David Gillespie (Lyne, National Party) Share this | Hansard source

I rise to speak on the National Health Amendment (Pharmaceutical Benefits) Bill 2014. I listened with some withheld mirth to the baits put out by the previous speaker. I look back and wonder why the other side objects to this increase in the PBS co-payment. I do not quite understand it, because my understanding is that they introduced the co-payment system. They even introduced the co-payment for pensioners, in 1991. Earlier than that, in 1985, they had doubled it from $5 to $10. Those opposite say it is a problem for us to put $5 onto the co-payment, but they increased it by 100 per cent. We are taking it from $36.10 to $41.10.

What has happened since the coalition came to power is that 181 medicines have been listed on the PBS. The PBAC recommended in March this year another $550 million worth of co-payments. New listings that have not yet been considered amount to $3.6 billion. Everyone wants their medication and the latest cutting-edge drugs and they expect to government—hey presto!—to provide them. But when you are in government and making responsible decisions you have to juggle things. That is exactly what this bill is doing. Every time a prescription is written there is a 60 per cent chance that the government on behalf of taxpayers will be paying for a large component of it. The average cost of a script is $43.50. That does not sound much, but in 2013-14 it will amount to $9.2 billion.People have become very blase about billions of dollars being mentioned in a budget, but $9.2 billion is a huge amount of money when you consider, 10 years earlier, it was 80 per cent less than that. With $3.6 billion in new drugs waiting to go through the PBAC, with $550 million worth approved just in March this year and with the 181 new listings on the PBS, you can understand why the system is under pressure. When you are a responsible government, you have to put initiatives in place to juggle those responsibilities. For consumers, once the cost gets above $41.50 some of these subsidies can be low for a $50 or $60 drug, but some of them are $8,000 per script.

It is because of amazing new drugs that our quality of life and our longevity have increased. It is not just procedures and operations and better diagnoses; there are better drugs, amazing drugs and drugs that extend life and improve the quality of life. You only have to look at drugs that everyone wants and takes for granted that, in Australia, are reasonably accessible to everyone through the PBS. These changes are designed to defend it so that you can get your heart drugs, blood pressure drugs, drugs for diabetes and cancer, particularly breast cancer and prostate cancer, and even drugs for hepatitis C that were not even available when I qualified as a specialist and are now mainstream. They cost thousands of dollars. Hepatitis C treatment 18 months ago cost $17½ thousand, yet the payment by concession card holders was only $6 a script. That is an amazing system, and these changes are aimed at defending that system and making it sustainable.

To put things in perspective, a concession card holder at the moment pays $6 for a PBS script. We are raising that by 80c. That is a very moderate increase and we will apply CPI. The average concession card holder receives 17 scripts a year. That is a sum total increase of $13.70. That is reasonable. For general patients—those who are not on concession—the $5 increase is, again, quite reasonable, as opposed to what the ALP did in 1985. They increased it 100 per cent, from $5 to $10. For a general patient, some of the common drugs do not even cost that much, so the PBS does not even require a co-payment; you are just paying the cost of the drugs.

For those who do have a lot of medications, it can be a challenge, but we have this thing called the safety net, which, again, we are keeping to a sustainable level. If you are a concession card holder, over four years you will be paying for two more scripts per year. That is a very gradual increase. It means that the safety net benefit will rise from the mid-$300s to $421.60. If you are a general card holder, that means you may pay $1,421. After that your costs, which co-contribute to the PBS system, will revert to $6 a script. That is quite reasonable. There are plenty of people who can afford that marginal increase when you consider what is coming down the pipeline. Drugs are being listed all the time which, when they first come out, are ridiculously expensive. We, as a responsible government, as I said, are putting in place measures that will make the whole system sustainable.

We could complain every time costs go up. As I have spoken about before, the government is not a magic pudding. We could cut everything. In fact, when we came into government and became responsible for how the Treasury is managed, there was almost $50 billion in deficit that the ALP, the Greens and the Independents created. If you keep having perpetual deficits like the countries of Europe and some countries in Asia, fine, we can go along and keep borrowing money and paying for everything, but then we will end up in the same situation as them, with huge debt that is perpetually being serviced by interest payments. At various times in recent world history, this has almost led to the collapse of the financial system. I do not want to go there. No Australian wants to go there. Australians want a safe, sound, secure financial system, and part of that is having a government that is not burdened with excessive debt.

These changes are moderate. They represent an increase, but we have a wonderful PBS system and this bill will help keep it sustainable. I do not think these changes are excessive. They are not cruel. An 80c increase per script for those who are challenged by their financial situation is a reasonable balance. We are not asking for anything outrageous. I commend good, common-sense measures to the House and support this bill.

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