Joanne Ryan (Lalor, Australian Labor Party) Share this | Hansard source

I rise to speak on the Health Insurance Amendment (Safety Net) Bill 2015. I note that it is a measure that was announced in the 2014 budget. Two years later, the government has finally decided to bring the amendment forward for us to consider.

It is important to reflect on the purpose of the Medicare safety net in any discussion around changes to the Medicare safety net. It was introduced in recognition that some patients need greater access to medical services—especially vulnerable groups, like those with serious and costly medical issues—at different times in their lives.

Having looked at why the Medicare safety net was introduced, I think it is fair to say that the member for Ballarat was very clearly suggesting that Labor has no problem with reforms in this area if they are going to be helpful but that in this scenario the government has gone about this by introducing a very blunt measure without clear justification. The introduction of the Medicare safety net was around particular groups of people who needed particular financial support to access high-end medical costs. The changes, therefore, need careful scrutiny. Labor has a problem, at the moment, with any evidence that that scrutiny has been careful. We have issues with the fact that we have not seen the evidence—nor have we seen evidence that these measures will address the issues, because it has not been fully explained.

At the time of the 2014 budget, the government argued that existing safety net arrangements were complex and difficult for both patients and practitioners to navigate and that this measure would simplify these arrangements. I am hearing a theme over the last two years: you say something is complex, you say you are going to simplify it and, before we know it, we have got a cut in front of us. So simplification has become a cut as far as this government is concerned, and I think this legislation today is another example of that. Again, it is a cut, the savings of which will not go back into the health system from this government—not in any meaningful way that is going to support patients and Australians in our health system.

I stand with my colleagues on this side to oppose this $270 million cut that has not been explained properly nor has evidence been presented to justify or rationalise it. Over the last few days, we have seen that theme come through. Prime Minister Turnbull has a knack of adding complexity when he claims to be simplifying things. We have seen that this week with cuts to the family tax benefit supplements being proposed under the guise of simplifying things at the same time as we are having a tax debate with a suggestion of a 15 per cent increase to the GST. The Prime Minister says that that will be fair, because in the process there will be compensation built into the system. So we are going to take cuts to the family tax benefit under the guise of simplification, talk about a 15 per cent GST rise and have a compensation process put in place—simplification? What we end up with is a complex system.

We are seeing a government that is confused: confused about what its ends might be and what the reasons for these cuts are. They are confused, because they continue to talk about deficits then introduce cuts and, all the time, they are stripping funds away from important areas like the health system. So simplifying things is the rhetoric; complexity is what we end up with.

Whilst acknowledging that the new Medicare safety net has lower thresholds for all patients, this bill restricts out-of-pocket costs that can accumulate towards the threshold and thus restrict the benefit payable once patients reach the safety net. The bottom line is that we are looking at a $270 million cut per year and, in the end, the people who will bear the brunt, or the cost, of that are patients. Again, it is a cut dressed up as simplification.

It is not just Labor saying this; specific concerns about these changes have been raised by fertility groups, radiation oncologists and psychiatrists, especially those providing psychotherapy services. We are hearing from those stakeholders specific examples: for instance, a radiotherapy patient with a malignant melanoma is facing new out-of-pocket costs of $7,000—this is where we get down to the human element where simplification is actually adding complexity; a radiotherapy patient with prostate cancer could face new out-of-pocket costs of $8,000; victims of sexual abuse and people with serious mental illnesses no longer have access to psychiatric services and are being priced out of that process; and IVF private patients, who currently face out-of-pocket costs of $4,000 per cycle, could now face the full cost of treatment, if these changes proceed, which is likely to be $10,000 to $15,000 per cycle.

We need to look carefully at the human cost of what these cuts will deliver and, when we look at those costs, it is natural to ask, 'What is the justification, the rationale, behind this? Where is the evidence that this is a good idea? Where is the evidence that it's going to make things simpler? Where is the evidence that it's going to improve the system?'

The sector, like us, are concerned that the government's changes could adversely affect some of the most needy—those with chronic illnesses, pregnant women, cancer patients. What is being exposed with this legislation in front of us today is that the glamour of the new Prime Minister and his government is fading, just like his predecessor. He is ignoring the health experts. He is ignoring the sector. You could go so far as to say that it is just another example of trying to Americanise our health system—a demonstration that the substance has not changed of this government, just the style.

Labor will not be supporting the $270 million changes to the Medicare safety net, because of the impact such a move will have on people in the community. If I look at my community in the electorate of Lalor—and remember that this was a 2014 budget measure that was brought in, the budget that was a cut-and-slash budget without thought or care for the people on the ground. If we put it into that context, there wasn't a huge amount of commentary on this measure when it was originally announced, because of course we were all very concerned about the other health measure—the GP tax—that was going to impact, particularly in a community like the one I represent. Remember: it was the biggest broken promise from before the last election.

In that context, when you look at this piece of legislation, you have to look at the impact of all of the things that this government has tried to do and what its agenda has been in the health space. In my community in the electorate of Lalor, the notion of the GP tax was extraordinarily cruel.

The electorate has 95 per cent of GP consultations, which are bulk-billed, and what has been exposed over time is that this government was hell-bent on a GP tax, but is really hell-bent on reducing bulk-billing rates in this country, and reducing the neediest's access to a doctor without out-of-pocket expenses. We know that that is still the intent, because we know that this government has not reversed the indexation freeze on the Medicare rebate, and until actions like that start to come from this government, we know that there is still intent on the same long-term agenda.

What are the impacts in my electorate of this potential change? In the electorate of Lalor, chronic illness is high. We have high rates of obesity, high rates of diabetes and high rates of heart disease. Chronic illness is high, which means the impacts of these will be high on those people. And we have a lot of low-to-middle-income earners, people who have worked hard all their lives, and perhaps have not been able to afford the highest health care, and they will now be further penalised through these proposed changes.

The government needs to go back to the drawing board on this piece of legislation. This government, that is the Abbott government dressed up as the Turnbull government—less lycra, probably; more leather, possibly—has the same insidious intent when it comes to Australia's health system. That is what this is demonstrating today. The measures from the 2014 budget that have been put in a cupboard are now being wheeled out, and this time they are being wheeled out with Mr Turnbull at the front. This legislation demonstrates clearly that the government has not changed, and I stand with my Labor colleagues to oppose it because, as the member for Makin said not a few minutes ago, it is a government that is still hell-bent on short-term savings and ignoring the long-term costs. It is a government that wants to make changes that are cuts, which are clearly slashing the health budget in this country without any thought to what the long-term health costs will be.

We know that if people are not going to the doctor, if people are not seeking the health care they need in the early stages of illness, that the costs go up and up, and of course they become extreme once someone reaches hospitalisation. We have a government hell-bent on short-term savings, not providing a rationale for the changes that they seek to make nor a rationale or explanation as to how these changes will solve an issue that they say they found but have not provided evidence for. I say to those opposite: 'Show us the evidence that this is needed. Show us that this $270 million cut is needed. Show us that it will help with the supposed issue, and show us the evidence that these changes will address those issues.'

The member for Ballarat has been incredibly diligent in her role in opposition of taking the forensic view of the changes being proposed by those opposite to our health system. In her work, she has exposed that, time and time again, we have seen changes being proposed to our health system that will undermine the basic universal nature of our healthcare system, that will undermine particularly low-income people's ability to access the health care that they need. This is just one more example of that today. Labor will suggest amendments, and we stand opposed to the Health Insurance Amendment (Safety Net) Bill 2015 as it stands and as it was brought to this chamber today. I know that people in my community are now very wary of any changes this government tries to make to health, because they are feeling on the ground the impacts of the changes they have already made by regulation—the GP tax through the backdoor. They are feeling those changes now as local doctors move to change their business model to ensure that they will still be in business to see patients in response to the indexation freeze. This government has a trust issue when it comes to the health space, and I think the people of Lalor will support Labor's opposition to this piece of legislation.

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