in another setting. The costs can be extraordinary, as can the social and family isolation and dislocation. It is very sensible to broaden health cover to enable them to access the treatments they are entitled to.

Currently, private health care must be performed in hospital if members are to receive a benefit from their health fund. Hospital tables with ancillary insurance are able to cover only other kinds of health services. As a result, many patients, such as the people in my electorate of Riverina, seek in-hospital treatment in order to utilise their private health insurance, even though safe and suitable out-of-hospital services exist at less cost for that particular treatment. I am not saying that this is the case for all treatments, but it is a simple matter of horses for courses. Until now, health funds have been prevented from covering preventative treatments and services that are provided as a substitute for in-hospital care, and this change is the most sensible decision I have seen in health in a long time. I congratulate the Minister for Health and Ageing for entertaining this possibility, for giving cost options and for looking at ways to put downward pressure on spiralling health costs for those people who take out private health insurance.

The change is not expected to have an impact on the premiums people pay now but it will effectively remove the current boundaries between hospital insurance and ancillary insurance. It will not be mandatory for health funds to offer broader health products, but I suggest it would be a very smart thing for any private health insurer to consider for all of the reasons I have outlined—and the lower the cost the better. The government’s changes will allow people to have that opportunity which they do not have now.

The government and the minister expect that this type of cover will become the principal form of private health insurance product, and I certainly endorse that. Research into broader health cover found that it would not lead to higher premiums, because health funds would have more flexibility in how they cover services. In offering broader health cover, a health fund may include a wider range of services than is currently available. It is an issue that we have needed to address for a long time. These guidelines were developed in consultation with the industry and with consumer representatives. We should not forget the consumer, because it is a consumer choice. If I had a family member who needed treatment, I would hope that I would be able to access that treatment at home in a comfortable, warm environment if that treatment could be delivered by a health service that could come to the house. I should be able to claim that and it would save the pro rata cost of a hospital bed when insurance premiums came to be determined.

I want to reiterate my absolute support for this bill, and in particular the area of the legislation I have spoken on today, because it enables private health insurers to provide myriad choices for the consumer. I also want to reiterate that, far from being ashamed of having private health insurance, as some in this House would advocate, people should be proud of wanting to have higher health insurance. In turn, those people who do not have health insurance because they cannot afford it should not be ashamed. They are entitled to quality public health services and access, off waiting lists, to procedures. It simply is not right that people who can afford to pay for treatment do not pay for it and take up valuable positions in the hospital and health system at the expense of having more and more people on waiting lists. In the New South Wales Greater Southern Area Health Service we already experience a disgraceful waiting list.

I think this legislation is one way of being able, quite rightly, to assist people who do not have the resources or the finances to purchase health insurance which would enable them to access treatment faster. If you are a person who pays into a health insurance scheme, far from feeling ashamed and that you should not undertake new and innovative treatments, you should feel that you are contributing to the health of other Australians who are not as fortunate as you. That will always be the case. In enacting this bill, we hope that other valuable and worthwhile Australians will be able to access the public hospital and health system far more readily, and particularly those in New South Wales. I commend the minister on his ability to cut to the chase and pick up these initiatives and I commend the bill to the House.

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