Ms Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health) Share this | Hansard source

As fans of Yes Minister know, you can get any answer you want from a survey depending on how you frame the questions. When Sir Humphrey asks Bernard if he thinks teenagers need more discipline and leadership, he agrees that national service is a good idea. But when he is instead asked if it is dangerous to arm teenagers and teach them how to kill, Bernard finds the idea of national service frankly horrifying.

So when a government that has sought at every turn to undermine Medicare launches a survey which attacks two of the fundamental foundations of our healthcare system—community rating and universal access to healthcare—we know precisely what is going on here. When the survey asks whether private health insurance should be allowed to cover GP consultations, it is important to spell out precisely what this option would mean: the undermining of universal access to healthcare—the fundamental principle of Australia's Medicare system.

As the former secretary of the Commonwealth Department of Health, Stephen Duckett has pointed out, our existing high rates of bulk billing act as a lid on prices:

If patients with insurance face no out-of-pocket costs, GPs might feel they can safely increase their fees for half the population—those with health insurance—with no impact on demand for their services.

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As well as charging insured patients more, GPs might decide to charge uninsured patients more, or reduce the number of services that they bulk bill. So the second impact of the change would probably be to reduce access to care for the uninsured.

So this is a policy that will drive up fees and cost the health system more, while making it harder for people to see their doctor.

The survey makes clear there is another agenda here as well. That is to prop up private health insurance by scrapping community rating and enabling health funds to risk rate members according to age, gender or health condition. And with the lead-in to the question which suggests that people over 70 are a huge burden to the health system, it is pretty clear this is about charging older Australians more for their health insurance. Brent Walker, a health fund actuary with 40 years experience, says that this policy is 'nonsense' and warns:

Health funds in New Zealand risk rate and when you turn 65 the premiums almost double, by the time you are 70 you can’t afford health insurance in New Zealand.

National Seniors has described the consequences for older Australians from risk rating as 'diabolical'.

The survey, of course, also asks if health premiums should be priced according to gender, which, according to Mr Walker simply means higher premiums for women of child-bearing age. Finally, it asks if different premiums should be charged according to a person's health or their health risk factors. This goes way beyond smoking, because when you scrap community rating and say that people should pay more on the basis of their health risk, where do you draw the line? Should people be charged more because they are overweight? What about ex-smokers, those who have three glasses of wine instead of two or those with Fitbits who do not register 10,000 steps a day? And, much more seriously, what about people with a family history of cancer or heart disease?

Just as important are the questions the survey fails to ask, such as whether to continue the current means testing of the private health insurance rebate, which the minister has repeatedly suggested she would like to reverse. I would look forward to seeing the $3 billion hit that would have to the budget contained in MYEFO.

The minister dismisses our concerns by insisting that this is just a modest survey, as if this were some sort of university exercise rather than the Commonwealth government and the Minister for Health conducting this sort of survey. It is an absurd proposition. You do not ask these sorts of questions, as a Commonwealth Minister for Health, in this loaded fashion unless you already know what the answers are. I will not be surprised if the minister uses this survey to give private health funds what they have been pushing to achieve for some time—an entry into general practice and a start down the path of risk rating. The only question is of course what she is going to want in return. It is a push poll designed to undermine Medicare and to benefit private insurers at the expense of consumers. It should be called exactly what it is.

The minister is trying to say that this is all Labor's fault. She has made no mention of the fact that a lot of the downgrading of insurance product has occurred at the instigation of private health insurers themselves when they tell people their products are no longer available. This survey is an absolute fraud. (Time expired)

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