Rob Mitchell (McEwen, Australian Labor Party) Share this | Link to this | Hansard source

I welcome this opportunity to speak on the important issue of health care and, in particular, Medicare.

On today, of all days, not only do we respectfully remember all of our servicemen and women through tributes at Remembrance Day ceremonies right across the nation but we also remember the Dismissal of the Whitlam government on 11 November 1975. As many people are aware, it was Prime Minister Gough Whitlam and a progressive Labor government who led the way for universal health care in Australia through the creation of Medibank, which was the precursor to today's Medicare.

It is with respect to Gough Whitlam's legacy of universal health care that I declare that I oppose the Health Insurance Amendment (Safety Net) Bill 2015. I do not support this bill, because it will have detrimental impacts on more than half the population of the seat of McEwen. The bill proposes a positive on one hand and then takes away with the other. It seems to be the story of this government.

The new Medicare safety net proposed in this bill has lower thresholds for all patients, and that is a good thing. But the kick in the teeth—as there always is with this government—comes with proposed restrictions. The bill restricts the out-of-pocket costs that can accumulate towards the safety net threshold. It also restricts the amount of benefit payable once patients reach the safety net. In the existing Medicare safety net arrangements all out-of-pocket costs for out-of-hospital Medicare services count towards the threshold. Once a patient reaches the Extended Medicare Safety Net threshold, 80 per cent of their out-of-pocket expenses are covered unless the service is one of the MBS items covered by a cap. The proposed changes in this bill will restrict which out-of-pocket costs can accumulate towards the safety net threshold. They will also restrict the amount that patients can receive back by capping it at 150 per cent of the MBS fee less the standard MBS rate. So, after we do the sums for the MBS fee less the standard MBS rate, the patient's out-of-pocket expenses are—surprise, surprise!—higher.

To give you an idea of the impact that these proposals would have on people and families in my electorate, think about this: with this bill, a patient with malignant melanoma faces new out-of-pocket expenses of about $7,400. With this bill, a patient with prostate cancer faces new out-of-pocket expenses of some $8,000. With this bill, a patient with breast cancer being treated by a private provider may face a 200 per cent increase in their out-of-pocket costs for their oncology treatment. With this bill, patients could face costs of $10,000 to $15,000 for IVF cycles from a fertility service. This is well above the current $4,000 cost per cycle, and that is something that I think members opposite should really reflect on before they vote on this. Are they really saying that they think this is fair and reasonable for people who are suffering with breast cancer—people trying to start a family and going through the pain and the indignity of the IVF? I know many people struggle to have children, and the IVF process is not one that is simple or nice, but people do that because they want the opportunity to start a family. So I am asking people on the other side: do you really think they deserve to be charged a lot more than they currently are just for trying to (a) stay alive or (b) have the opportunity to have children? This bill clearly demonstrates the disregard of the Abbott-Turnbull government for patients who need ongoing psychiatric care.

I want you to think about this. Think about how many people you know who may be going through similar situations. They may be treated for cancer related illnesses, mental illnesses, chronic illnesses like diabetes, heart failure or renal failure. You tell me if these people—sometimes forced out of work due to illness—can afford to cover new out-of-pocket expenses and treatment. I tell you, Mr Deputy Speaker, they cannot.

When Labor made changes to the Medicare safety net in 2009, it was supported by not one but two independent reports demonstrating the policy case for change. The changes we made put caps on specific MBS items identified in the two reports that contributed significantly to the expenditure on the safety net. We are not saying by any stretch that the current safety net arrangements are perfect, and I can see where the Minister for Health is coming from on this bill. Although it is expressed extremely clumsily, I think the same policy intent is there, but the problem with this bill is that it does not even try to target specific items affecting expenditure on the safety net. It is a blanket approach that will have serious adverse effects on patients, and that is not just my view. The President of the Australian Medical Association, Professor Brian Owler, has said that growing out-of-pocket costs will become a reality for all Australian families, including the most vulnerable in our community. The President of the Royal Australian College of General Practitioners, Dr Frank Jones—I met with Frank yesterday to discuss the college's vision for general practice and a sustainable healthcare system—agrees with the AMA. Dr Jones says that safety net thresholds will increase by CPI annually while rebates are frozen.

The financial impact has also had consequences for people's emotional and mental health. Dr Shirley Prager, President of the Association of Practising Psychiatrists, has said: 'If the new safety net is legislated, a significant group of high-need patients who require consultation with their psychiatrist more than once a week will lose the appropriate level of support provided by current safety net arrangements. Many of these patients are poor and unable to work as a consequence of illness, and the intensive psychiatric help that they urgently need to rebuild their lives will be lost under the new Safety Net. I believe that patients who need access to a psychiatrist in these circumstances will suffer significant and increased financial hardship or may very frequently be forced to give up much-needed treatment, to the overall detriment of their own personal health and wellbeing. The consequences are potentially disastrous.'

Mr Speaker, you and I both know that six years after the Black Saturday bushfires, which had huge impacts on both our electorates, there are many people still suffering with the trauma that that disaster caused, and putting more stress on them by putting them in a position where they cannot afford to pay for the help and support they need is wrong. It is not on. It is not fair. Many people are still suffering today because of what they faced, and it really surprises me that members of the coalition could be so comfortable in saying, 'Well, that's okay,' because, as you know and I know, these people have gone through an extremely traumatic experience, and they need ongoing help. It has been shown that even today people are still facing the demons they faced on that awful February day.

The outcome of these changes will severely compromise access to the appropriate treatment for a particularly vulnerable group of patients with serious mental illness, including sexual abuse victims, who are currently the subject of a royal commission that was set up by a Labor government that actually set up royal commissions into legitimate concerns in our community and in response to problems.

Mr Christensen interjecting—

You may laugh, Member for Dawson. It says a lot about your values if you think that that is funny.

George Christensen (Dawson, National Party) Share this | Link to this | Hansard source

You're having a go at union corruption. That's what I'm laughing about.

Rob Mitchell (McEwen, Australian Labor Party) Share this | Link to this | Hansard source

Having a laugh as I talk about a royal commission into people who have been made vulnerable—

Tony Smith (Speaker) Share this | Link to this | Hansard source

The member for Dawson will cease interjecting.

Rob Mitchell (McEwen, Australian Labor Party) Share this | Link to this | Hansard source

I think that is really appalling.

Tony Smith (Speaker) Share this | Link to this | Hansard source

The member for McEwen will address the bill.

Rob Mitchell (McEwen, Australian Labor Party) Share this | Link to this | Hansard source

I will not go into a battle of wits with an unarmed man, Mr Speaker, I promise you. These changes, if put into place, will lead to an increase in the incidence of suicides among this patient group. The bill represents a cut of some $270 million to the Medicare safety net. So much for the promise by the Abbott-Turnbull government of no cuts to health! I am here today to tell you that the Australian people are not the bottom line of the accounting sheet. I understand that the argument in this bill means many patients will meet the safety net sooner, but they will meet it sooner in a context where $270 million has been ripped out. These savings are only happening by restricting the total amount of out-of-pocket costs that can accumulate to reach the safety net and then by putting cuts.

Debate interrupted.