Bob Baldwin (Paterson, Liberal Party, Shadow Minister for Defence Science and Personnel) Share this | Hansard source

I rise today to address the Fairer Private Health Insurance Incentives (Medicare Levy Surcharge) Bill 2009. This legislation would alter the Medicare Levy Act of 1986 by increasing the surcharge for those workers who exceed higher-income thresholds but do not opt into private health insurance. This is part of a package of bills and has been presented in conjunction with two bills which seek to create three income tiers. These tiers would be used to determine the amount of private health insurance rebate people receive when they purchase a complying health insurance policy, and thus affects the price of premiums. The former provision is undoubtedly a means to punish those people on higher wages who choose to remain in the public health system. In simple terms, the act imposes a substantial cost on those high- and middle-income workers who rely on the public system, which in turn encourages them to pay for membership of a private fund.

The success of this system has been demonstrated by the increase in private health insurance membership which occurred when the surcharge was first established by the former coalition government. In little more than a decade, private health insurance membership has increased by more than 14 per cent. With the success of this program in mind, it seems ludicrous that the Rudd Labor government would seek to make damaging changes to the provisions already in place.

Increased private health insurance membership is vital to ensure the public system can cope with the demand of those who need it most. Currently, hospitals across the Hunter and across the country are overstretched. This has been highlighted by a number of recent reports, including the New South Wales Health Quarterly Hospital Performance Report. In the September quarter of last year, this report found that the Hunter’s three hospitals—the Calvary Mater, Maitland Hospital and John Hunter Hospital—admitted just 69 per cent of emergency patients in the recommended time frame, on average. Further, and most recently, the Productivity Commission revealed that in 2007-08, there were 59 cases of ‘sentinel’ events in New South Wales public hospitals—the highest of any state in Australia. These ‘sentinel’ events, as they are called, occur when there is a hospital system failure. This includes incidents involving the wrong patient or body part, medical instruments being left in patients after surgery, and medication errors. These events can result in serious injury or even death and can lead to a serious decline in confidence in the nation’s public health system.

Let us be clear on this issue: these failures are not to be blamed on the hardworking doctors, nurses and other allied health practitioners who perform outstanding work despite far from ideal conditions and who are stretched to the limit to perform, often encouraged to work extremely long hours and tiring shifts. These people are to be praised for their dedication, and in particular, for serving areas of real need. In Paterson we have a drastically ageing population and a shortage of health facilities. To put this into numbers, GP Access has found that in some parts of the Paterson electorate there are more than 2,000 residents for every full-time GP, while there are fewer than 800 per GP within many areas of Sydney.

To add further insult to injury, the Rudd Labor government has failed to initiate programs to attract more doctors to rural and remote Australia and the numbers continue to dwindle. In the Hunter region alone, including the Paterson electorate, more than half of all doctors are more than 50 years of age and 20 per cent are more than 60 years of age. These doctors are facing retirement and will cause numbers to decline even further. Despite this stress and demand, we still have a number of talented professionals who choose to serve patients across the electorate. Their dedication is truly appreciated.

10:44:30 Of course, these people are not to blame. Where we really must point the finger is at the Rudd Labor government, which has failed to put a real plan into place and make an investment to provide our public hospital staff with what they require to get the job done. In 2007 our Prime Minister looked into the eyes of Australians and promised to fix our health system. Now, after 2½ years of failed benchmarks, underfunding and broken promises, Kevin Rudd has finally decided to do something. Now, ironically in an election year, Mr Rudd has decided to take some action. Clearly, this is policy on the run and sadly, after all this time, he still has not managed to get it right.

Allow me to note how the private-public health system works. I will quote from the government’s own Department of Foreign Affairs and Trade website:

Private hospitals provide about one-third of all hospital beds in Australia. Private medical practitioners provide most out-of-hospital medical services and, along with salaried doctors, perform a large proportion of hospital services. Private practitioners provide most dental services and allied health services such as physiotherapy.

About half of all Australians have private health insurance. Forty-three per cent of the population (or nine million people) are covered by hospital insurance for treatment as private patients in both public and private hospitals. Forty-three per cent of the population (or nine million people) have ancillary cover for non-medical services provided out of hospital, such as physiotherapy, dental treatment and the purchase of spectacles.

The Australian Government is seeking to achieve a better balance between public and private sector involvement in health care by encouraging people to take out private health insurance, while it also preserves Medicare as the universal safety net. The Australian Government helps to make private health insurance more affordable by offering a 30 per cent rebate (and higher rebates for older Australians) for the cost of private health insurance premiums.

As you can see from the Rudd Labor government’s own webpage, 30 per cent of rebates are used to make health care affordable. It is amazing then that this same government wants to reduce rebates, by its own admission making private health insurance less affordable for workers. It would also punish those people who have already signed up to private health insurance by making their rebate smaller. This is extremely worrying because if private health cover becomes too expensive and premiums soar, many of my constituents will be forced to stop paying for private cover, especially those who are already struggling with rising interest rates, petrol prices, grocery bills, power bills and water rates—not to mention the threat of what will occur with the Rudd Labor government’s ETS.

This hurts not only those on middle and high incomes, who the Rudd Labor government is clearly trying to attack through this legislation, but also those people barely struggling to pay for private insurance in order to supply braces for their children and contact lenses for their teenagers and to afford to get those painful wisdom teeth removed. The Rudd Labor government may try to trick you into thinking that those on lower incomes will still pay the same amount for private insurance because their government rebates will not change; however, if higher income earners are forced out of the private health system, premiums will soar for everyone. And the more they soar the more people will drop out of cover, and the vicious cycle will continue.

This poses problems on many levels. Firstly, it is sure to force more people back into the public hospital system, which, as I have demonstrated in this parliament, is already struggling. It will make waiting lists longer, increase the time it takes to have elective surgery and place more demand on already stretched resources and hardworking hospital staff. Moreover, it could stop people seeking vital treatment for health conditions. Since many patients rely on private health cover to afford services such as dental surgery and optometry, these same people could be forced to go without.

This has turned out to be just the latest in a string of ill-conceived rebate cuts designed to fill the Rudd government’s coffers, which have been left empty and in serious debt because of Kevin Rudd’s cash splash. We have been forced to watch as Mr Rudd and his ministers spend billions of taxpayers’ dollars but get little or no results. Take, for example, the failed Copenhagen climate change conference. On 8 January Nine News reported that the Rudd Labor government’s delegation spent almost $1½ million on travel and accommodation. Did we get a binding target out of it? No. Did we get an agreement from our globe’s biggest polluters? No. What did come out of all that cash? A nice trip overseas for Mr Rudd and many of his supporters.

This is just the tip of the iceberg. The Rudd Labor government wasted $200 million of taxpayers’ cash before it finally lowered its inflated rebates for home insulation from $1,600 to $1,200. It made this mistake despite advice from the coalition that the $1,600 rebate was excessive. The Rudd Labor government has also now hit the $1 billion jackpot on consultants. What has come out of this spending? More talk, more reviews, more broken promises, very little action and no practical measures to actually help the families in my electorate of Paterson.

At the same time as this reckless spending has been occurring, Mr Rudd has also fought to cut vital life-changing rebates for cataract surgery and cortisone injections for arthritis suffers, which cost little in comparison. Thanks to the immense pressure from the coalition, the Rudd government has now backed down from its plan to cut the Medicate rebate for cataract surgery by a staggering 51 per cent and instead will—still cruelly—reduce the rebate by 12 per cent, most of which is expected to be absorbed by practitioners. But there is still no action on the cortisone injections.

This comes as a huge relief to many residents in my electorate of Paterson, who wrote to me that they were very fearful that they could be forced to go without sight-saving surgery. I am pleased that the coalition has, in this case, been able to force Kevin Rudd to see the error of his ways. Nevertheless, these attacks on health rebates by the Rudd Labor government raise questions over where the priorities of our Prime Minister actually lie. Even more so, it demonstrates his overwhelming inability to fix our health system and his total disregard for the elderly, frail and sick. This failure by Kevin Rudd was demonstrated in a report in the Australian newspaper just this week, on Monday, 1 February:

Medical students are emerging from the nation’s universities feeling inadequately prepared to deal with crucial tasks such as calculating safe drug doses and writing prescriptions.

In a challenge to Kevin Rudd’s twin promise to improve university education and doctor shortages, a government study has also revealed that medical supervisors feel the abilities of hospital interns fall short of their expectations.

The study reveals just 36 per cent of junior doctors think they have been adequately or well-prepared to do wound management.

And only 29 per cent of final-year medical students feel they have been adequately prepared to calculate accurate drug doses.

The landmark review of the nation’s medical education system was finalised 19 months ago but released only on Friday.

Medical leaders warn that the extra influx of students since the Education Department commissioned the research has made the failings it describes even worse.

News of the concerns about medical education comes before today’s release of a new Intergenerational Report warning that the nation’s ageing population will impose extreme pressure on the health system, including the medical workforce.

It also comes as The Australian has learned a Rudd government program aimed at addressing the drastic shortage of nurses in the nation’s aged-care facilities has failed, attracting just 138 nurses in two years, against a target of 400.

The article went on to reveal even more distressing figures from our medical graduates. It stated:

The report found medical students feared for their skills in a number of key areas, including knowledge of basic sciences, while hospitals increasingly struggled to make time for effective teaching in the face of packed waiting rooms.

Only 48 per cent of final-year students and 64 per cent of junior doctors thought they were adequately or well prepared to write prescriptions.

Interpreting X-rays was a concern for 69 per cent and 77 per cent respectively.

And just 44 per cent of medical students and 48 per cent of junior doctors felt they had been properly trained to insert a tube through the nose and down the throat of a patient.

This is yet another problem that has come with an overburdened public health system. With too many patients and not enough resources, doctors have been unable to devote the time required to train new doctors and have left many fledgling GPs feeling inadequately trained to serve the health needs of Australians.

As this example shows, the problems of an overstretched public health system are far-reaching. If the Rudd government has its way on these reforms and forces people out of private health insurance, the problems will only get worse. It is with dismay that I imagine even longer waiting lists, fewer people seeking help for dire medical conditions and doctors left to fend for themselves, feeling inadequately trained. Most people are aware of the problems associated with means-testing private health cover. That is why before the 2007 election Kevin Rudd and his ministers promised not to means-test private health. Here we are three years later with nothing but another broken promise and another ill-conceived bill before parliament.

It begs the question: why has Mr Rudd suddenly changed his mind? Of course, backflips are something we have seen a lot of during the time of the Rudd Labor government. But, in this case, to change his mind about something so fundamental to the way we live, breathe and survive can only be because Mr Rudd is panicked about the massive debt he has burdened this country with—the massive debt which will force interest rates to skyrocket over the coming years, the debt which we and generations to come will pay dearly for. The latest figures from the Mid-Year Economic and Fiscal Outlook place the Rudd Labor government’s projected net debt at $153 billion by 2013-14. This is money which will have to be paid back by taxpayers.

In an attempt to convince the Australian people we need these reckless changes to private health, the Rudd Labor government has said that not passing this bill will cost $100 billion over the next four decades. We were led to believe the details for this enormous figure would be revealed in this week’s Intergenerational report. Unfortunately, Treasury analysis does not appear in the report and we have been left wondering where on earth this figure has come from. To date, it appears to be nothing but a fear tactic orchestrated by a desperate government that is attempting to deal with its own money mismanagement.

The key message here is that we cannot afford to force people out of private health care. If this happens, our struggling hospitals will only struggle further because of increased demand on supplies and longer waiting lists. Those families who choose to remain in private health care will have to dig further into their pockets to be able to afford basic cover for themselves and their children. At a time when our population is ageing and demand for health services is already increasing, this is a mistake we simply cannot afford to make.

The current rebate on private health care and the Medicare levy surcharge are practical measures to encourage people to take up private health care and ease the pressure on our public system. These are practical measures we absolutely cannot afford to lose or tamper with. We cannot be fooled anymore by a Rudd Labor government that cares so little for the health of our nation.

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