Nick McKim (Tasmania, Australian Greens) Share this | Hansard source

From a political party that quite rightly celebrates the creation of Medicare as one of its most consequential actions in government for many decades, this bill and other reforms in the health sector are something that Australians would be well entitled to view as fiddling at the margins. If we really wanted to value Medicare in this country, we would be ensuring that visits to the dentist were covered by Medicare. If we really wanted to value Medicare in this country, we would be ensuring that mental health supports were covered by Medicare. The last time I looked, our brains, our nervous systems, our teeth and the inside of our mouths were actually part of our bodies. It's ridiculous that an allegedly universal healthcare system like Medicare, which is quite rightly seen as a significant achievement by Labor and well worth celebrating, doesn't cover dental and mental health.

The other great challenge facing Australians today is visits to GPs. We have a GP workforce crisis. I know in my home state of Tasmania there are some incredibly worrying projections about the number of GPs that we will have in Tasmania in the not-too-distant future, with a significant decline. There are regional communities in Tasmania now that are losing their only GP. That means that local health services are in decline, meaning people have to drive further, and where there is urgency in a situation it takes them longer to get to a GP. Often, when you want to make a booking with your GP, you're faced with a significant delay—many days or, in some cases, many weeks—because the demand for GPs is so high. There are simply not enough GPs to meet that demand and enable people to see a doctor that is close to them within a reasonable timeframe.

Then, when you get to see a GP, there's the gap payment. Some GPs bulk-bill at high rates; others bulk-bill at low rates or don't bulk-bill at all, and GPs have different ways of making the decision on whether or not to bulk-bill. I do acknowledge that GPs are part of a business. They have to either run their own business or be part of a business that someone else is running, and there are commercial imperatives there. I'm not blaming GPs for this, but what the Greens do say—and this is just a simple statement of fact—is that the average gap payment has continued to grow over the years because the Medicare rebate is not keeping pace with the cost of doing business.

Again, for a party that prides itself on Medicare, which at its heart was designed to enable free medical support for all Australians as a universal system, as it should be, what we are finding now is that, because the GP rebate and the government rebate for a range of GP services is nowhere near keeping pace with health inflation and the increased cost pressures that's placing on GPs, the gap continues to grow. That is actually pricing people out of being able to visit a GP. For millions of Australians, wherever they look right now, they are getting smashed by what a lot of people describe as a cost-of-living crisis but is actually becoming a cost-of-existence crisis. Whether it's the supermarket checkout, rent payments, mortgage payments, energy bills, transport costs or healthcare costs like going to a GP, people just can't make ends meet. Wages have been flatlining for many, many years in this country. Real wages have been going backwards for many, many years in this country. They are just starting to fall into the same ballpark as inflation. Whether that continues with the rise in inflation revealed in the CPI figures released yesterday remains to be seen. But people are getting smashed in a cost-of-existing crisis.

Health costs are a significant part of that. A significant part of health costs is people going to a GP. They are the first port of call. If you develop a health issue, the first thing you do is pick up the phone or log onto a website and book yourself a visit at your local GP. Far too many people now are being priced out of that opportunity. For far too many people now, their local GP has closed or reduced their opening hours and they have to travel further and pay more just for a simple GP visit which is the first port of call for millions of Australians when they want to take initial health advice about a health condition that they have.

We have a government that trumpeted, quite rightly, a recent anniversary for Medicare. I've got no problem with the Labor Party celebrating Medicare; it's worth celebrating, fantastic health system that it is. But, over time, it has become less than it was designed to be and less than it was created to be. Over time, we are seeing more and more Australians priced out of accessing essential health services. GP visits are essential health services. We've got to do something about this slow erosion of the principles of Medicare and universal free health care. We have to do something about the fact that more and more Australians who are getting smashed with costs right across the spectrum—rents, interest rates impacting on their mortgages, transport costs, power bills, bank charges, price gouging by the big supermarket corporations and now an ever steady increase in the gap payments for visiting GPs.

So I say to the government: while the Greens are supporting this legislation, this should be seen as a very preliminary step in what needs to be done to make the provision of essential health care more available and more affordable for millions of Australians—in fact, for all Australians. Medicare needs surgery. Medicare itself needs care. Medicare needs expanding and extending to make sure that dental and mental health supports are included within it, because our teeth, the inside of our mouths, our brains and our nervous systems are all interconnected inside our body with everything else that is inside our body. A true universal provision of free health care would include dental and mental health, and it would include a framework whereby GP visits were genuinely free and everyone in this country had a universal right to a free GP visit. End the gap payments. This is doable. This is affordable. These things are political choices.

When you're spending tens of billions of dollars in every budget subsidising the burning of fossil fuels in the middle of a climate crisis, and when you are spending tens of billions of dollars in every budget subsidising property speculators and investors, many of whom own five, 10, 20, 50 or in some cases many hundreds of investment properties—when you've decided you can spend tens of billions of dollars every year looking after the big fossil fuel companies, bolstering the super profits they are making, and in subsidising property speculators and investors—you can actually afford to end gap payments and make GP visits genuinely free. That can be done, and it's a choice that the Labor Party is making not to do that. They would prefer to subsidise the big fossil fuel corporations, cooking the planet at the same time. They would prefer to offer taxpayer subsidies, worth tens of billions of dollars a year in negative gearing and capital gains tax concessions, to property speculators who own multiple investment properties. They would prefer to do those things than to act to bring dental and mental health into Medicare and make GP visits genuinely free.

That's where we find ourselves, colleagues. We find ourselves, as we so often do in this chamber, debating political choices. We should be debating political choices in this place—of course we should—but I know in my home state of Tasmania that we are seeing fewer and fewer GPs, and the projections are frightening. We are seeing regional town after regional town lose GPs and, in some cases, lose their only GP. We need radical surgery on Medicare. We need to put dental and mental health into Medicare. We need radical supports so that Australians can actually access their GP for free, as was the principle behind Medicare in the first place. The way we do that is by ending the gap payments and making sure, therefore, that people can have a free visit to the GP. If we could just do those simple things—put dental and mental health into Medicare and make GP visits free—it would provide massive relief to people who are being absolutely smashed by rents that are going through the roof, by soaring interest rates with the prospect of more yet to come, by rising energy bills, by rising transport costs and by being price gouged by supermarket corporations and banking corporations.

We could provide genuine relief to people in the health sector. And that wouldn't only be a lightening of a massive financial burden on many Australians; it would be a massive lightening of a psychological burden on people. People would love to know that, if they got sick, they could get in to see a GP at a place close to them, it wouldn't cost them anything to do it and that they could see that GP within a reasonable timeframe. Those are the things that we should be aspiring to as a country, and doing those things would be a massive step forward for people who are getting smashed by a cost-of-existence crisis.