Mike Freelander (Macarthur, Australian Labor Party) Share this | Hansard source

First of all, let me reassure the member for Sturt that the private health insurance system is very safe whilst this government is in power. It's very important that people understand that Australia's health system, which I think is the best in the world, functions as a combination of public and private health insurance systems. That's what Medicare is—a public universal health insurance system that is complemented by a private health insurance system. While I'm here and present, while the minister for health is here and the Labor government is here, both systems are safe, as they work so well together.

I congratulate the minister for health for introducing this bill, the Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Bill 2024—yet another way that we, the Labor government, are improving our health system after 10 years of neglect by the former coalition government. We've come a long way. It's important to understand that Medicare—the precursor to Medicare being Medibank—was developed over 50 years ago by Scotton and Deeble, and this is the system Gough Whitlam adopted, when he came to power, under the name Medibank. That was the first universal health insurance system we had in Australia that provided universal access to health care for all Australians. It's important we keep that equitable model going. It was destroyed by the Fraser coalition government, with the defeat of Gough Whitlam, but it was reinvented and improved by the Hawke Labor government. It started in 1984, the year I started my private practice. We've come a long way since those days.

If you can remember going to see a doctor in the first days of Medicare, you had to sign a Medicare form which was then swiped by the provider, and one copy was given to the patient and the other copy was kept by the practice, and the bill itself was then bundled together and sent by post, by snail mail, to the department of health in Canberra. It was then processed, and, some weeks later, the provider got the rebate in a cheque form, which was then taken to the bank and banked. There were often problems with people not being able to read the item numbers on the forms, with people ticking the wrong box in the name—so you'd get the rebate back and there'd be mistakes and you wouldn't get the money you were owed for the consultation with that particular patient, and you then had to go back to Medicare and get another cheque issued. My secretary, Cheryl, who worked with me for over 35 years, had to then rebundle the bill and send it back to Medicare, and, again, some weeks later, you'd get the cheque that could then be banked.

Every day, thousands and thousands of Australians around the country use their Medicare card to access their GP, their specialist, and other medical services such as pathology and imaging. This has been done every day since Medicare was established by the Hawke government. This has helped Australians, particularly those with access difficulties, from lower socio-economic backgrounds or with chronic health problems, get access to some of the very best health care in the world. It was amazing when I started my practice in 1984. I saw many children with disabilities who had not previously been able to access specialist care, and it was a real game changer. It was something that was really important to the economic health as well as the physical health of the country, something that great Labor leaders like Hawke, Keating and Whitlam understood only too well.

Despite the proposed ease of the system, there were often complexities that still needed to be ironed out. This amendment seeks in large part to try and overcome some of the difficulties in billing practices through Medicare and the health system, particularly the private health system, where now we can get bundling of item numbers and so rebates can be paid directly to the practitioners in things like radiotherapy, radiology and pathology without separate bills having to be assessed and patients often being made to pay upfront and then having to try to get the rebate back into their own accounts later. So it's made things much easier for the patients, with less paperwork for the patients and also less paperwork for the practitioners.

It also enables a record to be kept of transactions. As we know, there are hundreds and hundreds of thousands of medical interactions every day in our system in Australia. These can now be tracked easily. Trends can be looked at. Data can be looked at. People can be reassured that they won't have big upfront costs when they first go and see a practitioner. We know that some of the costs involved for some of these transactions, including things like radiotherapy and some of the newer oncology treatments, can measure in the thousands of dollars. For patients to find that upfront is often very difficult. This will improve the ease of accessing these complex treatments, these modern 21st century treatments, and will take a lot of stress off interactions with health professionals. For the providers, it will also enable them to keep better track of the payment system and of their rebates and obviate the need for long hours spent by people looking at and tracking rebates. So it's a really important change.

In addition, this will greatly address the problem of Medicare fraud in the healthcare system. It happens. Medicare fraud does occur but only at a relatively small amount compared to the overall cost of the system. Nevertheless, it's an issue that all practitioners are aware of and believe should be addressed. It's important. Health practitioners must be seen to be above board and to be practising to the best of their ability in providing quality health care to all Australians. Many of my colleagues in all sections of medicine, including those in general practice, do their best to provide high-quality care and abide by the rules and regulations of the system. For those who don't do that, it's important that we track them and that we make sure they are held to account. Unfortunately, there are those who seek to deceive and defraud the system, which harms not only taxpayers and patients but also the healthcare profession and confidence in our healthcare system. Our government is very well aware of these issues and, following on from our Health Legislation Amendment (Medicare Compliance and Other Measures) Bill, which we passed in December 2022, we're working very hard to restore integrity and compliance for both the healthcare system and those who work within it.

As practitioners, we now deal with very large sums of money through our practices. I will just preface that by saying I no longer receive Medicare rebates, but I do still provide a clinical practice at our local hospital for which I do not charge the Medicare system or our public hospital system or the patients. But I am well aware of and talking to my colleagues about the fact that practice costs are increasing—as are Medicare rebates, thanks to this government's real active intervention in this space. It is important to keep track of cash flows. It is important to make sure that people are adequately compensated for the work that they do. This system will help keep track of the costs and the income of all these practices.

Some specialist practitioners have practices generating bills of millions of dollars every year. That sounds like a lot, but it's spread between a number of practitioners, and it's in the more complex treatment modalities that I've already spoken about, such as radiotherapy, which is a commonly used treatment for some of the major cancers of older age, such as prostate cancer and breast cancer. These bills can run to many thousands of dollars for each patient over a number of weeks. This system will improve compliance in this area. The patients, as I've said, no longer have to pay the upfront cost. The practices don't have to send separate bills, and they can keep track of the payment system—the same as people who are receiving some of the complex treatments for chronic diseases such as diabetes and cardiovascular disease. It enables them and the system to have a seamless way of paying the practitioners and tracking treatments. So it's a really important advance and yet another way that this government is doing what it can to make sure our health system remains the best in the world.

I'm proud of it, and I know all my colleagues that work in our health system are very proud of it, but we understand the stresses. We understand that it's a system that was developed many years ago and needs regular updates. That is something that was lost on the coalition government. It's important, of course, that public funds are providing this health insurance system. It needs to be seen as being dealt with properly and that people are earning their incomes in an appropriate manner and still providing high-quality care around the country. I'm very glad that this minister has brought the bill to the parliament. As I said, we've come a long way from the click clack of swiping our Medicare cards and the cheques that used to come intermittently from Medicare to all our practices, and I'm very glad about that. But it's a big change. It's something that should have happened some time ago, and the minister is to be congratulated for that. Medicare is too important to let the system slowly degrade, which was happening under the Liberal-National government. We are bolstering this integral institution to Australia's wellbeing—not only our health wellbeing but our economic wellbeing.

Outside of this building, stakeholders overwhelmingly support our efforts, from the AMA to the private health insurance industry to the private hospital system to general practitioners to specialists. Everyone I've spoken to applauds these advances in our healthcare system done by a Labor government that understands the importance of a universal healthcare system, such as Medicare, understands the importance of our health system and understands the importance of making sure that access to health care is equitable around the country. There's still a lot to do, particularly in some of the outer metropolitan areas and particularly in some of the National Party electorates, where health care has been neglected for a long, long time. It is important that we make sure that access is equitable, and these changes to Medicare will help do that.

There are new things happening in our medical system. Things like telehealth are becoming integral to the system. There's more complex care coming for a range of disorders, such as cardiovascular disease, diabetes and chronic respiratory disease. It's all changing, and it's changing rapidly. We have to have a system that keeps up with this. The present health minister, Mark Butler, is doing his very best to make sure our health system continues to be one of the best in the world. I applaud what the minister is doing. There is more to come. I'm thankful that our government seeks input from all the stakeholders. It's great to see that we have general agreement that what we are doing is certainly the right thing. I applaud the minister. I commend the bill to the House, and I look forward to better health outcomes for all Australians.

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