House debates

Monday, 13 October 2008

Tax Laws Amendment (Medicare Levy Surcharge Thresholds) Bill (No. 2) 2008

Second Reading

1:44 pm

Photo of Peter DuttonPeter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Hansard source

It is my pleasure to contribute to what is a very important debate about the future of health services in this country and about how the federal government is going to contribute to the private health sector and to the public health sector, with the overall aim, we hope, of improving the system generally for all Australians. The first point that needs to be made in the debate on the Tax Laws Amendment (Medicare Levy Surcharge Thresholds) Bill (No. 2) 2008 is about the origin of this policy that is being proposed by the Rudd Labor government. Many people will recall a debate about health in the run-up to the November election last year. They will recall certain promises and obligations that were undertaken by the then opposition, now government, in relation to health. They will remember a number of promises that were made, in marginal seats in particular, in relation to so-called superclinics. They will recall a number of other funding arrangements that were promised by the Labor Party. But what the Australian public will not remember is a promise or any utterance in relation to the particular policy which is being advanced by this ideologically driven government at the moment.

Despite the fact that the Labor Party had this policy worked out and despite the fact that they had the detail of this particular policy at the time of the last election, in the run-up to the last election the now Minister for Health and Ageing, then shadow health minister, stated that they would not be releasing details of this policy during the election campaign. Many opposite have heralded this policy as a way in which they can cut taxes for Australian families or for older Australians and a way in which they can provide support to the health system generally around the country. But they did not think it was such a good idea to make those same claims in the run-up to the last election. If this was a rolled-gold policy from Labor, why wouldn’t they have released the details, having worked out the details prior to the last election? I will tell you the reason why, and most Australians understand this as part of this debate.

This is a government which is driven by ideology, a government which at its core is opposed to the private health system in this country. This is a Trojan Horse way of disrupting the private health system, which provides coverage to many Australian families and older Australians right around the country. In this country, we have to make sure that our public hospital system is properly funded. The states over the last decade or so have had an appalling record in terms of health management and the way in which they have managed our hospitals in particular and our emergencies services in general. It is certainly a disgraceful period in this country’s history when you see our health systems run down. To see a further attack in the form of this bill shows exactly what this Labor government is about. This is not about delivering a tax cut and it is not about increasing thresholds to provide better outcomes for families. It is about attacking the private health system.

If the Rudd government wants to provide tax relief to Australian families then it should put forward a bill to do so. If it wants to make sure that Australian families pay less tax then it should do that through the tax system. If this government wants to provide tax cuts to middle-class Australians and to lower income Australians then it should put such a bill forward—we would vote for it—the same as we did when we were in government, reducing taxes right across every threshold in this country. We will support good legislation which provides tax cuts to Australians that are adequately funded, properly funded and well thought out.

This is not a policy about providing tax cuts. This is a policy which will force millions of Australians in the long term onto queues in public hospitals. It will force potentially hundreds of thousands of people, or on some estimates up to a million Australians, out of private health. It will ultimately make the private health system in this country unviable. It will drive up premiums for people who remain in the private health sector. That is why this is bad legislation. That is why the coalition is opposed to it. It is why Independent senators and Senator Fielding have also questioned this legislation. It is ultimately why many advocacy groups and many people who are concerned about the long-term viability of the health system in this country have come out in opposition to this policy.

When we look at some of the estimates that are made, we find they are quite disturbing. Access Economics and PwC show that anywhere up to one million people will leave private health insurance if the government achieve their ultimate goal in relation to this policy. They are a government which is intent on attacking private health because they do not believe in private health. Despite all of the rhetoric and all of what they say to the contrary, the proof is in what they present to the parliament in the form of this bill. If it was such a good bill and if it was such sound policy, either health policy or economic policy, why not introduce it to the Australian people in the run-up to the last election? The reason is that most Australians would have seen through this policy very, very quickly.

This policy in its original form has already been rejected by the Senate. The government have made amendments to the bill to reintroduce it to this chamber for further discussion and, they hope, to pass it through the other place as well. But they need to answer the fundamental questions about why it is right to drive people out of private health, in particular younger people, which will have a dramatic impact on the rising cost of premiums, particularly for older Australians.

Many people, particularly older Australians or those who want private health insurance for a young family or because they are infirm, regardless of their age, decide to take out private health insurance because it provides them with a blanket of security. Particularly at a time of life when they may be approaching further health difficulties, they want the support of private health cover. By driving out, in particular, younger people—who predominantly do not claim on private health—who are in that insurance pool, this bill will dramatically increase the premiums for those who remain, who are predominantly older Australians. That is bad policy, it is a bad outcome for all Australians and it is why it would ultimately be a bad outcome for health in this country. It makes no sense at all to drive people out of private health and onto public hospital queues that are already stretched to breaking point across every state and territory in this country.

I will give you one example of health management. In Queensland at the moment the Bligh government—with a decision that was originally formulated, as I understand it, by the Beattie government—has decided to close the Royal Children’s Hospital in Brisbane. Now, that is an appalling outcome for families on the north side of Brisbane. It is an appalling outcome because it will mean that people who have to travel long distances with sick children will not have the same services that they currently enjoy. From all of the professional advice that I have received, I can say that it would result, long term, in a bad outcome if there were an epidemic and we were trying to provide all those services needed by young children who are most sick. I think it underscores the fact that Labor is a side of politics which does not have the capacity to introduce, maintain and implement a good health policy. If we get the same style of management of the health system at a federal level that we have had from Labor at a state level over the last 10 years then pity help the health system in this country over the next decade or more.

When the then Western Australian health minister gave evidence in relation to this particular bill, when it was scrutinised by a Senate committee, he advised that the extra burden on the health system from driving people out of private health—and putting more procedures onto waiting lists in public hospitals around the country—would cost Western Australian taxpayers $50 million in one year. No doubt there has been some cosy deal stitched up between the federal Labor health minister, the state Labor health ministers and the territory Labor health ministers as to how the states are going to be compensated for these extra procedures in state hospitals. If that figure is multiplied out round the country then this will not be a bill that saves the government any money at all; it will be a bill that delivers worse health outcomes for people who are queuing on waiting lists at the moment in public hospitals, it will drive up the price of private health insurance for those who remain in private health and it will have a bad outcome in the long run as well because it will be more costly to the taxpayer at a federal level.

For all of those reasons it does not make any sense. If the Labor Party have a hidden agenda they should come out and talk about it. That is certainly what a lot of commentators are saying. A lot of people believe that this is a government hell-bent on implementing policy thought bubbles, not one that thinks through policy decisions. They are going out there trying to get media headlines but not thinking through the ramifications of the announcements. This is a government which is not yet 12 months old but already notorious for having these thought bubbles, for referring matters off to committees, for not being decisive and for not having the capacity to lead our nation in the way in which it deserves to be led. This is a trying time for our economy, it is a trying time right across the world, and the Australian people want the economy properly managed in this country so that ultimately we can provide more support to areas of public policy—in particular, the area of health.

We need to make sure we have a sustainable system into the 21st century. We need to make sure that Australian families, when they want to see their doctor, are able to see their doctor. We want to make sure that we have a health system that if people choose to go into a private health arrangement that takes a burden off the public health system then that it should be encouraged, not discouraged. This should be a public health system where, if people want to have arrangements that will allow them to age in their homes or to have access to world-class facilities as they age in our society, then they should have unfettered access to those services.

This is a bad bill because it does not achieve any of those principal aims. It will not save money, as the government predicts—they talk about it being a tax cut but this will ultimately, on the government’s estimates, be a savings measure—and if they want to implement some sort of tax reform or some sort of positive tax outcome for Australian families and older Australians they should do it through the tax system. That is a point that needs to be made.

I only have a few minutes remaining before we go into question time, and I intend to continue to contribute to this debate when it is reconvened, but I want to make it very clear to the House that the coalition remain committed not just to the public health system in this country but also to private health. We want to make sure that we have a sustainable system. We want to make sure that people recognise that under the coalition government, when we came in in 1997 the private health participation levels were quite low—they were at 33.9 per cent. They increased to 44.7 per cent. That was as a result of three definite pillars of good public policy: firstly, the 30 per cent rebate for 65-year-olds and younger, the 35 per cent rebate for 60- to 70-year-olds and the 40 per cent rebate for over-70-year-olds; secondly, Lifetime Health Cover; and, thirdly, the Medicare levy surcharge.

If this is a government that is hell-bent on destroying the private health industry in this country and forcing hundreds of thousands of procedures onto public hospital waiting lists then they are going the right way about it. But if they want to work together to make sure that we have a system which will cater for our ageing population and to make sure that we can restore confidence in the public health systems around the country then they should be coming to a sensible compromise. They should not be suggesting that this bill is about a tax cut when it is about anything but. This bill, make no mistake, is about an attack on the private health insurance industry. It is about an attack from an ideological basis, which in the 21st century is unjustifiable. The Labor government need to be honest with working Australians—or ‘working families’, as they like to put it—and they need to be honest with older Australians who are going to suffer as a result of this policy. They need to recognise that this will ultimately be quite damaging to those people.

This government needs to be decisive in its actions, because at the moment it is not decisive in any area. This is a government which is hell-bent on referring matters to committees. They have not thought through this policy properly. They certainly do not understand the ramifications. Many right around the country are describing what the effect would be of driving a million people out of private health into the public health system: hundreds of thousands will be driven onto hospital waiting lists. It is bad policy. It is not well thought through. It is a policy which Labor knew about prior to the last election but which they did not disclose to the Australia people because they knew that the Australian public would see right through this policy straightaway.

The call today is on the health minister to be honest with the Australian people about the costings and about why it was that in the first place she did not support this policy—this was an invention of the Treasury, not Health—and she needs to explain to the public why she is out there supporting a policy which is going to provide worse health outcomes than even the state governments are able to provide. It is pretty important to recognise as part of this debate that this federal Labor government is conducting itself in exactly the same way as the state Labor governments manage their health systems—and that is a bad outcome.

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