Bert Van Manen (Forde, Liberal Party) Share this | Hansard source

It is always a pleasure to stand in this place, having listened to a terrific contribution from the member for McEwen. But I have a little bit of history for the member for McEwen. The first major privatisation in this country, which was the first tranche of the Commonwealth Bank of Australia, was actually done under a Labor government in 1991. I say to those opposite: your party was the one that started the privatisations in this country. As usual, we see that those opposite are supremely adept at rewriting history for their own benefit but never for the benefit of the Australian people. That is why this bill is so important.

I rise today to support the Health Insurance Amendment (Safety Net) Bill 2015 because it is an important structural reform to the Medicare arrangements and will address a number of known issues that, surprisingly—and this might assist the member for McEwen—were identified in independent reviews of the Medicare safety net in 2009 and 2011. I wonder who was in government in 2009 and 2011? It was those opposite. But, as usual, they failed to deal with the issues that were identified six and four years ago respectively, and now it is left up to this government to fix up another of the issues that they failed to deal with.

The 2009 review identified the extended Medicare safety net to be structurally flawed with rapid fee inflation in some areas of the Medicare Benefits Schedule. It also highlighted that around 55 per cent of these benefits were going to the top 20 per cent of Australia's most socioeconomically advantaged, with the least advantaged 20 per cent receiving less than 3.5 per cent of the benefits. We hear those opposite talk ad nauseam about the fact that they are supposedly there for the battler. Well, they are standing in this place speaking against this proposed legislation, which is designed to actually help those at the bottom end get a better range of cover and benefits through these amendments and to put people at the top end, who can afford to pay, in a position where they are possibly going to pay more. So, yes, the top end of town will pay more, and the bottom end will be better covered. We hear them parrot on about equity all the time. I think this proposed legislation is well designed to actually deliver the equity they so frequently talk about. I find it amazing that we frequently sit in this place and see that the rhetoric of those opposite very rarely measures up to what they profess to believe in.

The 2011 review showed that the capping led to a reduction in safety net expenditure, and that this was relatively greater in wealthier areas and major cities. The Extended Medicare Safety Net is extensively flawed and many residents in my electorate of Forde have suffered as a result. It has perverse incentives for medical fee inflation, rigid rules which disadvantage families, as well as poor access for non-concessional single people on low incomes. The current safety nets, with the three overlapping arrangements and inconsistent benefit caps, are complex and confusing for patients and practitioners, and leave many people out of pocket, stressed and frustrated. Existing Medicare safety net arrangements include the flawed Extended Medicare Safety Net, the Original Medicare Safety Net and the Greatest Permissible Gap. No wonder it is almost impossible for patients to calculate rebates. The existing arrangements are complex, regressive and inflationary.

The Health Insurance Amendment (Safety Net) Bill 2015 seeks to replace all of the existing Medicare safety net arrangements with a new Medicare safety net. In the past, a number of changes to the Extended Medicare Safety Net have been made to address some of these concerns, but they have made it complex for both the medical profession and patients to understand. Unfortunately, these changes have failed to completely address problems with the program—some people reach the threshold almost immediately each year due to the unlimited amount of out-of-pocket expenses that accumulates to the threshold. This provides no further signals to the provider with respect to fee restraint.

The new Medicare safety net has been carefully designed to respond to the issues raised by the two independent reviews that I referred to earlier. In stark contrast to those opposite, we have taken the time to consult with stakeholders and the public and to consider its impact on provider charging behaviour and out-of-pocket costs faced by singles and families. While the new Medicare safety net will continue to provide an additional benefit to families and singles for out-of-hospital Medicare services, once the annual threshold has been reached it will also be more progressive. Thresholds for people without concession cards are reducing from $2,000 to $700 for singles and $1,000 for families, and for concession card holders from $638 to $400. It is expected that more than 53,000 additional people will receive a safety net benefit under the new arrangements, and for concession card holders, in particular, an additional 80,500 people will receive benefits.

As I mentioned earlier, we talk often in this place about equity, and I think this is a clear example of equity being extended to a far broader range of people in our community through their ability to access these benefits. Unlike the Extended Medicare Safety Net, the amount of out-of-pocket costs per service that counts towards the threshold will have a limit, and the amount of safety net benefits paid per service, after the singles or families threshold has been reached, will also have a universal limit. This will restrict medical inflation and limit the Commonwealth's exposure, while ensuring more Australians can access safety net benefits. Most importantly, the thresholds to access the new Medicare safety net will be lower than the thresholds for the Extended Medicare Safety Net for most people, and more people will receive a safety net benefit as a result. While the average benefit paid will be less, more people will be able to access benefits than under the current arrangements.

For many residents in my electorate of Forde who rely heavily on bulk-billing with their GP, the changes will not reduce access to GP primary care. Safety net benefits currently only account for about one per cent of total benefits paid for GP services, as a high proportion of people are bulk-billed. The bulk-billing rate for concession card holders is some 91 per cent, which means that these people do not have out-of-pocket expenses for these services at the moment and will therefore be unlikely to be affected by any of these changes. Most people do not receive safety net benefits for GP services and those that do are generally from areas where higher fees are charged, such as in the higher socioeconomic areas. As we saw before, it is those higher socioeconomic areas that are getting the greatest benefit under the old system. The lower thresholds under the new arrangements may mean that more people receive safety net benefits for these services.

This bill will also allow the government to continue to support singles and families who have high out-of-pocket costs, while streamlining the Medicare safety net arrangements. Importantly, for all in our health system, it will improve Medicare for the long-term future and benefit of this country. I commend the bill as it is presented to the House.

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