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

The mainstays of our health system, the Medicare Benefits Schedule, the Pharmaceutical Benefits Scheme, public hospitals, private hospitals and health insurance are all vital, but we need a bit of a reality check. Ten years ago the Commonwealth was spending $8 billion a year on the Medicare Benefits Schedule and, today, that is $19 billion. Without policy change, in 10 years' time it will be more than $34 billion. We need to ask the members on the other side: has our population more than doubled in that time? Has our government's income more than doubled, in fact, gone up 122 per cent like the Medicare Benefits Schedule payouts have? The answers to both those questions are no and no. So, I ask the opposition: how are they going to pay? Are they going back to the 'magic pudding' school of economics and just print money? Are they going to borrow money from overseas and increase our national debt? Are they going to put it on the nation's mortgage and rack up a mortgage that we have to pay off and then put it on the credit card?

The Medicare levy raises only $10 billion of the $19 billion on the Medicare Benefits Schedule. That is before the payments are made to the states for hospitals, or payments for the PBS, so there is a giant disconnect. What are the opposition proposing? Should we be like the NHS in England? When I was working there in the 1980s the NHS levy, the equivalent of our Medicare levy, was about 10 per cent of the taxable income. I do not know what it is now, but I bet it has gone up. We read in the papers from England that that nation is discussing introducing a co-payment because their system is not sustainable. Hang on, that is what we are trying to do here. So, it is time for a reality check.

The changes are quite reasonable, but I admit there will be a change to some practices and for some people. There is no avoiding that fact, but they are reasonable changes. As I have said in this House many times before, we try to be sensible and manage the nation's finances and the health system, and that is what this is all about. A $5 portion of the levy will go into the Medical Research Future Fund. It is staying within the health portfolio. There are projected dividends of $1 billion once the total gets to $20 billion, and the discoveries made from research should deliver health benefits to everyone.

A bulk-billing practice will change because they will need to ask for the $7 co-payment. The $2 can be used in a bank at their discretion for people that really cannot cope with the $7 co-payment. In my practice that happens; it is just a reality. My electorate of Lyne has more pensioners than any other electorate in the country, so I know how tough it is for some people, and managing off a pension alone is tricky. This will introduce the thing that some people seem to see as an existential evil, but I see as an existential necessity, and that is a price signal to both the patient and the doctor.

We have great doctors in Australia, but some of them have grown up with 100 per cent bulk-billing practices and they have never had to self-ration their services, because patients have never had to reach into their own pockets. They never say, 'Doc, do I really need this?' or 'Can't I come back in a fortnight or a month?' or 'Do I really need that blood test and an x-ray? I think I'm getting better anyhow.' There is a need for rationing, because, as I said our costs are going up and up much greater than our revenue is going up and up and much greater than our population is growing. We are all getting older and we are all going to retire with lots of requirements for a strong health system. What we are doing is trying to ensure that our health system is sustainable.

I think the opposition are being a bit hypocritical considering that, when they were in government, they cut a billion dollars out of the health budget in 2012 and they froze the MBS in 2013 on every item, not just this—and the then minister said, 'It's only going to cost 70c for the average consultation. (Time expired)

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