Stephen Bates (Brisbane, Australian Greens) Share this | Link to this | Hansard source

I move:

That this House:

(1) notes that:

(a) bulk-billing options are plummeting across the country and millions of people are delaying health care due to cost concerns;

(b) the cost of living crisis is both making mental health worse and causing an increasing number of people across Australia to delay or miss out on essential mental health care;

(c) over 60 per cent of Australians have delayed dental care in the last year, and the most common reason for doing so was cost; and

(d) everyone deserves to have access to good quality health care, including dental and mental health care, regardless of where you live, how old you are, or your bank balance; and

(2) calls on the Government to commit to universal health care and make the big corporations pay their fair share of tax so as to fund:

(a) bringing dental health into Medicare and expanding access to dental care to all;

(b) unlimited mental health care under Medicare; and

(c) a tripling of the bulk-billing incentive and the establishment of at least six free local health care clinics in each electorate to enable all Australians to go to the GP for free.

Back in 2013, I was living in the United States in Florida, working for a little company called Disney. I had an experience there that really set me up for getting into politics for the rest of my life. I'd never really been that interested in politics growing up. I'm not from a political family per se. But one day I walked into the stockroom at where I was working and one of my co-workers was on the floor in literal tears. Obviously, as any normal person would do, I went up to her and asked: 'What's wrong? What's happened?' She was having to make the decision about whether she paid her rent or paid for her insulin. I remember in that moment thinking: 'I don't understand how this has happened. I don't understand how we can be working for this giant billion- or trillion-dollar company, getting paid $7 an hour, and you've been put in this position where you have to decide between fundamental health care or fundamental housing.' It's an impossible decision. We were able to rally around and raise some money for her, but I kept thinking that that was only going to help her for one month. It wasn't actually going to change the system that we were living in, where she had been put into that position.

We hear all these horror stories that come out of the United States about their healthcare system, and we just cannot go down that same path. Having lived it and having seen people that have lived it and been at the brutal end of that system—we cannot do that. We have to turn the ship around now before we head down that path, because universal health care is vital to Australia. Everyone deserves to have access to quality health care, including dental care and mental health care, regardless of where you live, how old you are or whatever your bank balance may be.

A properly funded universal healthcare system actually saves us money in the long run. It reduces poverty, creates jobs, drives economic growth and helps to alleviate inequality. But our healthcare system, as it stands, is starting to falter. At the same time, nearly one in three large corporations operating in Australia pay no income tax. Large corporations are able to use various offsets to be able to pay no tax while everyday Australians can't afford to go to the doctor. The system is fundamentally broken, and we are all living it.

Bulk-billing options are plummeting around the country. Most people with a Medicare card are unable to find a bulk-billing appointment like they used to. In my electorate of Brisbane, only a few per cent of clinics still offer bulk-billing at all, and, what's more is that finding bulk-billing appointments outside of general working hours has become almost impossible. What this means is people skipping regular health appointments, prioritising their kids' health over their own, not following up on test results or avoiding care altogether because going to the doctor has become too expensive. People are waiting until issues become critical and then presenting to emergency rooms. Those healthcare horror stories that we all judge the United States for are well on their way to becoming a reality here, so what we need to do is triple the bulk-billing incentive for everyone with a Medicare card and establish at least six free local healthcare clinics in each electorate to enable all Australians to go to the GP for free.

According to a recent Black Dog Institute poll, the leading reason for Australians delaying or not seeking mental health care is the cost. Sadly, but unsurprisingly, young adults are being impacted the most. Sixty 60 per cent of those aged 18 to 24 reported that they couldn't afford to get the help they needed—more than across any other age group. In order to access mental healthcare sessions through Medicare, you need a mental healthcare plan through a GP. After the pandemic, these subsidised sessions were cut from 20 to 10 per year. That's just the subsidy; it rarely covers the full cost. Like GP visits, it has become incredibly difficult to access sessions without a gap payment. There are also extra hoops to jump through to access the final four sessions. For example, you need another GP referral, which is going to cost you more and more money. When it comes to mental health care in this country, for every person receiving treatment, at least one person is going without. We have to bring mental health care fully under Medicare.

Finally, everyone should be able to go to the dentist when they need help. Millions of Austrians are putting off going to the dentist because they can't afford it. This doesn't just lead to worse teeth; a range of other health concerns also come from that. The first thing I did after being elected to this place was go back to the dentist to get some fillings done, because I couldn't afford them while I was working in my retail job. Because I had left it so long, fillings became root canals and became exponentially more expensive. You shouldn't have to become a politician just to be able to afford to get your teeth fixed. Having healthy teeth should not be a luxury. Everyone should be able to use their Medicare card to go to the dentist. We have to bring mental health care and dental care fully into Medicare.

Marion Scrymgour (Lingiari, Australian Labor Party) Share this | Link to this | Hansard source

Is there a seconder for the motion?

Max Chandler-Mather (Griffith, Australian Greens) Share this | Link to this | Hansard source

I second the motion and reserve my right to speak.

Daniel Mulino (Fraser, Australian Labor Party) Share this | Link to this | Hansard source

There are parts to this motion on health care that I don't disagree with. I do agree with the underlying sentiment of the motion, which is to broaden access to core medical services. The fact that Labor introduced Medicare in the 1980s and has supported it significantly since then is the aspect of the Labor Party's legacy which I'm most proud of. I've thought about this a lot, I've written about it and I've undertaken research in relation to it. For me, it is one of the most important functions of government.

Where I don't agree with this motion is the extent to which it doesn't acknowledged the constraints. What it basically puts forward is an unrealistic wish list of things the mover of the motion would like to see achieved immediately. What I'm going to point out is that, in the context of what we inherited when we came to government, there has been a very significant turnaround in the underlying stability of the Medicare system, and it is one that is all the more significant given the constraints that this government has been operating under. When we came to government, we inherited from the previous government 10 years of neglect of Medicare, among other policy issues. There had been a freeze on Medicare rebates for six years. The previous government, of course, in their first horror budget, tried to introduce a co-payment. So the previous government, both through financial neglect and at times through ideological misadventure, had tried to undermine Medicare.

What we saw were a whole range of pressures building up. We saw pressures building such that GPs and others in the healthcare system were increasingly unable to offer bulk-billing. It is important to look at the particular timeline of bulk-billing, but what's really important, rather than looking at a year-to-year change alone, is to look at the underlying pressures that had been building up. What is clear is that, by the time we got to the 2022 election, all too many doctors were facing a situation where they were just not able to offer bulk-billing at the rates they would have liked to or, indeed, at all.

Indeed, the Royal Australian College of General Practitioners took the extraordinary step around this time of calling on every GP in the country to stop bulk-billing to maintain the viability of general practice. Dr Karen Price said that: 'This is why, as a college, I am exhorting everybody, including my own practice, to move as many people as you can onto private billing.' There was a huge pressure building in the system, and that was something that was going to play out in a very dramatic and adverse fashion, particularly for the most vulnerable. What happened when we took over is that we dramatically increased funding to strengthen Medicare. We increased funding by $6.1 billion dollars in the 2023-24 budget—a historic investment, particularly given the state of the overall economy, and that was backed up by an additional $2.8 billion in the 2024-25 budget. To put it in context, this government has delivered more than double the amount of indexation in relation to Medicare than the previous government did in a decade, and it did all of that at a time when the government's fiscal position has been under strain.

At the same time, we've put into place very significant measures in relation to cheaper medicines: a 60-day prescription and a cap of $31.60 for medicines on the PBS. All of these measures have saved billions across the community, but significantly—for those most vulnerable—they have been particularly beneficial. I can speak for people in my electorate of Fraser that the cheaper medicines initiatives that this government have brought in have been particularly welcome. We have opened 77 Medicare urgent care clinics across Australia, including 19, already, of the 29 Medicare urgent care clinics announced in this year's budget. There have been almost 860,000 visits to Medicare urgent care clinics across Australia, and all of these have been completely bulk-billed. This is a significant measure, and given where these are located—including one in my own electorate, and again, I've talked to people that have used that and seen the benefits that it has produced. This government has turned around this system. It has responded to the under-investment, neglect and ideological poor positioning from the previous government, and the Medicare system is, thankfully, much stronger than it was when we came to power.

Max Chandler-Mather (Griffith, Australian Greens) Share this | Link to this | Hansard source

I have spoken many times in parliament about bringing dental into Medicare, and, in response, we have received literally thousands of comments on social media from people across Australia describing their own shocking experiences. Rather than give another long speech, I'm going to let the comments of everyday Australians on Instagram and TikTok make a stronger argument for dental into Medicare than I ever could:

1. "Never even needed a filling in my life, but 7 yrs living with a single tooth infection …need it taken out by a highly trained surgeon bcos of where roots are positioned . Unless I hit the jackpot I've no idea how I'll afford surgery. I laugh when people say we r the lucky country with the best medical system . I'd have to sell my car to see a surgeon. The cruelest thing humanity has normalised is only the wealthy having access to proper health care "

2. "I legitimately nearly died because of a tooth infection because they told me it would cost me $6000 I don't even have that in my savings"

3. "6 times this year we have put off our dental appointments!!"

4. "I have a huge broken molar, been there for a year because living week to week doesn't enable one to get dental care"

5. "I just started having tooth sensitivity yesterday on a root canal tooth and now I'm stressing. It's going to cost so much. I'm freaking out"

6. "As a paramedic I've seen patients with severe toothaches and infections because they couldn't afford the dentist. This is a false economy and it is a flawed system which is causing the problem."

7. "Just lost a filling yesterday and the anxiety and the stress I am feeling is unbearable"

8. "Teeth literally falling out of my face but i don't have the thousands of dollars for the work needed"

9. "I was told after getting my two bottom teeth removed that I was not allowed further treatment because I was on a carers pension !!!"

10. "I can't afford for our family of five to go to the dentist for a check up and clean we are 18months over the time since we should have gone last. I'm ruining my kids teeth because I can only pay the mortgage and bills and that's it. I don't have $1500 for the five of us to go"

11. "I sat here watching this with a WILD toothache that I can't afford to get seen. makes me so angry."

12. "my mortgage is half my paycheque. just told I need 2 crowns and a root canal which is 6k. otherwise I lose my teeth. I can't afford it I have no savings I don't know what to do. I can't take out a loan"

13. "I have a huge hole in my tooth I can't afford a dentist it's now to the stage I've shred the nerves in that tooth"

14. "I'll have to take out my super to fix my teeth. […] Shouldn't have to but it's my only option."

15. "Im in so much pain from my teeth my dr thought I was having arthritis in near my eye and sent me for a CT scan but my rent is half my pay and food is the other half"

Finally, here are the last two:

16. "why are my mouth bones different to the rest of the bones in my body?"—

That's a good question—

17. "But who needs teeth when we can buy SUBMARINES??!!!"

Let's be clear about this: the total cost of bringing dental comprehensively into Medicare over the next four years would be $46 billion, as costed by the independent Parliamentary Budget Office. In context, one-third of Australia's largest corporations pay no tax on hundreds and hundreds of billions of dollars in revenue. There are large multinational gas corporations that pay less tax than a nurse, despite earning tens of billions of dollars in income.

Let's not kid ourselves: the country is wealthy enough to bring dental into Medicare, and yet we hear these stories from people across Australia who are suffering as a result of a political and economic system that always puts everyday Australians last when the financial interests of large multinational corporations are threatened. We have a plan to, for instance, raise taxes on the super profits of large multinational corporations. Over 10 years, it would raise half a trillion dollars—$500 billion. It could cover bringing dental and mental health into Medicare. It could cover making sure everyone could see a GP for free. Instead, right now that money is going into the profit margins of large multinational corporations.

The stories I just read out should not happen in a wealthy country like Australia. The stories that I read just out are preventable, if only we had a political class with the guts to stand up to multinational corporations, who right now get away with often paying zero dollars in tax. We can bring dental and mental health into Medicare. We can ensure everyone can see a GP for free. We can ensure that the millions of Australians right now who skip seeing the dentist because they can't afford to pay have some light at the end of the tunnel.

Dan Repacholi (Hunter, Australian Labor Party) Share this | Link to this | Hansard source

Labor is the party of Medicare. We will always protect Medicare, and we will always do what we can to strengthen it. As an Australian, one of the things that I am most proud of is that, no matter how much money you make, you can have access to world-class health care. This is because Medicare is fundamentally about universal health care. It means that anyone and everyone can get access to the care they need when they need it—using their Medicare card, not their credit card. This is something that should always be protected, and that's why we have made historic investments in Medicare throughout our first term of government.

Medicare went through some tough and scary times under the former coalition government, especially under the reign of the current Leader of the Opposition, who was at the time labelled as the worst health minister in living memory. What a reference to have on your CV when applying for the job of Prime Minister! The Leader of the Opposition will say he cares about everyday hard-working Australians, but he will make it harder for you to see a doctor when you're sick, just like he did when he was the king of cuts to Medicare. He doesn't care about how hard you work; he cares about how much money you make—if you don't make enough money, you don't get to see a doctor.

This is why strengthening Medicare has been one of our top priorities. In 2023 we delivered the biggest indexation boost for Medicare in 30 years. This year we delivered the second largest increase, with almost $900 million in additional funding for Medicare. This is where the difference between our approach to Medicare and that of the coalition sticks out like a sore thumb. This government has delivered more than double the amount of indexation to Medicare, compared to what the previous government did in almost a decade.

We are also focused on making it easier to see a doctor. Peter Dutton, doing Peter Dutton things, froze Medicare rebates when he was health minister. This is a trend that lasted for six years under the coalition government. As a consequence, it left the financial viability of general practice in serious trouble. That's why we have tripled the bulk-billing incentive, from 1 November last year, in the largest investment to bulk-billing in history. This has been a national increase of 1.7 percentage points in the first year and 5.4 million additional visits. We have opened 77 Medicare urgent care clinics across Australia. I know for a fact that the people of Cessnock and surrounds are forever grateful for the urgent care clinic in my electorate, which has helped thousands of people who need access to health care. Unfortunately, the opposition wants to cut these two.

We have also committed to reforming the mental health and suicide prevention systems, ensuring that Australians receive equitable access to the care they need, providing free mental health services through a network of 61 walk-in Medicare mental health centres. Two of these are in my electorate, in Muswellbrook and Cessnock, and the impacts they are having are clear to see.

There are always improvements that can be made to Medicare, and perhaps including dental is one of those improvements. I know that the Greens as a party has never and will never come close to forming government. They think you can sprinkle some fairy dust and click your fingers, but, unfortunately, that's not how this world works, and that's not how governments work, and including dental in Medicare isn't something that can be done overnight. However, we are committed to the long-term goal of expanding Medicare to dental health services, and that work is currently ongoing.

Labor will always be the party that prioritises issues that have real impact on people's lives. The Albanese Labor government are party who made the largest ever investment to Medicare, and the coalition are the party who made the largest ever cuts to Medicare. They just don't care about Aussies being able to afford to go and see a doctor. So, when you cast your vote, look at our track record and the things that matter, like Medicare, and then look at the track record of the Leader of the Opposition and the coalition team. This will make clear who really looks after you and who really stands up for the things that matter in your life. An Albanese Labor government cares about Medicare and cares about you, so please make sure you cast your vote wisely when it comes to having that choice.

Marion Scrymgour (Lingiari, Australian Labor Party) Share this | Link to this | Hansard source

The time allotted for this debate has expired. The debate is adjourned and the resumption of the debate will be made an order of the day for the next sitting.