Chris Hayes (Fowler, Australian Labor Party) Share this | Hansard source

Once again, we are seeing some of the core values of the Liberal Party well and truly on display as they continue their relentless attack on disadvantaged Australian families. We probably should not be all that surprised, given that in the lead-up to the 2013 election—maybe that is not the right way to say it—or rather on the night before the 2013 election, remember the promise made: there will be no cuts to health. They did go on to say there will be no cuts to education and a number of other things as well, about which many people around here have had their head down ever since. But the truth of the matter is, having said that, they formed government and, in doing so, one of the first things they did was slash $60 billion from the Australian health budget, from Australian hospitals. They cut straightaway. It was not just the opposition who were jumping up and down about that. The leaders of Liberal state governments wasted no time. New South Wales Premier, Mike Baird, said, 'This was a kick in the guts to all Australians.' This is not something that should be seen as a government-versus-opposition issue; this is something that should be seen as an issue of great importance.

This legislation is of such great importance that I would have thought, on a piece of legislation like the Health Insurance Amendment (Safety Net) Bill 2015, the government would offer more than three speakers. Only three speakers were brave enough to come into the House and try to defend their position on this legislation before us today. They are taking $60 billion from Australia's public hospitals and $370 million from preventative health programs, and they are imposing an ongoing development of their GP tax through the MBS freeze, which represents a $2 billion cut to Medicare. This is hardly consistent with what they said the night before the election: 'There will be no cuts. Trust us.' I think the Australian population's view of politicians' promises has probably been largely gauged through the rather black joke that has been played on them by this government. The bill that is before the House tonight, if passed, will give effect to that first and most infamous Liberal budget of 2014 and their budget measure to 'simplify the Medicare Safety Net arrangements'. This will cut approximately $270 million from the Medicare Safety Net.

At a time when we should be looking at healthier lifestyles in this country, we now have a government, and certainly a health minister, that is instead working to do the complete opposite. Under the existing Medicare Safety Net arrangements, there are two safety nets: the Original Medicare Safety Net and the Extended Medicare Safety Net. The Original Medicare Safety Net provides an additional rebate for out-of-pocket hospital services when the sum of the difference between the MBS fee and the MBS rebate reaches the threshold in any calendar year. From 1 January 2015, the annual original safety net threshold is $440.80. The extended safety net provides for additional rebates for Australian families and singles who incur out-of-pocket costs for Medicare-eligible out-of-hospital services. There are two thresholds under the Extended Medicare Safety Net which are indexed by the CPI on 1 January each year. From 1 January 2015, the annual Extended Medicare Safety Net threshold is $638.40 for Commonwealth concession cardholders, pensioners on concession cards, health care cards, Commonwealth senior cards and people who are on family tax benefit A.

By the way, there are 17,000 people on family tax benefit A in my electorate. I have often said that my electorate has much to be proud of in terms of being the most multicultural electorate in the country. The colour, the vibrancy and diversity of it is something that we have many, many celebrations for, and it is something that we can all revel in. But there being 17,000 families in family tax benefit A is probably indicative of the fact that my electorate is not rich. My electorate has a high degree of disadvantage. As a matter of fact, my electorate also has a very high degree—it is overrepresented, in fact—of families living with disability. So this is something which very much goes to them. In addition to those thresholds I just spoke about, there is a $2,000 threshold for all other singles and families.

Under the Liberal government's proposed new arrangements, there will only be one safety net. It will be called the Single Medicare Safety Net and it will be for out-of-hospital services. Under the Single Medicare Safety Net, it will be $400 for singles with a concession card or families with a concession card; $700 for singles with no concession card or families receiving family tax benefits part A—like those 17,000 families I spoke about in the electorate of Fowler—and $1,000 for families with no concession card. Leaving concession card holders aside, the average household income in my electorate is a tad over $50,000. So, again, that paints the picture: my electorate is an area of significant need. It is regarded as a low socioeconomic area. These thresholds will now clearly impact on many families and on many families of great need. This is a direct attack on them, particularly as, on the night before they entered the ballot box at the last federal election, they were told that there would be no cuts to health.

The new Medicare safety net will be at a lower threshold for all patients. But it is of concern, quite frankly, that it will restrict the out-of-pocket costs that contribute to a patient reaching the safety net. The threshold amounts will be reduced. What patients receive is going to be very much impacted. A great change is going to be foisted upon the chronically ill, pregnant women, cancer patients and anyone who is in the medical system and using it extensively. Over 800,000 Australians will be slapped with higher medical bills and out-of-pocket expenses worth over $600 a year, after receiving the standard Medicare rebates. This is not including the out-of-pocket costs for non bulk-billed GP visits, which will rise from $7.60 to $19.45 and will not be covered as out-of-pocket expenses.

In particular, Labor is concerned about the impact that these changes will have on radiation oncology patients, on patients needing the services of psychiatrists and on patients accessing IVF services. For instance, a patient with a malignant melanoma receiving stereotactic radiation treatment could face new out-of-pocket costs in the vicinity of $7,400, while a patient with prostate cancer accessing volumetric modulated arc therapy could face as much as $8,000. Similarly, a patient undergoing breast cancer treatment through a private provider might see a 200 per cent increase in their out-of-pocket expenses for radiation oncology. Significant concerns in relation to fertility services have also been raised by various providers, with some reporting that patients could face costs of between $10,000 and $15,000 for an IVF cycle, which is above the current average of $4,000.

Under the existing arrangements, all of the out-of-pocket expenses for hospital Medicare services count towards the threshold and, once a patient reaches the threshold of the extended Medicare safety net, 80 per cent of their out-of-pocket expenses are met. However, under the changes which are part of this bill, the amount a patient will receive will be capped at 150 per cent of the MBS schedule fee, which, quite frankly, is significantly less than the standard MBS rebate. These growing out-of-pocket costs will become a reality for many Australian families, including those most vulnerable individuals in my community. When you are living on around $50,000 a year and raising children, you do not expect to be kicked in the guts—as Premier Mike Baird referred to it—on matters of health and education—matters that really go to your normal day-to-day life. Sure, there are many other things that can be argued in this place. But when it comes to the most vulnerable, the last thing you want to be doing is making decisions as to whether or whether not you access medical services, particularly when there are kids involved.

This brings me back to what I said earlier: only three people on the government's side have decided to stand up in here and support and justify this legislation. Only three people were brave enough to get the call from their whip to say, 'This is a duty that you must deliver upon.' While my electorate has significant pockets of disadvantage and many, many challenges, the truth is that many of the people over there represent very similar electorates. Are they going to go back, look people in the eye and say, 'When I had a chance, I didn't do anything about stopping this. I just went along with the wave of $60 billion cuts to education not knowing that this was going to impact on people of need in my electorate'? There comes a day of reckoning for this stuff. This is not a game for economic rationalists. Here we purport to represent, openly and honestly, people in our communities. We bring their concerns here and we stand up for their rights and their liberties; we stand up for their families. What I can see here is that there is only one side standing up for Australian families and Australians who are looking after their families in respect of health, education and many other things. In respect of health, there is only one side here that is standing up to these cuts.

I am sure that this is one of those issues where the numbers will be crunched and this will go through, but this is a piece of legislation that should be remembered. This is an issue that every member in this place—the whole 150 of us that have the honour of serving our electorates—should have a view on. It should not just be left to Labor MPs to come out and say how it is going to affect people in our electorates. The government have the majority here; as I say, they can crunch this through, and they probably will. But they also need to look people in the eye and tell them, 'When we had a chance, we proposed doing nothing about protecting the interests of families when it comes to health.'

This will have a deleterious impact on health in our communities. It will cause people to decide whether they will access their doctors, in the full knowledge that there will be out-of-pocket expenses involved and that they may have to sustain those expenses. That is the last thing we want Australian families to have to do. People do a great job looking after their families, and in turn those families are the backbone of our community.

This legislation is all about communities—it is all about how we support our communities. Labor does not support this bill and will call for it to be referred to the Senate Community Affairs Legislation Committee to provide the opportunity for all stakeholders to express their opposition to these proposed changes.

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