Tuesday, 2 June 2009
Fairer Private Health Insurance Incentives Bill 2009; Fairer Private Health Insurance Incentives (Medicare Levy Surcharge) Bill 2009; Fairer Private Health Insurance Incentives (Medicare Levy Surcharge — Fringe Benefits) Bill 2009
What we are discussing tonight with the Fairer Private Health Insurance Incentives Bill 2009 and related legislation is certainly not an honest attempt by a government to implement its policies. This is a dishonest government that went to the electorate on an issue known to be sensitive, of great interest and a vote-influencing subject in the electorate. It promised over and over again, gave solemn undertakings, that things would not change in relation to the private health rebate and here we are, a year and a half in, and all of that has been junked and the dishonesty is laid bare on the nation’s parliament tonight as we debate what is a stunning betrayal of the trust of voters of Australia and a clear example of this government doing anything, once it is elected, to implement ideological agendas.
The Minister for the Environment, Heritage and the Arts, Peter Garrett, said, ‘We’ll just get elected and do what we really want afterwards.’ Never has such open honesty and transparency been laid as bare as it has been tonight. This is exactly what has happened. Many electors not only in the electorate of Dunkley, that I am proud to represent, but right across Australia actually took the Rudd opposition at that time at its word that it would not do a hatchet job on the incentives for Australians, not just high-income Australians but Australians right across the board, to commit their own resources to taking out private health insurance.
The reason this affects everybody is that a change in the balance, in the equilibrium, of our dual-track health system that recognises and resources both the public system and the private system reverberates right throughout the system. Tonight it may not be a $64,000 question for the people of Dunkley, but the private health insurance dollar certainly is an issue for 64,000 Dunkley residents who will pay a heavy price for the Rudd government’s betrayal and clear dishonesty in relation to private health insurance in what I believe is an ongoing attack on private health in this country. A lot of words have been said by Rudd government ministers and their very compliant Labor members of parliament, sticking precisely to the lines given to them by the executive. But there is a set of words you would not have heard from the minister herself in this debate, or from any of the Labor representatives who have stood up to parrot the lines given to them. None of them have said, ‘We support private health.’ They have not uttered those words. They do not believe those words. And here we are, looking at a second attack on private health—after we had the earlier Medicare levy surcharge reforms last year, we now have these private health insurance bills before us tonight.
The reason this is so significant to the people of Dunkley is that more than 15,000 families have chosen to put some of their own resources into taking out private health insurance. A further 17,000 single adults with private hospital and general treatment insurance are also part of the Dunkley community. They recognise that the more people who participate in the private health system, the more its insurance utility will benefit all. So if you start picking people out of that system, you are leaving a smaller pool to cover the risk and the costs of maintaining support and services for those who remain. That is why this is such an ill-conceived budget measure. Not only will it push up the cost of private health insurance by reducing the number that have taken out cover and therefore the coverage pool that supports those services; it will also discourage people from directly providing for their own health costs. It will add to pressure on waiting lists in public hospitals and the health system, and it is just plain dumb.
Why on earth, when we are looking for more resources in the health system, would we not say, when any Australian is prepared to put 10 of their own dollars in, that the $3 to support that from the government is a sound investment? You take the $3 away and the risk and the highly probable outcome is that people will take their $10 away. What you end up with is a net reduction in the resources in the health system of Australia to care for our increasingly ageing population, and this is just dumb. Incentives are about encouraging behaviour, and the behaviour here is to look the Australian people in the eye and say, ‘We encourage you to commit some of your own resources towards your own health care, and we will provide some encouragement for that’. In addition, those people continue to pay their Medicare levy. They continue to make a contribution through their levy payments and through their taxes to the public health system but we welcome and encourage their additional contribution to the private health system. All the Dunkley families and individuals that make these personal sacrifices to maintain private health cover will be faced with higher insurance premiums after the Prime Minister categorically broke his election promise not to change the health insurance rebates and instead slashed them savagely in the recent federal budget.
This further step by the Rudd government in dismantling the benefit available through the 30 per cent rebate on private health insurance in this budget will have an immediate impact on at least 1.7 million Australians, or 10 per cent of the population. That impact will flow on to private health cover for those that are not immediately directly affected because of the smaller insured pool, and also those in the pool are more likely to be those individuals with higher health care needs. That will mean premium increases for everybody. On top of that, those directly affected will have that burden of an increase in health costs of up to 42 per cent if they are not eligible for this rebate, while those forced to abandon their insurance will face a tax increase through the Medicare surcharge levy of about 50 per cent. But every Australian will eventually pay for this reckless decision. It is a reckless action by a government that is careless about honouring its promises and has lost control of the public finances. The budget changes will mean people will drop out of health insurance. They will join the queues of people waiting for treatment in public hospitals while those who keep the insurance will have to pay more.
Prime Minister Rudd was not honest with the Australian people. He promised that this would not be changed; he promised it over and over again and now he has stooged everybody. He stands condemned for that action, not only because of the appalling betrayal of public trust but also for the consequences that will flow from it. He promised he would not touch the rebates for private health insurance but he was not honest in making that promise. This commitment was shattered in the budget and we will all end up paying the price. So, I have illustrated the impact on those with private health insurance, through the additional costs for that insurance, and for those that may choose to opt out.
Some people think this is an ideological bent when public policy advocates have over and again recognised that our health regime needs both a vibrant and energetic public system and a vibrant and energetic private system. When this last attack on the threshold and the Medicare rebate was before this parliament we were reassured in speeches by the minister that any suggestion that there would be any messing with this system was not right. She said:
The government has committed to maintaining the private health insurance rebate, which provides support to the private health sector to the tune of approximately $3½ billion a year.
She went on:
Contrary to some of the overblown contributions from those opposite, Labor is far from throwing the private health sector out into the cold. In fact, the government has expressly made it clear that it believes the old paradigm of a split between public and private health systems is no longer a viable policy perspective if indeed it ever was.
Minister Roxon went on to say:
We have also committed to maintaining the Lifetime Health Cover measure.
That was less than a year ago and that undertaking has not been kept. We had promise after promise in the lead-up to the election designed to stooge the Australian public and mislead voters that this benefit would stay. The government has adopted the Milli Vanilli minister for the environment option. He said, ‘Let’s just get in and then we’ll do what we really want afterwards.’ And here we are where we are today.
In my remaining time let me make one other point. A couple of years ago Peninsula Health, in the Dunkley electorate, got a touch-up from the state government. They were told they were not doing enough to pull in revenue from privately insured patients receiving care in the public hospital. They were told they were underperforming in bringing additional resources into the health system through the Frankston Hospital by treating privately insured patients whom they could then bill. The Peninsula Health financial report shows that in 2004-05 there was $5.842 million in additional patient fees brought in through acute patients. In 2006 it was a little over $6 million. Then the touch-up came. After 2005-06 they were told, ‘You are not doing enough to draw in privately insured revenue to prop up the resources of your public hospital. Go to it.’ That revenue stream of a little over $6 million became $9.14 million in one year—nearly double.
I illustrate this point to emphasise that, when private insurance is compromised and made more difficult and less attractive, not only does the private health system suffer but the balance between the public and private health systems suffers. Here is a classic example of privately insured patients not only supporting private health and public health through their Medicare contributions; through their premiums they are also enabling hospitals in the public system to attract additional revenue by providing services to privately insured patients. This is a disaster of a measure. It is a dishonest action by a government that has misled people with its election reassurances. We have seen two instances of private health maybe not being ‘left out in the cold’, as we were assured by Minister Roxon, but, gee, there is sure an ill and chill wind blowing over private health. All of us must remain vigilant to make sure the ideology of the Labor Party does not see an end to private health, because that is a bad health outcome for all Australians.