James Stevens (Sturt, Liberal Party) Share this | Hansard source

I rise to speak in favour of the second reading of the Private Health Insurance Amendment (Income Thresholds) Bill 2021. I'll start by making a few comments on the previous contribution, joining with my honourable colleague in encouraging all Australians to get vaccinated against COVID-19. His points about vaccination and what it has done to change modern medicine in the last hundred years or so are very well made, and I'm very supportive of that. Can I just say that I take every opportunity that I get, as I'm sure all members do, when I'm out speaking to people in my community, whether it's at a Rotary or RSL club or a sporting event. As leaders in the community, we all have to do our job by encouraging everyone in our community to get vaccinated. Indeed, we need to encourage them not just to get vaccinated but to participate in spreading the word. If we can get as many adult Australians vaccinated as possible—hopefully the vast majority, as close to 100 per cent as possible—that is the best thing we can do, working together, to address the challenges that we face from COVID-19 but also the opportunities to open up our country, our economy and our society again as soon as possible. The most important thing we can all do, as members of this House, is encourage people to get vaccinated, and I commend anyone that is a part of spreading the word in that regard.

More specifically to the bill, I think it has been made abundantly clear. This is fairly straightforward, dealing with the private health insurance rebate threshold and, equally, the threshold at which the Medicare levy surcharge is applied, effectively freezing them from indexation for another two years. I'll speak initially a bit more broadly. Obviously, the great policy principle in this country is that we support and believe in universal health care for all Australians. I think that's something we're very proud of in this country.

To be honest, although I have a great deal of respect for countries like the United States for a whole range of reasons, I do despair for them that they live in a society where people can't access fair and comprehensive health care without having their own personal insurance. In fact, I was an employer in the United States, in a previous part of my career. It was surprising how, when you were advertising roles in the United States, when it came to remuneration, it was much more important to people to know that they were getting health insurance as part of that job rather than what the actual amount of salary would be. That goes to show that it's such an important thing for someone in the United States. That's something I would never want to see being the case in our country, and I'm very proud that anyone can access our universal healthcare system in Australia and that we provide the highest standard of care to all citizens here, no matter what their economic circumstances might be.

It's equally important, of course, that we encourage those who have the capacity to contribute more for their health care to do so, and of course we do that through the private health insurance system in this country. So what we're debating about, specifically, in this bill are the policy mechanisms we use to encourage people to have private health insurance.

There are reasons to have private health insurance, before you look at the impact on your income from the Medicare levy surcharge, which you pay when your income is over a certain amount if you don't have private health insurance, and also from the rebate. Obviously we provide a very good base standard of health care in this country, which is the highest standard you could possibly ask for. But it is always the case that there is an incentive to have private health insurance for certain additional extra services et cetera that aren't required to give you a fundamental standard of care but which, if you're prepared to pay for them, you might find of value. It's also good that we encourage people, through our income tax system, to have private health insurance when they're on an income where they can afford to do so. This clearly takes an enormous amount of pressure off the public health system—particularly the public hospital system, when it comes to elective surgery in particular. Everyone who holds private health insurance, when they need certain elective procedures, can, through their private health insurance, go to a private hospital rather than going to the public system. That is obviously then one less person putting pressure on the public system. That's going to ensure that we have lower waiting times, and so rapidity of care, but also the outcome where everyone in society gets the same standard of service delivery but where those who can afford to can take the pressure off the public system commensurately.

The obvious effect of putting a freeze in place is that if people's incomes are growing and if we're not commensurately increasing the income threshold then more people will come into the category of either paying the Medicare levy surcharge if their income passes the thresholds of $90,000 or $180,000, and/or of getting the private health insurance rebate. This gives us a two-year period to undertake a broader reassessment of the effectiveness of the current regime, of bringing back indexation, in two years time, and, of course, achieving the policy outcome we want, whereby people who can afford it are encouraged to take out private health insurance, because, clearly, we want as many people as possible to have it. I think there are around 14 million Australians with some form of eligible public health insurance, rebate-style cover, at the moment. We want to incentivise as many people as possible, of those who can afford it, to have that insurance, and this is a mechanism we've had for many, many years—decades, in fact. But the freeze on indexation means that more people will be encouraged to hold private health insurance, through the reality that, if they don't hold it, they'll be required to pay the Medicare levy surcharge if they move into those income brackets of over $90,000 or over $180,000.

I think we've all been able to take a great deal of pride in the Australian health system, and never more so than in the last 14 or 15 months, since the COVID-19 pandemic has put challenges and pressures on us in this country, as it has on every other country in the world. I can't think of a time in my life where it has been so easy to compare the impact of a particular challenge like this health pandemic on this country with the impact on literally every other country on the planet. There is almost nowhere that hasn't had to meet the challenges of COVID-19, from a health point of view and from an economic point of view. In both cases, I would say that Australia is at least equally at the top, in meeting the health challenges and the economic challenges.

It's a great tribute, of course, first and foremost, to the people who work in our health system. Even in my home state of South Australia, and across this country, I think no-one would say they hold anything but a great deal of pride in the quality and calibre and work ethic of our health professionals, in the way in which they have risen to what has been an extraordinary challenge for health systems across the planet.

Most people would expect that the health systems of many Western and European countries would be of a similar gold standard to the Australian health system. Unfortunately we saw, particularly in the early weeks and months, health systems in Italy, the United Kingdom and Spain put under an enormous amount of pressure. They sometimes burst at the seams and were incapable of handling the pressure that was put on them through the way in which COVID-19 burnt through the cohorts of those countries. It put on them a pressure that took them beyond breaking point. We never had that in this country, which was a great relief but also a great credit to our health staff and the staff who worked to keep our borders and quarantine systems secure.

There is criticism, which I find disappointing and unnecessary, of the quarantine system in this country, because I just can't think of anywhere else in the world that has done it anywhere near as good as us. We have natural attributes like, of course, being an island and thus having the ability to close our borders without a land border and the challenges of that, so we've got that luck. We are the Lucky Country, but we also make our own luck. We made some very important decisions early on to close the border of this country and only allow people to return if they were Australian citizens or permanent residents or dependents of those categories and only if they went through a quarantine process, where they quarantined for 14 days, which, pretty early in the piece, became through the hotel quarantine system. This has been a partnership between state, territory and federal governments. The concept that quarantining is a federal responsibility under the Constitution is completely irrelevant to the practical reality of how you should properly undertake quarantining against a health virus in human beings. It's the state and territory jurisdictions that have the health capability and capacity. Even if the Commonwealth was doing it without the states and territories instead of cooperating and working with them, the states and territories would bear the risk and burden of what may put an enormous amount of pressure on their health systems.

All of the reviews and the reports about quarantine that you have access to in the public domain make a few very important points. For those who warrant to talk about remote quarantine camps—and all the things that, bizarrely, the Labor Party used to criticise the coalition for so heavily on another policy topic when it came to managing the flow of people into this country—it is very clear that, when you undertake quarantine, you must have close access to tertiary health services so that, if people in the quarantine system do, in fact, have this COVID-19 virus and they do deteriorate to the extent that they need significant medical attention, they are close to that. That means ventilation and ICU in tertiary hospitals, which are, of course, located in the major population centres in this country—in particular, capital cities. You also want to have your quarantine as close to the international airports as possible where people returning to this country are landing. Every extra complexity you put in place between landing in an aircraft somewhere in this country and being taken into the quarantine system increases the risk.

Thirdly, you need a workforce available to operate the quarantine system as readily available as possible. So, of course, when you're holding people in quarantine in CBD hotels, it is the easiest place in which to get the workforce you need for all the various requirements and responsibilities of undertaking that quarantine. Doing that in the middle of outback Australia and thinking that you could manage all the various risks of not having a workforce, not having tertiary hospital systems nearby and having the long, risky transit from where people arrive in the country to putting them into these sorts of facilities are the sorts of risks that have been ruled out by the experts. I strongly endorse the approach of the Prime Minister when it comes to quarantining returning Australians, which is to work cooperatively with the state and territory jurisdictions, who have certain capabilities and capacities to manage this unique quarantine challenge that we at the Commonwealth level don't have. Equally we provide all the resources that we possibly do have to work collaboratively with them in undertaking this very substantial logistical challenge.

Obviously, any breach from hotel quarantine is extremely concerning and regrettable. But, if you look at the number of people that have come home to this country over the last 14 months and, against that number, the percentage of outbreaks that have occurred, it is an unbelievable statistic, more than 99 per cent. We don't want any outbreak whatsoever. We want this to be completely watertight. We've always learnt about opportunities for improvement from various lessons in that 14-month period. But the broad principle of how it is being undertaken is the right one. Liberal governments and Labor governments at the state level are all in agreement on the way in which we're undertaking the quarantining of people returning to the country while our border is closed, so that we can protect our population from bringing COVID-19 into the country.

With that said, I appreciate the opportunity to make a contribution on this important piece of legislation. As I said, it's fundamental to the principles of our health system, where we have universal health care for all but we want to have an incentive for those that can afford to contribute more for private health insurance to do so, so that we're taking pressure off the system and making it as sustainable as possible. I commend the bill to the House.

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