Andrew Laming (Bowman, Liberal Party) Share this | Hansard source

It is always good to engage in a health debate. It almost seems that nothing changes each year when we have them. But, fundamentally, what is this about? Medicare, at the heart of the Australian health system, is growing at an unsustainable rate from around $10 billion to $16 billion and, in 10 years from now, to $34 billion. We have to be able to have some sort of constructive discussion with the other side about real ways to reform and restructure Medicare to make sure it continues to deliver. Of course, Labor have a very short memory. They do not remember that they, themselves, took half a billion dollars out of pathology when they promised those savings would be reinvested into the health system. No, that has been erased away and they just take the cheap shots at the government of the day.

I know that there are a couple of healthcare enthusiasts on the other side. Certainly I congratulate the shadow minister for the fact that she at least turns up to the odd clinic to talk to patients and providers. But actually working in a hospital, as I do every fortnight, I get a fairly privileged look at exactly what is happening in Queensland hospitals. One great observation is that state governments that get serious about provision, reducing waiting lists and shortening time at casualty departments can do it. The one thing I noticed about Campbell Newman's era of running the health system was that the waiting list started to decline and Queenslanders got their operations. I know it is very tempting to dance around on the grave of a former premier, but I can tell you one thing: when you needed an eye operation, you knew you would get it under Campbell Newman's premiership.

Already now, those waiting lists are bloating out again. Why is that? Fundamentally, we have to remember that four-fifths of Australians get completely free Medicare services in this country. If you look at equivalised health earnings, that means that pretty much anyone earning more than double the minimum wage is quite probably paying no out-of-pocket expenses whatsoever under Medicare. That is something to be extraordinarily proud of. If both sides of parliament did not support that, it would not be the case in 2016.

But way more concerning, I think, is Labor's attitude. When given the choice between treating the poor and treating the sick, it is the sick that miss out under Labor. In Tasmania, if you have so much as a minimum wage job, you are denied the services of much of Tasmania's public health system because you are too wealthy to be treated. That is a complete disgrace. It is appalling to see state hospital and dental services turning away patients under Labor because they have a job. It is ridiculous. The member for Bass has told me of young working women who could not get a hole in their teeth fixed under the state dental system because they had a job. How outrageous! They are automatically ineligible. This is Labor's fixation on free health care, whatever the cost.

At the moment the percentage of bulk-billing in diagnostic imaging and in pathology is sitting in the high 80s. The odds that they are out-of-pockets are extremely slender in both pathology and diagnostic radiology. With respect, you have to look at the enabling structures in pathology and diagnostic imaging way more deeply than the shadow minister has done. You cannot just wander the corridors. You have to understand the cost of the equipment and the massively increasing volume of testing and the ability to do that and you have to look at whether the federal government can do this more efficiently. If you are stuck with a fee-for-service system, you almost cannot extract any savings whatsoever.

What are the three big challenges in health? Ageing—I am glad that people are living longer; technology—we have to find better ways to treat more people; and, lastly, the cost of human capital. In diagnostic imaging and pathology it is the workforce bill that is relatively small compared to the large cost of technology. Driving technology is the key. In a fee-for-service system, you have to look twice at paying blanket bonuses to those sectors because we know it may not change behaviour. A lot of those surpluses are simply pocketed by the provider, which is, in many cases, a large corporate entity.

Where two large corporates control the market, with the greatest respect, if one of them decides to change from a bulk-billing practice, they will see patients walk across the road. They will get the doctor to tick the box on the diagnostic imaging or pathology form and they will look around, because the day the policy changes the competitor across the road will put up a sign: bulk-billing is delivered here. That is the market effect that that side does not understand.

If we can improve pathology and diagnostic radiology and if we know that we can do it more efficiently and learn from the private sector that does it far better than the public sector, we have a chance to fund the cancer measures and the hep C cures. These are areas of expanding opportunity for the Australian health system that will keep it one of the best in the world. We should no longer be comparing it to the US. We must now match the achievements of the European health systems—and we can under the coalition.

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