Anne Stanley (Werriwa, Australian Labor Party) Share this | Link to this | Hansard source

A very important milestone was celebrated on 1 February this year. The event that it celebrated occurred 40 years ago and it has shaped modern Australia for the better. Further, it was an event that has placed Australia head and shoulders above almost every other country in the world. I am of course referring to Medicare. To mark the 40th anniversary of Medicare, a special commemorative green card was produced, and, along with the Prime Minister, I was pleased to attend a small morning tea in the building.

Commemorative cards and cakes are wonderful and they certainly have their place, but an even better way to celebrate Medicare is to strengthen it. Let me recount a personal story that could be replicated all over the country by people of my vintage. It highlights why bulk-billing and the 40th anniversary of Medicare are so important. When I was about eight, my sister and I were both unwell. There was no Medicare, no bulk-billing and only enough money in my household for one doctor's visit. Suffice to say, my laryngitis lost out to my sister 's inability to breathe. I recount this story because the choice my parents made all those years ago was a choice that no parent should ever have to make. Thankfully, as members can attest, my voice survived the ordeal, my sister is still well and my family did not have to become bankrupt because of the medical costs.

Labor has always had Medicare's back. We thought of it, built it, added to it and we are always defending it. Few government programs are as widely loved or respected as Medicare. The program makes dilemmas of the type that my parents faced all those years ago a thing of the past. Perhaps it's the universality of Medicare that appeals—that is, regardless of position or status or where one went to school, Medicare applies to all without discrimination. The green card we have in our pocket or wallet is the envy of the rest of the world, and we intend to keep it that way. After years of neglect by the former government, the Albanese government is always looking for opportunities to make Medicare fit for purpose, and our record in just two years is impressive.

On the large scale, we've bolstered the backbone of Medicare: bulk-billing. We did this last year by tripling the bulk-billing incentive. This was one of the signature announcements of last year's budget, and it's worked. Even today we see another increase in the bulk-billing rate across the country. Every state and territory has seen an increase in bulk-billing since last year's budget. But it does not end there, which brings me to the legislation before us today. The previous government neglected Medicare. The heart, ideology and, importantly, budget dollars just weren't there. But all good ideas, even in practice, need to keep going and mature. This bill modernises bulk-billing and makes it easier to be bulk-billed. The bill addresses two things that were not addressed by the previous government: making bulk-billing arrangements easier and safeguarding Medicare from fraud. The result was that, when we came back to office two years ago, Medicare was open to fraud and bulk-billing arrangements were archaic.

The legislation before us will make reforms easier, particularly for patients and their practitioners. Under current arrangements, the Health Insurance Act sets out a complex method by which a patient can assign their Medicare benefit to either their insurer or their practitioner. This involves paper forms requiring two signatures. This bill will bring the assignment of benefit process into the 21st century. The proposed amendments before us will enable electronic and digital solutions to be used when seeking agreements to assign benefits for Medicare services. The end result will be a simpler process for both patients and practitioners and a stronger Medicare. There is still some work to be done regarding the forms and the systems that will be used in the new processes, and I know the appropriate practitioner representative organisations will be consulted in this process. We need to get it right the first time. But the bill is an important step after years of neglect by the previous government.

A stronger and fairer, fit-for-purpose Medicare is the aim of this bill and of this government. It's something that all Australians can agree on and it's something that Labor governments will always strive for. I commend the bill to the House.

James Stevens (Sturt, Liberal Party, Shadow Assistant Minister for Government Waste Reduction) Share this | Link to this | Hansard source

I rise to speak in favour of the second reading on this bill, the Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Bill 2024. As the lead speaker for the opposition has indicated, we support the passage of the bill. Clearly, any opportunity to improve the way in which the private health insurers, the private hospitals et cetera and, most importantly, the consumers are interacting with the Medicare system is a very good thing. But it is also an opportunity to speak about some broader issues around Medicare and private health. Obviously, we in the opposition, like any Australian in the community, are quite concerned about elements of the Medicare system at the moment, particularly the reduction in bulk-billing rates. When we left office, it was over 88 per cent, and now it's down to 77 per cent under Labor. That is in the middle of a cost-of-living crisis, meaning that more people are paying more out of their pocket for their health services and that, quite concerningly, a lot of people aren't accessing the health system when they should be, because of the cost to them and their inability to meet those costs.

In my home state of South Australia, things are very grim within our health system. There are problems everywhere we look. We've endured days of elective surgery cancellations across the major metropolitan hospitals in Adelaide and ambulance ramping is worse than it has ever been—the data released for the month of May had it at the highest on record. This is reverberating throughout the health system. Obviously, if people are waiting in the back of an ambulance because they can't get admitted to a hospital, then that's not only a problem for the person that deserves and needs immediate care; it's not only a problem for the efficient running of our hospital system; and it's not only a problem for people who are therefore waiting longer for ambulances that can't respond to the call because of course they've got a patient in the back of their ambulance, which is ramped outside of the emergency room because they can't unload them, but it also means that there are enormous pressures through the broader system.

I also want to take this opportunity to put on the record my strong support for the private health insurance system and the private hospital system. I have a number of private hospitals in my electorate, and I know that the peak body for private hospitals in Australia is very concerned about the sustainability of private hospitals in this country at the moment. It's something that I hope the minister is looking at very closely and considering, because part of this bill talks about more efficiencies for Medicare benefits being processed through the private system. What I'm very concerned about is the overall sustainability of the system and whether or not the payments to private hospitals are rising appropriately. Given that private health insurance, certainly, is increasing fairly significantly, are those increases to private insurance premiums flowing to increases from the insurers to the people providing the service? We'll be in big trouble in this country if we see the private hospital system continue to deteriorate. In South Australia, a number of private hospitals are hitting viability brick walls and that's taking capacity out of the overall health system.

For people who demonise the private health system, particularly those in the Greens party, I'll just point out that every procedure done in the private system is one taking pressure out of the public system. It's just like private schools. The Greens always had the position that they don't want a private system at all; they've always had positions like scrapping the private health insurance rebate. Ideologically, the Greens don't want a private system—much like they don't want a private system in education, I might add. But they don't want private hospitals to exist. It will impact on my constituents very substantially if the Greens ever get their way and see the destruction of the private health system—particularly the private hospital system in this country. I've got hospitals like the Burnside Hospital, an endowment from Mr Otto bon Rieben, who passed away in the 1940s and left his home to the Burnside council. It operates as a private hospital now, and provides an enormously important service. In fact, my father—who might not have given me consent to reveal this to the House!—had a procedure there recently. I won't give further detail about what it was, to protect his private medical records! But he had a procedure there, and we very much appreciate the services that private hospitals like the Burnside Hospital, North Eastern Community Hospital and Sportsmed—and the list goes on—provide. They take enormous pressure off the public system, and the public system in South Australia, like across the country, is already bursting at the seams, so undermining the private hospital system is the last thing that we need right now.

In commending this bill to the House, and given that this is a bill about the way in which we support private providers and private hospitals through the health insurance system, I urge the health minister to please listen to the concerns they're raising. This concerns me greatly: whilst private health insurance premiums are increasing significantly for consumers, are the payments from private insurance companies increasing at the same rate to the people who are actually providing the services? If they're not then there's a serious viability issue imminent. I know that some of the smaller hospitals are already struggling to keep their doors open, and we don't want the situation where that capacity in our health system goes.

I also urge the Greens to reflect, when we're debating this legislation, on their dangerous position to get rid of the private health insurance rebate, to undermine the private health system in this country and to effectively remove an enormous capacity for treatment of Australians who need it more than ever. If we saw the collapse of the private health insurance system and the private hospital system because the Greens don't support it ideologically, then all Australians will be the worse for that. I just warn the Greens that their dangerous position in this area is not good for any Australian and is something they should strongly consider changing.

With those comments, I commend this bill to the House.

Mike Freelander (Macarthur, Australian Labor Party) Share this | Link to 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.

Michael McCormack (Riverina, National Party, Shadow Minister for International Development and the Pacific) Share this | Link to this | Hansard source

When you sit in the chamber of the House of Representatives in the federal parliament and listen to Dr Mike Freelander, the member for Macarthur, you learn things. I have the utmost respect for the member for Macarthur and certainly thank him for what he has done in his local community as far as health outcomes are concerned. I went on a trip with the good doctor to Papua New Guinea, where we looked at Pacific global health initiatives, and I know that the follow-up we did after that trip was beneficial to one of our closest friends and allies. In fact, Dr Mike is so good he should be the health minister. If he were, I would probably get more signed correspondence from him than I do from the current health minister, the member for Hindmarsh. Of the 29 reps that I've made to the Minister for Health and Aged Care, 28 have been signed by his chief of staff and one by his acting chief of staff. I know that, when I was a minister, when I got a rep from a colleague, from either side of the aisle, I followed it up in person or personally signed the correspondence back to them in most, if not all, cases.

But I appreciate this is a debate on the Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Bill 2024, and I want to take the member for Macarthur up on some of the points that he made. Whilst I agree with him on some of the points that he raised, whilst I respect him always, whilst I appreciate he has probably forgotten more about health than most of us may ever know, I want to take him up on some of the points he made about the years that we were in government. I will start with bulk-billing, which, in Minister Butler's own words, is the 'beating heart of Medicare'. But it has plummeted by 11 per cent since the last election. That is a fact. That is a truism. It has fallen from 88.5 per cent when the coalition left office in May 2022 to 77 per cent under the current health minister. That is such a shame.

Whilst in government, the coalition did the following. I know the member for McArthur said that they were years of dysfunction and neglect. Well, that is not true, because we provided $99.3 million for 80 additional Commonwealth supported places so more students could study medicine at rural campuses. He mentioned National Party seats. Many of those rural campuses are in National Party seats. Sixty-six million dollars was invested to make it easier and more affordable to access Medicare-funded MRI scans in regional, rural and remote Australia from 1 November 2022. That was a big step forward.

There was $36.2 million to establish two university departments of rural health in the South West and Goldfields regions of Western Australia, in Edith Cowan University and Curtin University. I appreciate this is a long way from my electorate of Riverina and a long way from the electorate of Parkes, the seat of my good learned friend who sits supporting me. But I've been to WA many, many times as a member of this place, and, let me tell you, remote health services and outcomes are so important. There was $14.8 million to support Charles Sturt University to deliver a rural clinical school. We were also supporting, when we lost government, the National Rural Health Student Network of rural health clubs with $2.1 million over four years.

This will be interest of the member for Parkes, and I know he knows this very well. An additional $33.3 million—

Graham Perrett (Moreton, Australian Labor Party) Share this | Link to this | Hansard source

He's fast asleep! What are you talking about?

Michael McCormack (Riverina, National Party, Shadow Minister for International Development and the Pacific) Share this | Link to this | Hansard source

The member for Moreton comes in and starts yelling already. He'll get his turn. There was an additional $33.3 million over four years towards a 10-year strategic agreement with the Royal Flying Doctor Service worth almost $1 billion. If there has been a champion of the Royal Flying Doctor Service, it is the member for Parkes. So many of those people who have fallen foul of accidents and farm incidents and needed the Royal Flying Doctor Service have been championing those services, that investment, via the member for Parkes. Certainly his efforts in western New South Wales have been second to none in making sure the right investment is in the right place. And the right investment in the right place has often been with those wonderful people from the RFDS.

In addition, we put $14.3 million towards: expand nursing and allied-health student training in aged care to another five locations in the Northern Territory, Victoria, New South Wales and remote Queensland; incentivise more doctors and nurses to work rurally by eliminating their HELP debts if they worked in rural towns and remote communities; and made telehealth permanent and universal, allowing timely access to health professionals no matter where they lived. That was so important in those worst years of COVID, and telehealth will never, ever—I hope—replace that personal, face-to-face consultations but, let me tell you, it was vital in those years where there wasn't face-to-face contact possible. Getting rural professionals is so difficult, and I appreciate the job that the government has to do. We need to do better and we need to do more, and I implore those regional members of government, particularly if they sit in cabinet, to do more and to be very vocal to make sure that their city friends address these rural health issues.

Upon my appointment as deputy prime minister in February 2018, I secured $95 million for the Murray-Darling Medical Schools Network. That is making such a difference in Wagga Wagga, in Orange, in Dubbo, in Bendigo and in Mildura, because it's making sure the training is done and stays in its regional setting from start to finish. The chances are, if you have a person doing a course in a rural university, particularly medicine, if they start and finish the course in that rural setting, they are 75 per cent more likely to stay in that rural setting because they fall in love with the local community—they might fall in love with somebody in the local community, because they're at that age where they're partnering up. It makes such a difference. To go to the Wagga Wagga Biomedical Sciences Centre recently, where they did the topping-out ceremony, to see the progress made was one of my proudest moments since being elected to this place in 2010. I look forward to the opening later this year.

That's some of what we did in office. Although the coalition support this bill, we are very concerned—as we should be—that the government has stated the bill 'represents more progress on the government's commitment to strengthen Medicare'. It has become clear, all too sadly, that under this Albanese government Medicare has only been weakened. Labor is overseeing a primary healthcare crisis that means it has never been harder or more expensive to see a doctor, and that's simply not good enough. One of the main problems with being able to see a doctor was the fact that the priority areas of distribution of GPs were changed when Labor came to power. Once upon a time, and certainly under the coalition government, those priority areas were considered regional, and in remote areas. Nowadays, Labor have changed it so that a doctor could put his or her shingle up in Newcastle, in Wollongong or in the Gold Coast and claim that priority-area accessibility to get the various incentives that government provides. What that means now is that doctors are less inclined and less likely to want to go and put their shingle up in a remote area where doctors are in short supply. And then we get that insulting comment by our Adelaide minister for health, who says that in a regional centre—or anywhere, for that matter—if you can't get a doctor who is happy to bulk-bill, put the phone down, ring the next doctor and see if they will. That might be all well and good in the leafy suburbs of Adelaide, but I'll tell you what: when you're out in regional Australia, it's not that easy to get a doctor first up, let alone one who will bulk-bill. Certainly, if you get a doctor and get an appointment, you're not going to then quibble about being bulk-billed—you're happy to get that appointment. You can have choice, and you can be fussy if you want, in a metropolitan setting, but you don't have that choice and you can't be that fussy in a regional area where you're lucky to actually have a doctor.

We know how much pharmacists—certainly regional pharmacists—were demonised by this Labor government, by this Labor health minister, who refused to listen to their complaints about 60-day dispensing until they came and sat in the gallery in their white coats and complained bitterly about the lack of funding they were going to receive from this federal government. Yes, of course patients always come first, are always the most important, and chemists realise that and acknowledge it. But when we have 324 country towns in Australia where the only health professional in the vicinity is the pharmacist—they don't have a doctor to speak of—then those pharmacists should be listened to. Thankfully, the minister was dragged kicking and screaming to the Expenditure Review Committee table and finally did something, when he signed the latest pharmacists accord, to make sure that pharmacists were looked after. But it took the Nationals to bring that home. It took the Nationals to make sure that was even considered by this city-centric government.

As I've said, the bulk-billing rates are nothing short of disgraceful. There is a healthcare organisation called Cleanbill. Alarmingly, Cleanbill did what was called their Blue report, an electorate breakdown, which showed that the statistics are completely at odds with what health minister Butler and the Labor government have been trying to peddle—the nonsense that they've been putting out there. Cleanbill's report found that nearly 87 per cent of electorates saw a decline in bulk-billing at general practitioner clinics over the course of 2023. I'm sure the figures aren't any better this year, and we're already into June. All the while, Labor has been pretending that nothing is wrong. We know it is. Those Labor members who are in regional electorates, whilst often they come in here and just read the talking points that have been given to them, know that in their communities there are real issues about accessing a doctor. Whilst this amendment bill is supported, there are real and widening cracks in the health system that are not being addressed by this Labor government.

As I say, bulk-billing has been collapsing since Labor came to office. I appreciate that the bill's amendments will remove some of the current rigid paperwork requirements, to allow for more streamlined processing of MBS bulk-billing claims, particularly for telehealth consults. That's good. Well done! We support those sorts of things. Anything that can cut through bureaucracy and paperwork is to be commended. It will reduce the regulatory and administrative burden for healthcare providers who provide bulk-billed services, for private health insurers and for approved billing agents. Great! But when there are fewer and fewer bulk-billing providers then that is an issue, a major issue. This will ensure that the payment of Medicare benefits is aligned with modern practice, reducing the burden for health professionals. If that goes some way to encouraging people to put their shingle up in regional or remote Australia, that's great. But I doubt it will, because of all the issues that I addressed earlier.

We support these sensible amendments; they'll streamline processes for healthcare providers and private health insurers. But it is so hard. I have a situation in the north of my electorate, at Parkes, where the mayor, Neil Westcott, tells me they haven't had a birth in the town in five years. I appreciate that this isn't just a federal responsibility and that state public hospital issues come into play. But Parkes is a town of 12,000 people, and Parkes deserves better. I've certainly written to the health minister. I've written to the Assistant Minister for Rural and Regional Health, Emma McBride, whom I also have a great amount of respect for. She comes to this place as a pharmacist. What we want to see is better and more health services for our regional communities, certainly in a town the size of Parkes. When a town the size of Parkes, which has 12,000 people, doesn't have obstetrics and maternity services, there's something really wrong. I commend the bill to the House.

Graham Perrett (Moreton, Australian Labor Party) Share this | Link to this | Hansard source

I rise in support of the Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Bill 2024. I say the name of the bill for those who were listening to the member for Riverina. They might not have actually realised what the legislation was about. It was a lovely presentation of material by the member for Riverina. He's got a fine turn of phrase. He did occasionally drift into the legislation, but he then saved himself and moved away from it.

Medicare is a proud Australian institution. Indeed, it is a proud Labor innovation. Medicare is one of the legacies of Gough Whitlam, although back then it was originally called Medibank. It was introduced by the Whitlam Labor government in 1975. It was a big year, and I seem to recall something bad for democracy happened around 11 November that year. Sadly, Medibank was short lived. The Fraser government, after taking office in November 1975 and under the guidance of Treasurer John Howard, introduced a series of modifications, which resulted in Medibank being dismantled by 1981. Then, in 1984, Medicare was reintroduced by Bob Hawkes's magnificent reforming government. We're now 40 years on, and this nation's universal public health scheme is going strong. Whether you're young or old, from the bush or from the city, Medicare works for you. In fact, that one Labor policy has done more for people in the bush than every single National Party MP and senator ever elected combined. I'm sure the member for Riverina would agree with that!

Medicare guarantees all Australians access to a wide range of health and hospital services at low or no cost. For the past 40 years, Medicare has ensured that the quality of health care Australians receive has nothing to do with where they live or how much they earn. Medicare allows all Australians to get the medical treatment they need, regardless of their circumstances in life. It is their Medicare card that counts, not their credit card. Labor has always defended and strengthened Medicare when we're in office. We do that despite the long history of coalition governments trying to run it down. I'm sure, if you're of a certain age, you will remember John Howard's promise to Australians that he would not touch Medicare. Then, when elected in 1996, he cut funding to Medicare, raised the safety net threshold and scared Australians into taking up private health insurance.

I remember opposition leader Tony Abbott campaigning when he promised no cuts to Medicare. Remember that campaign in 2013? That 2013 election is quite a difficult memory for me. He also promised me a $500 cut to my power bill. When is that coming? But I digress. During the Abbott-Turnbull-Morrison shemozzle, the coalition froze the Medicare rebate, tried to introduce a GP tax three times and planned to privatise the Medicare payment system. That was under the nation's worst-ever health minister, who now leads the opposition. The Labor Party's fundamental belief is that every Australian deserves access to universal, prompt and world-class health care. This is an enduring value and one that all party members hold dear.

Since coming to government, Prime Minister Albanese and Minster Butler have prioritised measures to help GPs and health professionals provide the medical care needed by Australians. We're committed to strengthening Medicare and making it fit for purpose. That's what I'm here to talk about today. This bill amends the Health Insurance Act 1973 to modernise the assignment of the Medicare benefits for bulk-billed and simplified billing services. Labor wants to take all possible measures to make it easier for Australians to be bulk-billed and easier for Australians to access the health services they need. We've worked hard to stop the slide of bulk-billing. I know how crucial bulk-billing is for those doing it tough at the moment and for those with health concerns. Last year, Labor's record $3.5 billion investment in bulk-billing led to an increase in the practice in every state and every territory. I'm sure the member for Riverina can take comfort from that. Now we want to make it easier for patients to be bulk-billed.

In 2023, we tripled the bulk-billing incentive, and now, in 2024, we're making it easier for medical professionals to bulk-bill their patients. The reforms concern the process of assignment of benefits. In this process, a patient assigns their Medicare benefit to a healthcare provider or to their health insurer when they have a no-gap arrangement. The Medicare benefit is then paid directly to the provider or insurer. The patient does not need to pay for the service and then be reimbursed, which we would all agree is more simple and more efficient. However, getting to this point is not. The act currently specifies that the provider or insurer and the patient sign an agreement to assign the benefit. The provider must keep a record of the documentation. As the Assistant Minister for Health and Aged Care said:

GPs have long complained of an overly complex and onerous paperwork process that is inefficient and holds back productivity.

To be continued.

Steve Georganas (Adelaide, Australian Labor Party) Share this | Link to this | Hansard source

The debate is interrupted in accordance with standing order 43. The debate may be resumed at a later hour and the member for Moreton will be able to speak in continuation.