Chris Bowen (McMahon, Australian Labor Party, Shadow Treasurer) Share this | Hansard source

And we are going to point out that it is a gimmick—I am indebted to the member for Oxley—and that it is an accounting trick which is a vainly designed attempt to divert public attention from what this government really thinks about Medicare. The Medicare guarantee is nothing more than a sham. It does not guarantee anything. It provides no policy stability, no guarantee of additional funding and no guarantee that a coalition government in the future will not make further cuts to Medicare or, for that matter, or the PBS. We have made this a key point of difference between the government and the opposition and we will continue to do so, and no number of accounting tricks or budgetary mechanisms will change that.

So let us look in some detail at what this bill actually does, because it is very interesting. You would think that, if this was really the Medicare Guarantee Bill, it would provide some form of guarantee—that it would provide some form of locked box; some form of parliamentary mechanism to say that Medicare cannot be touched or cut. It does none of those things. It does not provide any guarantee. It is a misnomer. It is a poorly named bill. It should not be called the Medicare Guarantee Bill, because it does not guarantee Medicare—which you would think would be a pretty fundamental part of the Medicare Guarantee Bill.

Currently—and this is a very important point—the consolidated revenue fund is the only fund that really exists; it is the only one that is constitutionally provided for. The consolidated revenue fund is it; it is all that exists. At the moment, authority to appropriate funding from the consolidated revenue fund for the purpose of MBS benefits is granted through the Health Insurance Act 1973. Similarly, authority to appropriate funding from the consolidated revenue fund for the purpose of the PBS is granted through the National Health Act 1953. So, basically, the way the system works now is that funds from the budget are appropriated through authority granted by two pieces of legislation directly for the purposes of MBS benefits and PBS payments. This bill changes that, so that the consolidated revenue fund will be appropriated directly: firstly, into a Treasury special account and then into a health special account and then to MBS benefits and PBS payments. So it is just a very minor difference in the accounting treatment.

It has no practical or substantive impact. It will work on an annual basis, so after determining how much is required to pay out MBS benefits and PBS payments for a year, that amount is credited to the special accounts. I emphasise there is no locked box here. There is not even a vague attempt to say, 'Future governments shall not be able to reduce the amount of funding to Medicare.' Of course they would not be able to do that—one parliament cannot bind another parliament—but they are not even attempting to do that. There are other ways off-budget that that can be done. The Future Fund, for example, is a locked box. It cannot be impacted upon without legislation, but this is not a locked box. In fact, as I said, the Constitution makes it very clear that the only fund that exists in any meaningful sense is the Consolidated Revenue Fund. Section 81 of the Constitution states:

All revenues or moneys raised or received by the Executive Government of the Commonwealth shall form one Consolidated Revenue Fund, to be appropriated for the purposes of the Commonwealth in the manner and subject to the charges and liabilities imposed by this Constitution.

So all this guarantee is is a new way of appropriating funding as is required under the Constitution.

We will have members opposite talk about how this is guaranteeing Medicare, how they have seen the error of their ways, perhaps, how the $7 GP tax was a mistake in hindsight. It was so important that the poor, old member for Warringah told the gathered world leaders at the G20 that this one this government's key priorities—the GP tax. They were scratching their heads at that one let me tell you, Mr Deputy Speaker. There will be lots of alibi-making by members opposite, but I am drawn to the evidence before the Senate estimates by Minister Cormann. Minister Cormann told the truth before the Senate estimates. Senator Gallagher was questioning him closely and she said, 'Is there a practical difference in how the MBS and PBS were funded last year and how they are going to be funded once this guarantee fund is established?'

Senator Cormann, who was trying to spin it, said: 'There is a practical difference. That is there is clear visibility of the full cost and there is clear visibility of the full funding allocation.' That is it—visibility! This should be called the 'Medicare visibility bill', if anything, because apparently there is more visibility if you have a separate account. That is no guarantee. What worries me, I have to confess, is if there is more visibility it just makes it more tempting for the government to cut Medicare into the future, that they will say: 'Look at that visibility. We will have some of that visibility. Thank you very much, and we will cut Medicare.' That is what they are prone to do at every single opportunity.

There is no difference other than so-called visibility and transparency and, as I said, the Labor Party does not oppose transparency so we will support this bill. Let us not pretend for one second that this is any sort of guarantee; it is simply a government which has undermined confidence in Medicare and has attempted to attack Medicare from the day they were first elected—against their election promises. We all remember the former Prime Minister at the stadium in Penrith: 'No cuts to health. No cuts to education. No changes to the pension.' But, cuts to Medicare are cuts to health, and that is the form of the Liberal and National parties. They go to elections promising to protect Medicare. They win elections then they attack Medicare. It is what they do. It is a bit like superannuation. They oppose superannuation at every turn, and yet they undermine it at every turn while pretending they really support it. 'We really support Medicare,' they say. 'We really support superannuation. We just attack them at every opportunity.'

Medicare has defenders on this side of the House and in the other place, and we will defend Medicare at every single opportunity. We will defend Medicare whenever it is attacked by those members opposite. It is fundamental to what we do. It is fundamentally important to our agenda in government and, when we are in opposition, it is fundamentally important to what we seek to protect and defend whilst we are in opposition. We will defend it and protect it. It is a key role for us in opposition—protecting Medicare from those opposite who attempt it at every opportunity.

I understand that people at home might think: 'A Medicare guarantee fund? That's a good thing. It's good to have a fund which actually guarantees funding Medicare. Sounds good. Why not? Let's have a fund which guarantees Medicare.' If only it were true. If only there was some mechanism in this bill which would actually say governments cannot cut Medicare, we would strongly support that because there is only one type of government which strives to cut Medicare and it is the type of government that sits opposite. Labor governments do not try to cut Medicare. This Liberal and National Party government tries to cut Medicare, as their predecessors and successors no doubt will do. And no type of accounting treatment will change that other than a genuine locked box, which says, 'Medicare shall not be cut.' But, of course, this government is not proposing that. I would love to hear the members opposite, and the member for Forde who is going to follow me in this debate, tell the House that it is going to guarantee that Medicare will not be cut into the future. We will be listening. We will be listening because if he does he will be misleading the House, which is a very serious thing. I am sure he would not do that. I think the member for Forde is quite an honourable gentleman, and I am sure he will not mislead the House by pretending that this is some sort of guarantee of Medicare. He should call it as it is. He should say that this does not guarantee Medicare. He should say, 'This is an accounting trick!' He would be welcome to say it because that is what it is. All honourable members opposite should be saying that, just as members on this side of the House will be pointing it out that when you freeze the MBS, when you impose a $7 charge to go to the doctor, when you do these things, that was the government.

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