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

Thank you. Of course, we know that this government was planning to outsource parts of the Medicare system to the private sector. Labor staunchly and vehemently opposed that move. In the two years since that election, the government has been busy trying to rewrite history, pretending that that somehow didn't actually happen, that they weren't planning to do that, that they hadn't commenced the work—nor was it in their budget papers, which it was—that somehow this was a Labor invention, that it was a scare campaign. That is utter nonsense. The government was actively planning to outsource the Medicare payment system to a corporate player—one of the big four banks, perhaps, or a private health fund. That is what this government was doing. If we had let them get away with it, that would have been the beginning of the end for Medicare as we know it. The government dropped their plan because of Labor's tireless efforts to highlight the damage that they had done to our healthcare system and because the Australian people agreed that it was a terrible plan and punished them for it.

Eventually, as we know, the Liberals will have another crack. They'll come up with another scheme to undermine, weaken or sell off parts of Medicare, because they have form. Remember their $7 co-payment from just a few years ago. It was an unprecedented attack on the universality and accessibility of Medicare, effectively meaning that we would have a system where people were increasingly having to pay substantial out-of-pocket costs for Medicare. Then, too, it was Labor, it was the parliament, it was the Australian people who ultimately stopped the government from going down that road. As is so often the case, we helped save the government from itself, but the plan revealed what was in their hearts. When they couldn't get that plan through, they resorted to extending the freeze on Medicare rebates—a freeze that is still in place today—for six years. Again, under intense pressure from Labor, doctors and the public, the minister announced a thaw in that freeze in the budget last year. But, today, there still hasn't been a single element of it lifted. Some elements will come off as of 1 July, delivering GPs a 55c increase in the Medicare rebate for patients. It won't put a dent in the soaring out-of-pocket costs, and other elements of the freeze will stay in place until 2020. That's six years of slugging doctors and, ultimately, patients who simply want to access health care.

The rebate freeze has saved the government billions of dollars, and they're still banking those savings from patient rebates today. That is billions of dollars that should have gone into providing health care in this nation. Meanwhile, the latest Medicare data shows that the cost of seeing both GPs and specialists is at record highs because of those Liberal cuts. In the first three months of 2018, Australians paid an average out-of-pocket fee of $38.44 to see a GP and nearly $47 in some states and territories. The national figures have risen nearly $4 from $34.53 cents at the end of July 2017. Out-of-pocket fees to see specialists have soared even higher, up to an average of $87.62 in the March quarter. That's up from $71.75 in the last three months of 2017—up nearly $16 in just a single quarter. In some jurisdictions, the average out-of-pocket cost of seeing a specialist has now soared to well above $90. These are the average costs. They are far too high. Meanwhile, the government has tried to trumpet funding for the projected growth in Medicare service usage as, somehow, a record investment in Medicare. The Australian people are far too smart to fall for that. They know that the cost of going to see a doctor has risen under this government. They feel it every time they get sick or injured and need to access health care. That's why so many of them are delaying going to see a doctor. Official Bureau of Statistics figures show that one million Australians delay or avoid seeing their GP each year due to cost, with another 1.7 million Australians skipping specialist appointments. About the same number don't fill prescriptions because of cost. Older Australians fare worse, with one in eight telling the Commonwealth Fund that they have problems getting care because of cost. Only patients in the US—obviously no role model for us when it comes to universal health care—fare worse.

There have always been challenges with Medicare's universality, such as the difficulty of accessing services for Aboriginal and Torres Strait Islanders as well as for people in regional, rural and remote Australia, but, in recent years, out-of-pocket costs have become a significant barrier to universal access. Medicare statistics show that, 10 years ago, Australians paid an average out-of-pocket fee of $21 to see a GP. If that cost had increased in line with inflation, it would be around $26 today. The same is true for specialists. Ten years ago, Australians paid $44, equivalent to around $54 today, yet the Liberals make the laughable claim that Medicare has never been stronger. What rot. Whether it's making Medicare more expensive, cutting public hospitals or putting private health insurance profits before patients, the conservatives can never be trusted when it comes to our universal health insurance system.

In the last round of budget Senate estimates, officials said that the government's latest budget was trying to bend the curve of Medicare—that's their fancy new way of saying 'a cut to costs'. This government wants to bend Medicare, basically, until it breaks. In stark contrast, the Leader of the Opposition announced the first of Labor's new investments in Medicare in his budget-in-reply, and that is a significant investment in MRIs. Unlike other diagnostic imaging services, MRI scans can only attract a rebate if they're performed with an eligible machine. The licence system is difficult, but it worked relatively well until 2013, given that the last Labor government granted over 238 licences. Unfortunately, the current government has neglected MRIs, granting only four licences in almost five years. That is a woeful record when you know that there are communities across the country who are desperately seeking access to this diagnostic technology and are having to pay substantial amounts of money to do so. It is a woeful record. As a result, access to Medicare MRIs is patchy, with many Australians travelling long distances or experiencing significant wait times to access an eligible machine.

Labor's Senate inquiry into MRI licences heard evidence that in some primary health networks people are waiting an average of 50 days for an MRI after a specialist referral. That is too long. The inquiry also heard that a shortage of Medicare MRI licences could have deadly consequences, with evidence that children were being overexposed to the radiation of CT scans. That's why we announced that we will grant 20 new full MRI licences. The first 10 will be reserved for public hospitals, with locations determined based on evidence from Senate estimates and from advice from state governments and the Royal Australian and New Zealand College of Radiologists.

We've already announced that the first licence we intend to deliver is in Western Australia, with the community of Kalgoorlie to benefit from that. I do note the pretty appalling evidence that has come to light, that this government was prepared to trade an MRI licence for the people of Kalgoorlie for a vote in the Senate for its $80 billion worth of tax cuts—an appalling indictment of the way that this government does business when it comes to health. The remaining 10 licences from Labor will be awarded via a transparent application process under a Labor government. This will be the first opportunity for communities around Australia to apply for a licence since Labor was last in office. This $80 million investment will ensure that more communities have affordable access to life-saving scans. We've also said that Labor would re-invest into Medicare every dollar saved from the clinician-led MBS review. That is because we see the MBS review as an opportunity to improve innovation in Medicare, not as a cost-cutting exercise.

The government is making the claim that it will re-invest or redirect its savings back into the Health portfolio overall, but we on this side simply do not trust a single word that this government says when it comes to Medicare. The government's assurances are absolutely worthless. So, while there is $190 million in savings from the MBS review in the 2018 budget, there is just $25 million in new MBS listings, which means a net cut to Medicare. The minister is seeking to claim that putting money into the projected usage of Medicare services is somehow investing in new innovation in Medicare and investing all of the savings from the MBS review back into Medicare. It is not.

It is certainly not going into our hospitals, either. After four years of Abbott-Turnbull cuts to our public hospitals, Australia's public hospitals are in trouble. This government cut Medicare, they've cut public hospitals and they do everything they can to prop up the big private insurers. That is the Liberal Party's vision for health care in this country. Labor, of course, will have more to say about new investments in Medicare in the months ahead.

I understand the government will have two amendments that it will be moving to its own bill. The first is to resolve a drafting error to ensure existing debts can be recovered, and the second is to clarify that it is not the intention of the changes to PSR summons to see individual practitioners being subject to multiple penalties for nonappearance. Labor will support both of these amendments, but I do note that the government's approach has been very sloppy here. One would be warranted in thinking that maybe they are rushing things through a bit in an attempt to clear the decks before an election. As I signalled before, we will be supporting this bill, but, given the contribution to the debate, I move:

That all words after "That" be omitted with a view to substituting the following words:

"whilst not declining to give the bill a second reading, the House condemns the Government for its ongoing Medicare rebate freeze and its attacks on the health of all Australians".

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