Ms Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health) Share this | Hansard source

I, too, rise to speak on the Tax and Superannuation Laws Amendment (2014 Measures No. 1) Bill 2014. It is a pleasure to follow the member for Scullin, who has a very complex understanding of these issues and is representing the people of his electorate, particularly in relation to health needs and Medicare, very well.

This bill does a number of things. In essence, schedule 1 of the bill introduces penalties for promoters of schemes that result in the illegal early release of superannuation funds—something on which, we know, people who are in very vulnerable circumstances can come under some pressure. Schedule 2 of the bill introduces penalties for contraventions relating to self-managed superannuation funds. Schedule 4 of the bill amends the list of deductible gift recipients identified by name.

Schedule 3 is the schedule that I will focus most of my comments on, being shadow minister for health, and that is the phase-out of the net medical expenses tax offset through a transitional approach by the end of the 2018-19 income year. These were measures that Labor announced in the 2013 budget, and I am glad that the government has recognised the need for this policy. The change will make more funds available to be invested in other areas of the health portfolio. It was, whilst a difficult savings measure, in essence a savings measure which was all about ensuring that we were able to continue to invest in very important areas in the health portfolio, and I certainly appeal to the health minister to ensure that the savings raised under this measure do go back into health care, disability care and services.

As I stated, the phase-out of the net medical expenses tax offset will occur through transitional arrangements. During the income years 2013-14 through to 2018-19, people will still be able to claim for disability aids, attendant care and eligible aged-care expenses up until July 2019. It is crucial that Australians who require assistance and support for medical expenses receive that support in a fair and equitable manner.

The net medical expenses tax offset is poorly targeted, however. Australians with high out-of-pocket health expenses who do not have a tax liability do not benefit from this offset at all. That includes nearly 87 per cent of Australians aged over 65 who do not pay income tax, and it of course also covers those Australians who are on extremely low incomes, on disability support pensions and on other pensions and benefits who do not have a tax liability. Secondly, as the net medical expenses tax offset is calculated and then refunded at the end of the tax year, Australians with very high upfront costs are having to wait, often for long periods of time, until they can recoup some of their out-of-pocket expenses.

These changes as announced by Labor will certainly deliver expected savings of over $400 million over the coming three years and more into the forward estimates. That is $400 million to provide essential medicines and vaccines, critical services, workforce initiatives, and health and disability care to vulnerable Australians. These savings must be reinvested back into providing universal healthcare access to all Australians to ensure that they get the care they need and not just the care that they can afford. It is important that those savings are realised within the health portfolio and that they are committed to those areas that Labor intended to commit them to.

The government has, however, signalled a very different approach to health, and the amendment moved by my colleague really goes to the heart of what is happening in the debate about health care in our country at the moment. The government has certainly signalled its intention to Americanise our health system—to create a two-tiered system where those amongst us who are most vulnerable will certainly be worse off but will experience a different level of care to those who have the means to pay for it.

Labor fundamentally believes this is wrong. We believe in a universal healthcare system where a person's financial position should not and does not affect the quality or the timeliness of their access to health care. The Prime Minister and this government seem to be intent on destroying the universal healthcare system that is Australia's Medicare system.

The government has already hit Australians with the biggest increase to private health insurance premiums in over a decade. This decision was announced just two days before Christmas, in an attempt to sneak that decision out with as little commentary as possible—that is, until people started receiving the letters from their insurers, some of which were notifying them of an eight per cent increase in their premiums. I have heard countless stories of Australians concerned at the thought of having to pay eight per cent more for their private health insurance. They are additionally concerned about the risk that they now face of a potential $6 fee—a $6 tax—to go and see their GP.

When Labor was in government, ministers would routinely take several months to negotiate and approve increases to private health insurance premiums. These negotiations were not always easy and would often involve making sure that insurers were justified in their increase proposals and that Australian consumers were getting the very best deal possible. That is clearly not what has happened in this case. It was a very rapid decision which resulted in the highest premium increase for private health insurance in almost a decade.

Following the hit to the hip pocket on private health insurance, we now also know that the government is actively considering a proposal to tax Australians when they go to visit a GP. Governments should be encouraging people to visit general practitioners to seek primary care and prevention, to pick up any illnesses as early as possible, to help Australians to manage their chronic conditions, to keep people out of hospitals and to keep them well. Not only do primary care and prevention save money for every Australian, but the benefits of healthy people over the longer term, I am absolutely sure, are invaluable to families and communities everywhere. The savings to health care in caring for people at the primary care level are also significant, and healthy people are economically productive people as well. GPs in primary care are the cheaper end of the health system. They are an incredibly vital end, but they are not the end of the health system where the greatest costs are incurred.

While Labor were in government, we fought to increase bulk-billing rates to their highest levels ever, particularly by providing incentives for doctors who bulk-billed their concessional patients. Now all patients, including concessional patients, could potentially be faced with a $6 tax to visit their GP. That, in essence, ends bulk-billing, full stop—no more bulk-billing at all. It is a proposal that should not be considered at all and should certainly be fought against.

Some members opposite may say that $6 is not very much. The member for Gilmore said that it is just a cup of coffee. But, for some of our most vulnerable families, that $6 is actually the difference between putting food on the table that week and looking after their sick child and visiting a doctor. We also know that many families have more than one child and that illness goes through families very quickly, and it is often not just one doctor visit that we are talking about. People with chronic conditions, too, often have numerous visits to a general practitioner, so it is not just a one-off $6 fee that we are talking about; it is a $6 tax every time you go to visit a general practitioner.

I want to give you some examples of how this tax is likely to cost Australians in each of five electorates. Residents in the electorate of Chifley, for example, are looking at an extra $8.3 million per year in this GP tax—over $8 million in taxes to see their family doctor—should this proposal go forward. The member for Lindsay can expect her constituents to fork out close to $6½ million each year in this tax. Australians living in Barton, in Wakefield and in Port Adelaide can all expect to pay around $6 million in GP taxes every year. These net numbers are definitely not 'just a cup of coffee' for Australian families in these electorates.

This is something that the government never talked about when they were in opposition. They certainly never talked about it during the election campaign. But they are certainly flagging their intentions now, and no amount of weasel words can possibly say that the government do not have this proposal under active consideration. They are either being entirely disingenuous in saying that, or they are being incredibly ill disciplined. A senator for Western Australia came out and argued that this co-payment is essential, and the member for Higgins is running an entirely dubious line in her argument that it is not really a tax; it is just a fee, and really it is important that people pay this if we are going to see the differential in health services change in what happens in general practice.

In fact, her article particularly misses the point. The entire point of putting a price signal on general practice is to stop people going. That is the problem with the entire proposal. You do not want to stop people going to the doctor, because it is exactly what you want to encourage people to do. The entire premise of Medicare—in fact, the first principle of Medicare—is access. It is access to GPs. Put a barrier in place of access and Medicare is gone.

In terms of the other proposals that we have seen really strongly flagged by this government, this is obviously one of the very significant proposals. But the next proposal is the idea of opening up general practice to private health insurance products. This is a very, very serious threat to the universal nature of Medicare and the universal nature of our healthcare system. If you do that, if you start—like the trials that are already going on in Queensland and other parts of the country—to open up the possibility of a private health insurance product being available for general practice, you go absolutely down the pathway of there being doctors who provide private health insurance patients with a particular service, and then the rest of the community. That is what you end up doing if you open up a private health insurance product to Medicare billable services in general practice. It is a very serious threat to the universality of our Medicare system if the government goes down that pathway.

I am not convinced, on all of the advice that I have seen, that the private health insurance trials in fact comply with the existing legislation, and I will certainly be pursuing that matter. Certainly the government not only appears to be unconcerned about those trials but also seems to be saying, 'This is the best thing since sliced bread, and we're going to really open this whole market up.' If you do that, Medicare is gone. It is absolutely gone. So I would caution against opening that private health insurance product up to GP services in that way.

We saw the government approve the highest premium increases at Christmas time. With a nationwide trial of GP services accessing private health insurance, how much will Australians be paying for their private health insurers, and what will also happen to our health system if we allow private health insurance into this domain? The government is clearly not here making sure that Australians get access to the health care they need. It is important that Australians do get access to the health care they need, not just to the health care they can afford.

As I have said in this place previously, to date all we have seen from the government are concessions to industry to the detriment of consumers and cuts to the health portfolio, to important infrastructure projects and to organisations operating in preventative health, such as the Alcohol and Other Drugs Council. That body had been providing advice since Robert Menzies was Prime Minister. Sadly, that organisation closed its doors forever on Friday last with no signs of regret or any remorse from those opposite at its having done so. From everything this government has done to date regarding health, it is clear that health is not a priority for them. I have no confidence that this government is at all interested in providing universal health care.

I will go back to the bill in the last few seconds that I have left. This bill really is an important one in terms of providing savings within the health portfolio to be reinvested in those important areas of health and disability care. I certainly support that proposal. I equally support the amendment. This has been a very important debate about what we are doing in health and what is actually happening in terms of what the government is proposing for health. So far, the signs are not at all promising in terms of our continuing to have a decent healthcare system in this country. Certainly, under this government we will no longer have a universal Medicare system—to the shame of this country.

See this speech in context