Stephen Jones (Throsby, Australian Labor Party, Shadow Parliamentary Secretary for Regional Development and Infrastructure) Share this | Hansard source

It is a pleasure to be speaking on this bill, the Health Insurance Amendment (Extended Medicare Safety Net) Bill 2014, and to be following two MPs from the Hunter Valley, the member for Paterson, who directly precedes me, and the member for Shortland. I had the great pleasure of visiting the Hunter Valley on the weekend and joining with them and many hundreds of members from the local community in a conversation about the future of health care in this country.

We are in the midst of a national debate about how we organise and how we fund our health system. The unfortunate thing about this debate is the way the government is handling it, because the process is almost as confused as the policy itself. It is almost like we have a sheet of salami so long and we are slicing it up into little bits and throwing a few of those little bits into the parliament every month or so. Nowhere does the parliament have the opportunity to have a debate about the policy changes as a whole. It was this concern that moved the member for Ballarat to move amendments in her speech in the second reading debate to ensure that debate on this bill encompassed a debate on all of the government's proposed changes to the health system. I seek to direct my contribution this evening to those changes.

I see the member for Paterson has left the chamber. He talked about the alleged untruths that were being spoken in relation to the government's budget proposals. I am quite sure that he was not referring to his own parliamentary colleague, the member for Swansea in state parliament, who said, when I was in the Hunter valley on the weekend, that he did not support the federal government's changes. He said he opposed them, because he thought they were bad for the health system. I am quite sure the member for Paterson was not referring one of his Liberal Party colleagues as one of those people telling untruths. I am also quite certain that he was not referring to the New South Wales Liberal Party Treasurer, Mr Andrew Constance, who said, when he delivered the New South Wales government's budget last week:

There is no point pretending that the broken agreements of the Federal Budget won’t hurt the people of New South Wales.

It is quite clear that they will hurt people in New South Wales.

The table in the document I have here, the state government budget papers, tells the story. You have a slippery dip going in one direction, and a table in the other. Quite clearly, the Treasurer is concerned about the cuts to hospitals—about $3 billion worth of cuts to hospital funding in New South Wales. The state member for Swansea is concerned about that. Obviously the member for Paterson does not share those concerns.

The process that we are dealing with is as confused as the policy itself. The government is attempting to sustain an argument that the costs in the health system are out of control, that this is a recent discovery and that these steps need to be put in place otherwise the whole thing is going to collapse. We have heard the Prime Minister, the Treasurer and the Health Minister oft quote: '10 years ago Medicare cost around $8 billion a year, and today it costs closer to $20 billion'—I think it is around $18 billion to $19 billion, but we will not quibble over that. 'The PBS 10 years ago cost $5 billion; today it costs $9 billion.'

Those figures, left alone, have a seductive force. But, when you interrogate them, you begin to understand that this is tosh on stilts. It is absolute tosh on stilts. I had a look at it, and the only valid test of whether health costs are in control is to have a look at the percentage of cost as a proportion of the overall government outlays. That is the only true cost. If costs are running out of control, you would expect there to be an intense disproportion in the growth of health costs as a percentage of overall government outlays.

So I had a look at this. In 2003-04, Medicare was costing around 4.8 per cent of total government outlays. If the costs were running way out of control, if we had a budget emergency, you would expect to see a figure that was maybe three, four or five times that number. But, when you look at the percentage of government outlays for Medicare in 2013-14, what is it? It is 4.6 per cent. That is actually 0.2 per cent less than it was in 2003-04. So, far from seeing health expenditures at emergency levels, they are 0.2 per cent less than they were in 2003-04 as a percentage of total government outlays.

I wanted to see whether the Medicare expenditure was a complete anomaly when compared to the PBS expenditures. If we saw an emergency in terms of our healthcare spending, you would expect that our PBS figures, as a proportion of government outlays, would be five, six or seven per cent more than they were 10 years ago, because this is the reference point that the government uses. In 2003-04 the PBS as a proportion of government spending was 3.2 per cent. What is the figure today? It is actually a percentage point less—2.3 per cent. It has dropped almost a complete percentage point as a proportion of government outlays. So this massive scare campaign—this tosh on stilts—that the government is seeking to execute its argument to radically overhaul the whole policy arrangement and funding arrangements through our healthcare system is nothing more than a complete beat-up.

They often like to present themselves as the team that are able to find savings and present Labor as the team that are unable to find savings either in our health budget or in any other part of our budget. It is a damn shame that the member for Paterson did not wait around to hear some of these contributions, because I am sure he would have liked to know that if you look at the big health saves, if you look at the big savings that the government is finding in its health portfolio in the 2014-15 budget, they are actually initiatives that were introduced by the former Labor government. The heavy lifting is in initiatives that were introduced by the former Labor government.

The biggest, of course, was the accelerated PBS price disclosure, which will find about $3.8 billion worth of savings over the forward estimates. Nowhere did I hear the member for Paterson or any of the other government speakers refer to that Labor government initiative in terms of their overall health portfolio saving. The other area you might like to look at, Deputy Speaker, because it is one of the fastest growing uncapped areas of health expenditure, is the private health insurance rebate. We fought tooth and nail against members opposite when we introduced that legislation to means-test the private health insurance rebate. People like me on good salaries do not put an overburden on the tax expenditures of the Commonwealth because we can afford our private health insurance, and we do not need a tax expenditure from the government to enable us to do that. They fought tooth and nail against us doing it. They bagged $2.8 billion worth of savings over the forward estimates because of this initiative alone. So there will be $6.6 billion worth of savings from these two initiatives alone.

Now, let's stack that up against what these heroes of financial rectitude are doing, because if we had a crisis in our health expenditure, and if this is the team to fix it, you would expect to see some sense in their policy prescriptions and their funding arrangements. If the co-payment—the GP tax—were truly a measure introduced to inject more revenue into the Medicare system, you would expect the revenue from the GP tax to be flowing back into the Medicare system. That would be a logical move. It would be one that we would oppose, but it would be a logical move. You would say, 'Okay, this is a genuine co-contribution.' We call it a tax because if it were a genuine co-contribution the revenue would be going towards funding the Medicare Benefits Schedule. But it is not going towards funding the Medicare Benefits Schedule; it is going to fund a cause, albeit a worthy cause—medical research. So it can be seen as nothing more than a hypothecated tax. It has got absolutely nothing to do with rectifying this false crisis that they have invented because, quite frankly, they just do not support Medicare.

That is the first problem with the GP tax. The second conceptual problem with the GP tax is that it is built on a false assumption. Everywhere you look there are false assumptions. They seem to think that people are visiting the doctor too often. They seem to have this theory that there are a whole heap of people who are bored and lacking reading material out there, and they are rushing down to their bulk-billing doctor so they can catch up on back issues of The Australian Women's Weekly and National Geographic. Nothing could be further from the truth. Deputy Speaker Griggs, you and I know that in this day and age, when people have to put in place childcare arrangements, get time off work and put all sorts of personal arrangements in place just to get down to the doctor, they do not need another barrier. They are not going there because they are bored, and they are not going there because they are hypochondriacs. They are going there because they need to.

The Treasurer is fond of quoting a figure from the National Commission of Audit. He seems to think that the average number of times that people are visiting the doctor is 11 times a year. You would think that if you had commissioned people to look into this figure they would actually get their facts right. He was looking at the wrong column. It is actually six times a year, not 11 times a year. You would think that, if they put in all that time and effort and had all the resources of government available, the least they could do is to get their facts right. This is a confused policy which is attempting to address a problem that does not really exist.

In government, we were willing to ensure that the costs of both the PBS and Medicare were addressed through sensible savings and through sensible reforms, and we remain committed to doing that. The legislation before the House is indeed one of those measures. I admit that it was a coalition government that first introduced the extended Medicare safety net, but it was a Labor government that had to put in place initiatives to ensure that it was not rorted. We did that through capping arrangements—as you would know, Deputy Speaker, having been a former worker in the health system. We are willing to support logical arrangements that are well crafted and deal with an actual problem, but not this absolute farrago of confused policies that we see as part of this debate.

In the minute or so that I have left, I would like to make a few observations about the impact of the government's health policies on regional and rural Australia. It is in regional and rural Australia that out-of-pocket health costs are higher, that incomes are lower and that the chronic disease rates are higher. There is also a higher proportion of the Indigenous population with poor health conditions, suffering a lot of chronic disease issues. Indeed, that is one of the reasons why there are disproportionately bad health outcomes in rural and regional Australia. It is for this reason that we need to ensure that our policies are not crafted in a way that is adversely affecting health outcomes in rural and regional Australia. The propositions which are being debated, which were introduced in the budget—which are a part of and envisaged by the member for Ballarat's amendment to broaden this debate—go directly to those issues. That is why we should not be debating this proposition in isolation from the other policy changes that are before the Australian public and that should properly be before this parliament as we debate these proposed changes to the Medicare safety net. (Time expired)

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