Nola Marino (Forrest, Liberal Party) Share this | Hansard source

I rise to speak on the Fairer Private Health Insurance Incentives Bill 2009 and cognate bills. These bills are simply further proof that Australians are now paying the price for the Labor government’s reckless spending and bad financial management. The bill title, which includes the phrase ‘fairer private health’, is itself a misnomer. There is nothing fair about these bills or the misleading repeated assurances by both the Prime Minister and the Minister for Health and Ageing that they would not reduce the health insurance rebate. However, the Australian people now know that they cannot trust this government and that this was just another example of the Prime Minister’s now infamous spin.

These bills cut the private health insurance rebate and at the same time increase the Medicare levy surcharge. Effectively, this is a double hit on Australians who are taking personal responsibility for their health needs by paying for private health cover. We are seeing Mr Rudd, the minister for health, Nicola Roxon, and the Labor government taking billions of dollars out of the private health system to pay for their $124 billion spending spree over the past 18 months. It is a direct and deliberate attack on both the private health system and the Australians who pay for it.

We have seen in the budget the very serious implications for the nation and for the Australian people, particularly for enterprising, hardworking families and businesses in regional Australia, including those in my electorate of Forrest. What we have in real terms is a return to the same old historic Labor governments of endless debt and deficit, now in proportions this country has never seen before. This debt and deficit is now forcing those on private health cover and their children to pay for this government’s reckless spending and its mismanagement of the economy. Those who are being forced to pay are essentially hardworking families who have taken personal responsibility, as I said, by taking out private health insurance and, in so doing, are reducing the cost and pressure on the public health system.

Why attack the health system? Why attack those with private health cover? My constituents, particularly those affected by this decision, cannot understand why the government has driven such a reversal in our economy, given that the Labor government inherited the best economic conditions of any government in the history of federal politics. In simple terms, 18 months ago we had no debt and $22 billion in budget surpluses. The deficit for 2009-10 is estimated to be $58 billion, with the net debt to grow to $188 billion by 2012 and with interest payments of at least $8 billion per year.

The budget, in effect, contains $315,000 million of peak debt and deficit by 2015-16, all on the nation’s credit card. This supposed temporary debt and deficit is all borrowed, and now those who are paying for private health insurance will help pay for the Rudd government’s temporary debt and deficit by cuts to private health. But people in my electorate know that this $315 billion has to be paid back by hardworking families and businesses like those in Forrest—the same 79,655 people who have private health insurance and who are now paying through cuts to their private health rebate and an increase to the Medicare levy surcharge.

But those Australians in the public system who do not have private health insurance will also pay, not just the 11.1 million Australians with private health insurance, over 1.8 million of whom are aged between 20 and 35. People between the ages of 20 and 30 years have a one-in-six chance of being admitted to hospital this year, as you would know, Mr Deputy Speaker. Also, insured Australians who earn over $75,000 will pay more because of the cut to the private health insurance rebate. If they drop out of private health cover entirely, they will pay more due to the increased Medicare levy surcharge. Insured Australians who earn under $75,000 will pay more through increased premiums if the younger and healthier people drop out of private health insurance. Uninsured people in my electorate will be waiting longer in the public hospital queues for necessary treatment because of those who will drop out of the private health system or who will reduce their ancillary cover. This would mean that more people would be dependent on the public health system. Hospitals will be under even more pressure than they are now. The government’s own figures show that these changes will affect 1.7 million adults. Industry analysis shows that the changes could affect over 2.4 million Australians in total.

My constituents also understand that the interest payments alone on the government’s $315 billion of borrowings, as we have seen in the private health insurance cuts in this bill, ultimately mean there will be less funding for core government services like health. My constituents also understand that the eventual repayment of principal and interest will have to be made by our children and grandchildren. People in my electorate will now suffer from the Prime Minister and the Minister for Health and Ageing’s broken promises. The Prime Minister and minister for health repeatedly and unequivocally promised the Australian people that they would retain the existing private health insurance rebates. This is not just a broken election promise; it was a frequently repeated commitment:

The clash between public and private in the health sector is an old one that has had its day. More importantly, Labor is committed to making sure both our public and private systems can work together for the benefit of the community, and that they are of world class standard.

That was Nicola Roxon on 7 April.

On many occasions for many months, Federal Labor has made it crystal clear that we are committed to retaining all of the existing Private health Insurance rebates, including the 30 per cent general rebate and the 35 and 50 per cent rebates for older Australians.

The Liberals continue to try to scare people into thinking Labor will take away the rebates. This is absolutely untrue—

said Nicola Roxon, the shadow minister for health, in a media release dated 26 September 2007. So much for the word of the Prime Minister and the health minister. Clearly, neither can be trusted on private health insurance.

This is not a minor issue. As I said, 1.7 million Australians will be affected by these changes, facing either higher premium payments or higher tax payments through the Medicare levy, and one million of these live in households with annual incomes of less than $26,000—the real battlers, the people who go without many basic needs just to have the security of private health insurance, people just like all of those with private cover who have taken responsibility for their own healthcare needs.

It is worth noting that private health insurance funds pay for 56 per cent of surgical procedures in Australia, and that includes 55 per cent of major procedures for malignant breast conditions, 55 per cent of chemotherapy treatments, 63 per cent of major joint replacements and 70 per cent of same-day mental health procedures. The coalition believes Australia should be a country of choice, which is why the previous coalition government increased the funding of Medicare from $6 billion to $12.5 billion—a 48 per cent increase in real terms—and increased private health insurance coverage from 34 per cent to 44 per cent. The Rudd government clearly does not understand the need for a strong, well balanced health system that supports Medicare but also encourages self-reliance through private health cover.

Western Australia has the highest rate of health cover in Australia. As I said, I have over 79,000 people with private health insurance in my electorate. So we in the west will feel the greatest impact of this decision. Those who exit private health insurance will become a greater burden on the public system in the south-west, and then the waiting lists will increase.

Health funding is a direct casualty of the Labor government’s cash handouts and reckless spending. Obstetric services, ultrasounds, reproductive technology and cataract surgery will all be affected. Women charged an average fee for private obstetric care will pay $500 more for their treatment with the proposed changes to the Medicare rebate. I quote the National Association of Specialist Obstetricians and Gynaecologists from 12 May:

Australia’s peak group of specialist obstetricians and gynaecologists today said the Government’s Federal budget announcement to wind back safety net rebates for private obstetric services will significantly affect affordability for the majority of Australian women choosing care from specialist obstetricians.

Dr Andrew Pesce, President of the National Association of Specialist Obstetricians and Gynaecologists, said this is a disappointing outcome for women who seek choice, access and affordability for pregnancy care.

Dr Pesce said although an increase in Medicare Benefits Schedule rebates will partially offset some of the financial burden and provide welcome relief for patients in regional and rural Australia, the end result for pregnant women and their families will mean significant increased out-of-pocket costs.

“If this increased burden means women can no longer afford private obstetric care, they will inevitably be forced to go over to the public hospital maternity services which are already overwhelmed and barely coping with the increased birth rate of the last five years,” Dr Pesce said.

The Australian Health Insurance Association data shows that since the 30 per cent rebate was introduced in 1999 total benefits paid by private health funds increased by 154 per cent.

The cut to the Medicare rebate for cataract surgery simply proves that the Labor government values complex precision cataract surgery at half the cost of a pair of glasses, and this ignores postoperative management, which is included in the rebate. It takes 12 years to train an ophthalmologist. Cataract surgery is extremely complex surgery with a very high level of technology and very little room for error. It is a procedure that keeps younger people in the workforce and enables people to continue driving. It prevents depression and prevents our more senior Australians from falling and breaking their hips, as well as preventing some nursing home admissions. Anyone who has had this surgery will tell you just what an impact it had on their life. Some people say it would certainly be worth more than half a pair of glasses, and most of us value our sight as possibly the most important of our senses.

This decision by the Labor government will change specialist service delivery in regional areas. The longer term impacts of this decision may be that regional and remote communities will no longer receive ophthalmology visits or surgery. Visits will no longer be financially viable in some instances. Then the most needy and disadvantaged regional and rural communities will be the worst affected. Gap fees may increase for patients, and those who cannot afford the gap will be placed onto increasing public waiting lists. The same battlers with the least resources will be impacted the most.

I asked the minister yesterday in question time:

Given the government’s reckless cash splashes, how does the minister justify this callous measure, which will have a devastating impact on the wellbeing of thousands of Australians—mostly battlers and pensioners—and in particular those in rural Australia?

The minister’s response was, in part:

The question of cataracts is certainly something that we do not resile from at all.

This is the same minister who said:

On many occasions for many months, Federal Labor has made it crystal clear that we are committed to retaining all of the existing Private health Insurance rebates, including the 30 per cent general rebate and the 35 and 50 per cent rebates for older Australians.

The Liberals continue to try to scare people into thinking Labor will take away the rebates. This is absolutely untrue.

What is crystal clear is that fewer people in my electorate will have access to crystal clear vision because of public health waiting lists for cataract surgery. And the Liberals’ statement was not untrue at all, was it? In fact it is the minister who has misled the Australian people. The Labor government is clearly and ideologically opposed to private health insurance.

My constituents have every reason to be scared of this callous, debt and deficit, same old Labor government. It is a government that has lost control of the nation’s finances. It is clearly a government that prefers to give out cash splashes rather than maintain essential health outcomes. Not only is this an attack on the private health system it is also an attack on the viability of small- to medium-health service businesses and enterprises in my regional electorate.

The coalition does not support any increase to the government’s $315 billion of debt and deficit, which it has admitted to at this time—which is clearly not the full extent of the debt and deficit—which is why we have offset this measure with a proposed increase of approximately 12.5 per cent in tobacco excise. This also a genuine health measure and one supported by the Heart Foundation, the Australian Medical Association and Quit executive directors. I support the amendments and oppose this legislation.

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