Wilson Tuckey (O'Connor, Liberal Party) Share this | Hansard source

There is the sensitivity being demonstrated. They can stand up here and talk about the Australian government not sending another billion dollars when it was the Howard government, in the interest of giving the states a growth tax for the very purpose of financing their health and education systems and their law and order responsibilities, which denied itself any political advantage. In fact it suffered great political loss to deliver that tax to the state governments. And we had the Labor Party opposing it.

Of course that money should be spent on hospitals. We now have the situation where they say the GST should flow totally without any deductions and as decided by the Commonwealth Grants Commission, which takes into account the other revenue capacity of individual state governments—not decided here in this House. The Grants Commission knows what is a fair distribution, and that is for the states to look after their hospitals. But they have managed to distribute that money somewhere else. Frequently agencies of the government spend all their time stopping the tax-paying sector—for instance, our development sector—from undertaking the sort of development necessary, while they justify their jobs. That is apparently more important than delivering a tax service.

But if the government seriously wants to save some money on health, why not allow Australians to insure for a visit to the doctor? That is expressly forbidden in the act—it was brought down by the Hawke government, in the process of trying to socialise medicine--—and for good reason: a lot of people would have taken that option. And remember that is forbidden under the Constitution. Australia cannot have, by decree of this parliament, British-style national health. The Australian government never had any responsibility for health; it was a state responsibility retained by them for themselves when they wrote the Australian Constitution; there was no parliament to write it. The reality is that money was put in and the states kept it for themselves and offered an entirely different system. Private health insurance was available, whether it was to pay the doctor or to pay for a hospital. When the act was brought in, for Medicare as we know it, you were forbidden to pay a doctor yourself through insurance. We saw a progressive campaign during the Hawke government to drive out the private hospital sector. Private health insurance is only the means by which we can have private hospitals and when private health insurance, as it was, became more expensive, more people left. And they were all the so-called ‘good risks’—those who made the least claim on the insurance sector.

There was great anticipation within the Labor Party and the Keating government by that time. He was a man who boasted that he never had any private health insurance but got his wife into a private hospital with a private room and a surgeon of choice. When you are the Treasurer or the Prime Minister of Australia you do not need private health insurance when you know how to work the system. And that is an absolute fact. But the reality is, had the Howard government not been elected when it was, had the Howard government not progressively introduced such issues as this rebate, private health insurance would have been unable to maintain a sufficient membership base to finance the private hospital system.

There is some suggestion in the minister’s second reading speech that ‘they will not notice the difference out there.’ The government think that 25,000 people who may no longer be covered by private health insurance hospital cover might result in 8,000 additional public hospital admissions over two years. We have waiting lists now but they shrug their shoulders at 8,000 additional admissions. We are of course told that it is insignificant—they were the minister’s words—because it has to be compared to 4.7 million overall admissions. It is like comparing the budget deficit with other nations that have been in the process of borrowing money when Australia under the Howard government was paying it back.

The interesting point is that we are told that the private sector, for example the Australian Health Insurance Association, the AHIA, have got very nervous about this. I am most interested in how important the private sector is to people. They tell us as follows: in respect of major procedures for malignant breast condition—I would think the next speaker would have some interest in that and I did not hear the member for Page on the subject—55 per cent of selected episodes are performed in the private hospital sector, but every effort is being made by the government to undermine the insurance scheme that keeps that afloat. Cancer therapy, chemotherapy, 55 per cent of selected episodes. Hip replacements—the difference between being in a wheelchair and being able to walk in comfort—55 per cent of selected episodes. Other major joint replacement and limb reattachment, 63 per cent. Mental health treatment same day—I presume that is psychiatry of some description—70 per cent. Lens procedures, which is the simple right of people to see, are being independently attacked by the government. I well remember during my time as shadow minister for health when a woman wrote complaining of the waiting lists and said, ‘I have been condemned to live in darkness for another two years because that is when my first chance of getting a public procedure will be available.’ Complex middle ear infection, 70 per cent. Other knee procedures, 77 per cent. Whilst it is difficult to display it here—I suppose if your name were ‘Prime Minister’ I would hold it up—they provide a graph showing change in hospital treatments by hospital type, and of course the private hospital contribution is going through the roof compared to public hospitals.

The minister trumpets the fact that they have thrown I think it was another $64 billion at public hospitals, but have the waiting lists disappeared? No, they have not. Here we have a proposal which became fundamental to maintaining balance between both the public and the private hospital sector. Of course that was the Medicare rebate of 30 per cent to all citizens. Why? It is not because they are rich or poor—and please remember the very poor do not pay the Medicare levy—it is because they have taken a voluntary option to make a significant financial contribution to their health care. Of course—and it will not happen, praise God—if everybody walked away from private health the savings to government would be the 30 per cent rebate, but the cost would be 100 per cent of the delivery of their health services. That is pretty odd accounting but not surprising when one heard this government defending its moves to borrow $315,000 million. The reality is that, as with private education, as with private health services, the people involved make a very real contribution.

When we get to this particular issue, why the problems are as we see them is of further of interest to me. I saw Medicare introduced and I have watched it. I served as shadow minister for health and as the minister identified the other day I came up with an alternative proposal. That alternative proposal was to subsidise pensioners by 100 per cent because, if they all got into private health along with other sections of the community, the cost to government and the Australian taxpayer would fall by 30 per cent by the simple act of aggregating all the contributions into one side of the insurance ledger. Now that is not the policy of the opposition. It never was simply because the then leader, John Howard, was too scared to tell Australians there was a better way. But that is just by the way.

What I am saying is that there is a great difference between the conduct of a public hospital and a private hospital. Public hospitals get budgets. A budget makes a patient a liability, and you have got to be careful that you do not get too many of them. When patients all turn up and want a hip joint replacement and you have not ordered in enough prostheses for that purpose, because your budget limited to how many you could buy, you put them on the waiting list. I attended a conference where the keynote speaker was a lady who had got a knighthood. She was a dame from New Zealand who had got her knighthood for her services to the public hospital system. She said a couple of things that are burnt on my brain. One was that waiting lists were part of the process of conducting the business of public hospitals. She then spent about five minutes of her speech on complaining bitterly—and I thought she did so with some character—about the administration of waiting lists. They are not honest, they are not fair dinkum and, as I have already said, if you are the Treasurer of Australia you can go straight to the top of the queue. That is communism and that is socialism where you have a new elite; they are called the public service. That is just one of the many problems.

But here I am talking about my electorate where if you are not privately insured you are severely disadvantaged. There are not the hospitals on your doorstep to which you can go for common or serious ailments, and you have to be privately insured because you cannot just drive down to the city and demand immediate admission for whatever your problems are. I am also talking about people who, when it comes to certain ailments, cannot be too long away from their farm or other business, so they pay up. Consequently, as I am advised by a private health insurance group, 46,000 persons in my electorate are currently covered by private health insurance, being 50 per cent of the voters listed in my electorate. Irrespective of their income, they are entitled to that small rebate of 30 per cent.

I also object, and continue to object, to this arbitrary list as to means testing. There is no argument in the world that says $150,000 in family income is necessarily making you rich. There are a variety of reasons why you could be on the breadline while you are on $150,000. They are not recognised. If only it were a net income or a taxable income or if some other circumstances were recognised. If only there were some sort of acknowledgment as you move further away from the very centralised hospital system that has developed over more recent years. All that is not there. If you are a pensioner out in a country area and you have a need, it is double that of a pensioner in the city for private health insurance. So why attack these people and why is that the process of saving money? When the thresholds for the super charge were changed and lifted, that was due to the generosity of the government. They wanted to give money back on private health. That is what they said. Now I think they see it as a means of attracting something like $1.9 billion. That is the rip-off.

More importantly, when it comes to public health, the opposition has made a very sensible proposal to the government: cancel this attack, keep your promises and let us increase the tax on one of the most debilitating practices of humanity, smoking. I have never smoked. My mother smoked from 13 to 73. My wife, in her younger days, smoked 40 a day. Nevertheless, we know it is a serious health issue and as such there is no reason why you cannot go and increase the cost of cigarettes in the hope of doing something about it. If the government wants revenue to save people’s lives, it should go down that road, but it should not discourage people from making a serious financial contribution to their own health services. As I have said, if you want some money do it the other way around: let people insure for their own doctors visits.

See this speech in context