Richard Di Natale (Victoria, Australian Greens) Share this | Hansard source

It is health and education. Thank you, Senator Bilyk. People say it time and time again. The whole point of economic progress is to be able to provide people with the means to spend money on the things they value, and that is health and education.

There is a notion that people visit the GP too frequently. Again, this is not borne out by any evidence. It is true that some people visit the doctor unnecessarily—that is, that if they do not visit a doctor their symptoms would resolve and they would not be any worse off because of it. But the whole point of having a trained health workforce is so that people who do not have the means to be able to distinguish between what is a serious symptom and one that is benign can get that advice and reassurance from a trained health professional.

As a former GP, I can tell you that a lot of what we did involved assessing and diagnosing, and providing people with reassurance. That is what the job involves. That is not a wasted visit. That is actually quite important, because the person sitting at home with a pain in their chest and who does not know if it is indigestion or the early signs of a heart attack, needs to have a professional assessment of those symptoms. That is what visiting a GP does. If you put a price barrier in front of a patient, you can be absolutely guaranteed that we will deter some of those necessary visits. The person sitting at home with chest pain and who is worrying, 'Could this be heart attack? No, it is probably indigestion', will be influenced by the fact that they will have to face a charge to see the GP potentially to have a blood test or an X-ray and have their script filled by a doctor—all of which will absolutely deter some of those necessary visits. As a consequence, it will cost our health system more. People will end up in emergency departments and in intensive-care units, because simple, treatable and preventable problems were missed in the first instance. That is why this is such a short-sighted policy.

There are so many things that we can do to improve the efficiency of our health system. We can invest much more in health promotion and illness prevention. We should be doing that. For example, we know from a study by Deakin and Queensland universities that the 20 best prevention strategies, based on good evidence, would cost us about $4 billion and return $11 billion in savings. We know that. Yet, at the same time that we introduce this co-payment, we are dismantling the Preventative Health Agency. It is short-sighted not just in terms of the impact it has on the lives of ordinary people, but because it will cost us money. Also, in medicine we do too many things that are not based on good evidence. We should be funding what works. A lot of what we do adds very little value. There is a big opportunity to start looking at the current Medicare list and reviewing how we fund a number of procedures that add very little value—the number of arthroscopies we do in this country, for example, many of which are unnecessary. We should also look at Vitamin D testing, and the new and complex forms of prostatic surgery. They add very little value but a lot of cost. Of course, this would mean taking on some big interests, but we need to do that if we are going to make our already effective and efficient system more efficient.

We need to make sure that we resist the temptation—the great folly—of assuming that moving towards a user-pays system, introducing a price signal, is going to make the system any more efficient. It will not. You only need to look at the international evidence—to look at those countries that base their health system on fair taxation and universal access versus those that adopt the notion of user-pays in health—to be able to see a recipe not just for a less fair system, which is obviously something I am concerned about, but also a much more expensive system. That is why the US spends double what we do on health care and gets much worse health care as a result.

This is bad policy. It is unfair, inefficient and it must be stopped.