Cathy O'Toole (Herbert, Australian Labor Party) Share this | Link to this | Hansard source

I am proud to rise in this place as a Labor member because I know that it is only Labor that will fight for and protect Medicare for all Australians. Australia has one of the best health systems in the developed world, and it is thanks to the Labor Party's vision and commitment to universal health care under the Hawke government. Labor clearly understand that the health of the nation has a direct impact on productivity and the economy.

This was also made evident in the PwC report Creating a mentally healthy workforce:return on investment analysis. This report focused on the cost of poor mental health to productivity and the economy, and the results were somewhat amazing. The report identified a total cost of $10.9 billion annually to productivity and the economy, and it comes from specific areas. Most surprising to me was $1.6 billion from presenteeism—that is, people at work, performing at 50 per cent. Absenteeism, people not at work at all, is $4.7 billion. Only $145.9 million is due to compensation claims. I say 'only' in comparison to the costs of presenteeism and absenteeism.

We are witnessing a rise in diabetes, renal failure, heart disease and cancer. Clearly, the best way to address rising tertiary care costs is by funding prevention and early intervention, including in the space of mental health—and that is the role of primary health care.

This government constantly talks about all of the drugs it has added to the PBS, which is commendable. But have they not realised that, if one cannot afford to visit the GP and/or a specialist, these drugs are completely useless, because people cannot write their own prescriptions? Adding to this situation, we see that no growth in wages—in my electorate, unemployment is incredibly high—and cuts to pensions are leaving a number of families and other people forced to choose between which prescriptions they can afford to have made up and which they will just have to let go. Properly funded Medicare care is essential if we are to be a society that creates a growing economy. Growing economies require flourishing societies.

This government labels its budget as fair, but tell me what is fair about a system that challenges people to access affordable healthcare services. Clearly, a budget that locks in a $2.2 billion cut to GPs, specialists and allied health services does not in any shape or form seem fair to me or, more importantly, to the people in my electorate of Herbert. A budget that commits only 1.2 per cent of the funding that has already been ripped out, being directed to lift the Medicare freeze in the next financial year, simply highlights a $2.2 billion shortfall over the next four years, which is clearly not fair. It is a budget that plans to index only seven per cent of Medicare radiology services, which equates to only 59 services out of a total of 891, and that will not come into effect until 2020. GPs in my electorate are not happy. In fact, I have been told that this measure, the lift on the Medicare freeze, will return 12c per visit for two years and will then grow to $2 per visit. That is nothing to be overjoyed about. The government's Medicare guarantee is not worth the paper it is printed on.

For the Turnbull government to say they presented a fair budget is a disgrace when it comes to Medicare, because in reality this government's budget is a massive insult to every Australian who relies heavily on Medicare to stay healthy. It proves yet again that the government are still determined to make Australians pay more when it comes to health. How completely out of touch can they be? The government also plan to increase the Medicare levy by 0.5 per cent, to use their words, 'to fully fund the NDIS'.

The NDIS was created by Labor. In fact, the coalition was dragged kicking and screaming to acknowledge the importance of the NDIS and the transformational change that it would bring for people living with a disability. I have worked in the community sector for more than 15 years. I have worked in the disability sector. I can tell you that the NDIS is the most transformational change that people living with a disability will have seen in their lifetime and in the lifetime of those that have gone before them. The NDIS gives every person living with a disability a chance to live a life of purpose, meaning, choice and citizenship. For this government to say that Labor did not fully fund the NDIS is a complete insult and an utter myth.

The reality is that the government have chosen to give corporate business a $65 billion tax cut, which has left them with no alternative but to increase the Medicare levy. That is not fair on low-income earners. To add insult to injury, members of the coalition government, including the Treasurer, are calling the Medicare levy a progressive tax. I think the Treasurer and his comrades may be a bit confused about the meaning of progressive taxes and flat taxes. But once again I am more than happy to clear things up for the government right here, right now. A progressive tax is a tax that takes a larger percentage from high-income earners than it does from low-income individuals, whereas a flat tax is merely a system that applies the same tax rate to every taxpayer regardless of their income bracket, and that is exactly what this increase does. This government has chosen to increase the Medicare levy for every wage earner by 0.5 per cent of their income. Under Malcolm Turnbull's plan, someone earning $55,000 pays $275 more tax and someone earning $80,000 pays $400 more tax. In order to not put further pressure on low-income earners, Labor is proposing that this increase be applied only to the top two tax brackets. This is much fairer, and Labor actually understands the meaning of the word 'fair'.

So it is very clear where the Turnbull government stands when it comes to supporting low-income earners. Low-income earners are families, pensioners, teachers, nurses, blue-collar workers—people who keep the cash flowing in our economies. The government's priorities are to give tax cuts to millionaires and multinationals and to increase tax on ordinary low-income workers, once again only further disadvantaging the already disadvantaged and vulnerable. Wage growth is at the lowest it has been since the Great Depression. In my electorate alone, unemployment sits at 11.3 per cent and youth unemployment at 21.7 per cent, yet this government continues to attack the vulnerable. How are these people expected to afford much-needed health care. We need real action by this government, not broken promises and taxes that create further disadvantage.

A Shorten Labor government will reverse Malcolm Turnbull's Medicare freeze immediately, because Labor knows that every day until the freeze ends is another day on which Australians will be paying more for health care or simply not accessing health care, because they cannot afford it. In fact, since the government introduced their Medicare freeze in the 2014 midyear economic forecast, out-of-pocket costs are at an all-time high. Non-referred GP attendances are now $33.45, up 14 per cent under their freeze. Specialist attendances are now $69.75, up 19 per cent under their freeze. Allied health is now $40.45, up 21 per cent under their freeze. Despite this, Australians will be left waiting years and years for relief, impacting on many of Australia's most vulnerable patients, such as those needing critical oncology treatment, obstetric services and paediatric treatment.

Malcolm Turnbull said he had gotten the message on Medicare, but it seems he has missed the mark entirely. Labor is the party that built Medicare and only Labor can be trusted to fight for and protect Medicare. Labor knows that 804,000 Australians delay seeing a GP, due to the out-of-pocket cost. We know that 600,000 Australians who need specialist care delay a visit, due to cost. We know that 300,000 Australians are deciding to forgo vital diagnoses every year, due to costs. Labor understands that every single Australian will continue to pay more for their health care as a result of this budget. Labor believes this is simply not good enough. Labor will support a Medicare levy rise only for people earning more than $87,000 a year.

Under Labor's fairer alternative 80 per cent of Australians are protected from a tax increase and the budget is $4.5 billion better off over the next decade. Labor believes that people who are the lowest income earners in society should not be expected to pay more for proper health care. At the election, Malcolm Turnbull promised the Australian people that no-one would pay more to see a GP, yet we are waiting for this government to drop its cuts and to start acting for the most vulnerable people in our society, because, sadly, they are generally the people who need health care the most.

I have taken action in the Herbert electorate by forming a health reference group, which consists of representatives from a range of local health services and sectors. The group consists of representatives from the general and private hospitals, the mental health sector, Northern Australia Primary Health Limited, allied health services, the Torres Strait Islander health service, home doctor services, dental services, youth services, access to therapy services and many more. The purpose of this reference group is for me to listen to and receive expert advice from the professionals who currently work within the industry. In my opinion, there is no point forming policy if you have not spoken with those who are on the ground and know the issues of concern. The difficulty for our low-income Australians is the reason that Labor is committed to a progressive solution rather than a flat tax on everyone earning over $21,655.

I condemn this government for giving a tax increase to low and middle income families, while giving big business a tax cut. When inequality rises our tax system should be more progressive, not less. There is nothing fair about raising taxes on middle Australia and cutting taxes on multinationals and millionaires. This government needs to acknowledge that raising the Medicare levy is a flat tax change and letting the budget repair levy expire is a regressive tax change. For this government to continually call the levy progressive is simply untrue and provides only false hope to the Australian people. You cannot trust this government on Medicare and I think it is about time they started working for all Australians.

Lisa Chesters (Bendigo, Australian Labor Party) Share this | Link to this | Hansard source

I rise to make a contribution in the debate on the Treasury Laws Amendment (Medicare Levy and Medicare Levy Surcharge) Bill 2017 because it actually speaks to priority. The budget demonstrates once again how this government is prioritising those at the top end of town, those who are in big business and those who are millionaires; meanwhile, they are again whacking people on the smallest of incomes and middle incomes—people who are earning less than $87,000 a year. I support the amendment that has been moved and in my contribution I wish to outline why. On budget night, there was a lot of rhetoric from the government. They said that they were going to protect Medicare. There was a lot of rhetoric about how they were going to make it fair and a lot of rhetoric about how Labor did not fund the NDIS and that is why they need to increase the Medicare levy. That was all rhetoric.

On the weekend, I had the great opportunity to be participate in a panel as part of the Woodend Winter Arts Festival. This topic came up in conversation. One question came from the audience and they said that there is no real difference between the coalition and Labor. The person was quite cynical about where things were at in politics. The truth is that, when we unpacked it, discussed it and debated it, there is a very big difference in terms of policy between the government and the Labor opposition. Unfortunately, however, the government has started to copy of a lot of Labor's rhetoric in the hope that people will not understand the policy differences and the shallowness of the government. As we have shown since budget night and in this debate, as well as in the debate in our communities, when you have the time to explain to people the real policy differences, people soon realise that the government is nothing but rhetoric. They are not saving Medicare, for all of their claims, and they are not supporting the NDIS in the way that they should. When Labor was in government, the NDIS was fully funded. The money was in the budget. What we have seen from this government is their priority to increase taxes for workers earning over $21,000 by increasing the Medicare levy and, at the same time, cutting big company taxes and cutting the tax that millionaires and people in the top tax bracket pay. That is the truth of it. They are taking from one column and putting it into another column. That is their priority.

In regional electorates, above 80 per cent of workers earn less than $87,000 a year. In my electorate of Bendigo, it is 87,000 people. In some other electorates, like the member for Murray's electorate and the member for Mallee's electorate, nine out of 10 workers earn less than $87,000 a year. What Labor is saying to those households and workers is: 'We don't believe that you should have to pay more tax.' What Labor is saying to workers in regional communities is that we believe that we should continue the tax rates for those on the highest incomes. Instead, we are seeing the government giving the high-income earners, the millionaires, a tax cut. We are seeing from the government tax cuts for big business and they are yet again expecting our workers—people earning a wage, like our doctors, nurses, and school cleaners—to pay more. As an example, some millionaires will get a tax cut and they will save about $16,400 a year, whilst someone earning $60,000 will pay an extra $300 a year in tax. Another example: a nurse might be earning $70,000 a year and will pay an extra $350 a year in tax, while someone earning $500,000 a year will receive a tax cut of $6,400. It is in the figures. They say to people, like our teachers and our nurses—people who have chosen to support our community; our hardworking public servants—that they should have to pay more tax while those who earn the bigger salaries, and there are very few of them in regional communities, will get a tax cut. It is just not fair to allow low- and middle-income earners to be asked to pay more tax while millionaires and those in the top tax bracket receive a tax cut.

It is also quite interesting that the government has chosen to again highlight Medicare. I just want to put on the record again how shocking this government has been in supporting Medicare. Just after the federal election, like the member for Herbert, I launched by own inquiry and set up a task force to examine the rising costs of health care in my electorate and what is happening with Medicare. The truth is that people are really scared about what is happening to our once-universal healthcare system. They are really scared about what is happening to Medicare. Yet again, this government has lied to them.

At the round tables we held throughout the electorate, some quite alarming results came out. We talked to people in the postcode 3550, which is the postcode for Bendigo. We surveyed all the medical services in that postcode and found that we are down to one practice that is 100 per cent bulk-billing, and that is the Bendigo Community Health Centre. That is the only 100 per cent bulk-billing practice left in 3550 postcode. We found that throughout the electorate people were paying, on average, $21 out of pocket for each GP visit. We found that the number of clinics that did not bulk-bill concession card holders was on the increase. We found one clinic, on the east side of town, actually charging $50 out of pocket per doctor's visit, and that was also for pensioners and for children. This government will say: 'Well, that's just competition. Go to the next clinic.' The problem is that we are getting to a stage in regional Australia where there is no 'next clinic'; every clinic has an out-of-pocket fee attached. Whilst the government says that they are lifting the freeze, that will not be until next year. And, as we have already heard in this debate, it is by only 12c. These people are paying on average $21 out of pocket per visit; 12c and $21 does not add up.

So, what we have seen from this government is a confirmation that Bendigo residents will continue to pay these high out-of-pocket fees. Here are some of the comments that we heard from people. One Bendigo retiree said: 'I'm so grateful for Medicare. Without Medicare, the last 12 months would have been terrible. When you are going through sickness you do not want to have the extra stress of paying out-of-pocket up-front fees. However, I have noticed that they have started to ask me to pay more and more.'

A former paramedic living in Heathcote said that people are concerned about what is happening, that 'there is a fragmentation of services, particularly in our small towns.' At the same hearing we heard how in the town of Rochester it is $50 out of pocket to see a doctor. So, from your bank account, you have to be able to pay the full fee, and then they reimburse you. But you are still $50 down. For somebody who is on a fixed income, that is a lot to be out of pocket by. We also heard what the freeze of the Medicare rebate means for GPs, how they are charging more for visits. We heard from a doctor in Maldon who is trying to keep their clinic going. They are close to bankruptcy. They know that incomes are low in Maldon, and they know that for every extra dollar they charge they lose more and more patients. Fewer people will actually go to the doctor when they need it. They are prolonging going to seek help. In fact, 40 per cent of the people who participated in our hearings said that they delayed seeing a doctor because of price. These are the out-of-pocket expenses that they are paying this year and that they paid last year. And the 12c that this government is offering them is not going to help those GPs lower the out-of-pocket fees.

One hundred per cent of people said they believed that the government should be doing all it can to protect a universal health system. And right now you cannot say that what is going on in Medicare is universal. If we have entire parts of our community that cannot access a bulk-billing doctor then we can no longer say, hand on heart, that we have a universal healthcare system. People are now paying more for Medicare and more for their GP services than they ever have before. That is what really stinks about what the government is doing. They are saying to the 40 per cent of people in my electorate who are already—

Debate interrupted.