Lisa Chesters (Bendigo, Australian Labor Party) Share this | Hansard source

I rise to speak in favour of the amendment to the second reading of the Tax and Superannuation Laws Amendment (2014 Measures No. 1) Bill 2014 that has been moved by the member for Fraser. I agree that the phase-out of the net medical expenses tax offset is a sensible savings measure and it is the right thing to do. It was first proposed by the former Labor government, and we congratulate the coalition for getting on board, finally, with this proposal, recognising that it is a sensible policy and it is the right thing to do.

The NMETO is a poorly targeted measure. Whilst it aims to compensate those with high incomes who can afford to pay up-front their out-of-pocket health expenses, it is a luxury that many households in our community simply cannot take advantage of. Many people with little or no taxable income are unable to benefit from this scheme, and that is why it an unfair measure and it is right that it should be removed, as this legislation proposes. If we are genuine about all Australians having access to universal health care, then it is right that schemes like this, which favour those with the financial capacity to pay for private healthcare expenses now or later, should be abolished.

The former Labor government announced this measure in last year's budget. It was reported by my local paper that this phase-out could result in a saving to the federal budget of close to $1 billion over four years. That is a lot of health dollars that could be better spent. That is the key point of the argument that I wish to make today. The question is: what will the new coalition government do with the savings generated by this measure? The savings generated by this measure, we argue, should be reinvested in providing universal health care to all Australians, ensuring that they get the care that they need, not just the care that they can afford.

In this debate, the Parliamentary Secretary to the Treasurer has said—and for a moment, when reflecting on his comments, I thought perhaps he had joined the Labor Party!—that these changes refocus health expenditure on Australia's universal Medicare arrangements. Those words could have been taken word for word from the Labor Party platform. The parliamentary secretary went further to say that the focus for the Commonwealth should be on getting the primary healthcare response right and continuing to support our current arrangements in health care. If only we could believe the parliamentary secretary. Whilst these comments are something that I agree with, these comments are just words and could not be further from the truth in terms of government action. It is yet another example of how this government is not matching its action with its rhetoric.

The Prime Minister and his government are intent on destroying universal health care, including Medicare. They are working to create a two-tiered system, further disadvantaging those who have smaller household budgets. It is critical for the government to commit to investing in policies that target assistance to medical expenses for those most in need. I am talking about our pensioners, our low-income earners, the people whose budgets are tight. That is where we need to be focusing our attention.

What we are seeing, though, from the government is Australia going backwards. They are proposing policies that will target the most vulnerable, who will be worse off. Policies such as the GP tax that has been proposed will only create poor health outcomes for some of the most disadvantaged families in our communities. Take, for example, some of the households in my electorate of Bendigo. Their budgets are already quite tight. I am concerned about the effects that a GP tax will have on bulk-billing and GP visits in the Bendigo electorate. Under the former coalition government—cast your mind back to when John Howard was the Prime Minister—bulk-billing in the electorate fell as low as 49.9 per cent in 2003. That was a very low rate that we experienced just over 10 years ago. Under the former Labor government, however, they were able to reverse that figure so quickly that it got back up to 74.6 per cent, just before the change of government. So the bulk-billing rates are back up high. This meant that people were getting to the doctor when they needed to.

Despite these rates being high, Bendigo still is ranked 99th of 150 electorates. We are not the best at bulk-billing, but we do have a higher rate than we used to. This is despite the fact that at least 30 per cent of households in the Bendigo electorate are living on less than $600 a week. This is not even minimum wage that 30 per cent of the households in my electorate are surviving on. It means that they do not have the room in the budget for a GP supertax. It means that, rather than paying to go to the doctor, they will forgo going to the doctor.

If the tax was introduced and levied—and just doing a rough calculation on $6 per GP visit taken last year in the electorate of Bendigo—the government would be taking an extra $4.5 million out of the pockets of Bendigo households. This is another example of the government saying that we should be reinvesting and making sure we have a universal healthcare system while at the same time proposing a GP tax, which would see more money taken out of household budgets. The government needs to back off on this tax and back off Bendigo households because their budgets are tight and they cannot afford further out-of-pocket expenses.

This tax would result in fewer people in my electorate attending a GP. It would increase the pressure on hospital emergency and urgency care departments. For those who are not from country electorates, hospitals that are downgraded and do not have emergency departments would have urgency care departments—and there are at least three of these in my electorate—where there are no on-call doctors and patients are triaged by nurses. If people stop going to their doctor because they do not have the means to pay an up-front fee, they will start arriving at these urgency care facilities only to find that there is no GP on call. This will create extra demand and extra pressure on our public healthcare system.

We should be encouraging people to attend their GP to stay healthy and to get involved in preventative health. We heard the parliamentary secretary say in his speech that we want to be a country that focuses on preventative health, but we are not seeing the actions of this government match that talk. We have seen this government talk about disincentives and discouraging people from seeing their doctor and maintaining their health. Here is another example of how the parliamentary secretary's words do not quite match his actions. He said, 'These changes refocus health expenditure on Australia's universal Medicare arrangements,' yet, as I have just highlighted, this is the same government that is talking about imposing a GP tax. You cannot have it both ways: either you support Medicare and universal access or you are going to water it down and start charging people if they require medical care. Primary preventative healthcare measures save money not only for the individual but also for the health system. They mean that we are not dealing with people in crisis, people with acute conditions, in emergency care, or urgency care if they are in the country, because they have not been maintaining their health.

It is about time we heard some more positive policies from the Abbott government on how they are going to put patients, families and carers first. It is no secret—the Australian people and this chamber know—that the true party for universal health care is Labor. We will always stand here and defend the right of every Australian to have access to health care when they need it, not when they can afford it. I also note that the parliamentary secretary in his second reading speech referred to the National Disability Insurance Scheme, a scheme that many on this side of the parliament are quite proud of. In his speech he said:

The National Disability Insurance Scheme … is expected to cover all related expenses previously covered by the net medical expenses tax offset for those eligible for a funded plan from the NDIS.

That is another example of how the government can use tricky language. He said 'is expected'. Does that mean that some medical expenses will not be covered? The parliamentary secretary went on to say:

The government is committed to delivering a sustainable NDIS across Australia to support people with significant and permanent disability.

What does 'sustainable' mean? Does that mean that there will be a limit on what an individual can claim? Does it mean that there will be a limit on who can claim? That is another example of the tricky language by this government, and that was not the first time on the National Disability Insurance Scheme.

Last November the Assistant Minister for Social Services spoke about the need to address expectations. I fundamentally reject the notion that Australians with a disability, those who have fought so long and hard for this scheme, should lower their expectations on the NDIS. This is the most significant policy reform since Medicare. It is about helping those in need now, not when they can afford it. Again this is tricky language by this government, which is focused on making cuts to the NDIS and starting to soften the community for those cuts.

Currently the NDIS trial in Geelong is delivering exactly the kind of care and support we thought it would deliver. It is changing people's lives. Let me give you an example. Kate and her family live in the Barwon Heads NDIS trial site. She spoke recently about the importance of this for her son. Her son William, because of his disability and the way the scheme is rolling out, will receive an additional $15,000 worth of support each year, including extra support on weekends and the equipment he needs so he has the opportunity to meet with his peers and socialise like most 15-year-olds. Kate said:

While this may seem costly to some, it makes a lot more economic sense than if I could no longer work and had to go on social benefits.

Yet, despite this good news, despite having this opportunity and despite the NDIS rolling out in Geelong and Barwon Heads exactly as we saw it would, all we have heard from the Abbott government is talk about how the costs are blowing out and how it has to be 'sustainable'. It is time the government came clean and told Australians, particularly those with a disability, the truth on the NDIS. What is going to be funded? What will not be funded? Who will receive funding? What does it mean by 'sustainable'? In a truly universal system, in a system that ensures that everybody gets the support they need not support they can afford, there would be no such word as 'sustainable'. Under Labor, the NDIS when fully rolled out would have provided support for an extra 100,000 people with a disability in Victoria, including 3,400 in my own electorate. Of those in my electorate, 1,400 would have received extra support who do not currently receive any or adequate support. I ask the government: are these people in my electorate still on your list? Are they on the cost blow-out list? Are they on the list that you are saying is unsustainable?

Whilst we agree that the phase-out of the NMETO is a sensible saving, will the government do the right thing and re-invest the savings generated by this measure into universal health care? They should be invested in Medicare and in the NDIS so that all Australians—regardless of their disability, regardless of their capability—get the care they need when they need it, and not just when they can afford it.

See this speech in context