Andrew Laming (Bowman, Liberal Party) Share this | Hansard source

The option of having half of Australia covered under private health has gone away for the government. Access Economics predicts as many as 800,000 Australians will pull out of private cover. Most of those will be the young who can say, ‘You know what, it is not an insurance policy; it is just money I do not need to pay. What am I getting for my premium?’ We do not think about that with house insurance. We do not say, ‘What am I getting for my money each year?’ We think about it as providing for the future. But the government thinks that this is money that we can return to the kitchen table. When those people are old enough that they need high-level, expensive, cutting edge, state-of-the-art health services and we have not paid for it over those many, many years, there will be no option, no answer and no plan.

When people drop out, they leave behind others who keep paying the increased premiums. They will be those senior Australians who did not pop up in the Hawker Britton popularity polling. They will be those who have to stick with private cover. They have been there for 10 or 20 years. They will keep paying those heightened premiums because they have no choice. They know that, if they want to get their hip or their cataract done, the only hope in a state public hospital system is to remain insured and pay those heightened premiums.

For the younger Australians, you are going to endeavour to convince them that this was a short-term fix to get that budget to balance and to fund all of that $30 billion of Labor spending. The way to do it of course was to make these cheap cuts in such areas as having to pay out a 30 per cent private health rebate. When this government was sitting over here in opposition, we could see them seething with discontent about having to support a 30 per cent private healthcare rebate. But they did it for political expediency. They silently restrained their anger and frustration that government resources should go towards private health cover without realising that, for every 30 per cent the government pays, an individual for the first time in their life pays 70 per cent of their health care.

It did not cross their mind, did it? It did not cross their mind in opposition, and today they resent the fact that Australians have elected to pay health insurance premiums, just as Australians elect to pay for independent schools. This is that kitchen table test: the choice of putting some money into private cover or some money into independent schools—making a choice as to where I want to invest my money. It is a choice for Australians to make. Premiums are highly competitive and Australians can make a decision. But what you are doing tonight is removing that option completely by allowing those, particularly of my age, to elect for a cheap way out for the next decade, because I can actually avoid a Medicare levy surcharge, take a cheap option and then hopefully dive back in when I am 45 and think I might need my first operation. That sort of gaming of the system is what this government is allowing by taking a short cut in health care.

We have heard the rhetoric about public health cover and we have heard the rhetoric about health prevention. We have heard the rhetoric about planning for the future. But it is in this legislation that we are seeing the reality. The reality is that, if you as a couple are earning $149,000, you can take the short cut and avoid the surcharge. You can worry about your health care later, worry about it when you turn 60, and community rating hits all these people up for one per cent of their age over the age of 30. Do not mention community rating to them now; just give them the easy out. And this from a government that was going to take the hard yards, end the blame game and be the new light on the hill for governments working together and taking farsighted decisions.

What you have done is effectively reduce the base. It is as simple as that. Health works on economies of scale, and by reducing the base you have simply allowed moral hazard—that sense that I can get away without private cover. If I need to queue up, I am happy just to sit there all night. It does not matter that seniors are going to pay a whole lot more for their health cover. Of course, you have the other end of the scale—all those people who said, ‘I’m feeling great now, I don’t need to pay, and I will take a chance. I’ll worry about it when I am 60.’ These are the people that you as a government have just fed right into—the short-cut takers, those who say, ‘I don’t feel too bad at the moment.’ The very people that in public health we are trying to target, saying, ‘Worry about your heart. Worry about your prevention of everyday chronic disease. Worry about your weight.’ We have these people effectively paying private health rebates and talking to their providers every day and having access to allied health cover that they had never known under state government funded hospital systems. They had never had access to those kinds of health services because, with respect, under Labor state governments, waiting lists are not waiting lists for health care; waiting lists are dying lists. You sit on that waiting list and for so many Australians your operation just never comes, it never materialises. Why? Because other people get close to death and simply jump in front of you. If you want to wait for a cataract operation in your average public hospital, you will be waiting so long as you are simply supervened by those who have urgent conditions that require treatment that you may never see that operation. That is the state hospital reality we are faced with at the moment.

There are three choices for you on a waiting list. You can wait—others who have more urgent cases can be treated first; you can elect to pay for some private cover and have the operation done; or you can die on a waiting list. That is the great tragedy that as a doctor I would be told, ‘No, you have to move down the waiting list. Mr X has passed away waiting for his operation.’ That is the hidden saving in having a waiting list that does not move because the hospitals are not appropriately funded. Do not let anyone tell you that today’s legislation somehow better funds the state Labor hospital system. In fact, you have actually done the reverse. You have an enormous number of people and the great concern is you do not know how many people are now going to be queueing in those public hospital waiting lists. Australia has a very delicately balanced model: a GP focused health-care system. After hours you typically either get an after-hours GP who comes to your door through the former coalition federal government’s initiative or you go to a public hospital. The entire triage system after hours is typically through an A&E department. By slowing down service delivery, public hospitals manage to delay services and handball them back to GPs the next morning. That is one of the great cost shifts in the health system that we are trying to avoid. So the first thing that this government does is simply add more people onto that waiting list, add more people onto that queue in the A&E department. That was your great healthcare reform of early 2008. Historians will look back on that contribution. They will look back on how you have damaged those economies of scale—

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