James Bidgood (Dawson, Australian Labor Party) Share this | Hansard source

I rise to speak on the Private Health Insurance Legislation Amendment Bill (No. 2) 2009. The purpose of the bill is to amend the Private Health Insurance Act 2007 to allow for conditional listing of prostheses in the Private Health Insurance (Prostheses) Rules and to allow the Minister for Health and Ageing to make rules specifying criteria for listing prostheses in those rules.

Under the Private Health Insurance Act 2007, private health insurers are required to pay benefits for a range of prostheses that are provided as part of an episode of hospital treatment or hospital substitute treatment for which a patient has cover and for which a Medicare benefit is payable for the associated professional service. The types of products on the prostheses list include cardiac pacemakers and defibrillators, cardiac stents, hip and knee replacements and intraocular lenses, as well as human tissues such as human heart valves, corneas, bones—part and whole—and muscle tissue.

Under the current provisions of the Private Health Insurance Act 2007, the act, there is some ambiguity as to whether a device can be conditionally listed where a Medicare benefit is payable for the professional service associated with the provision of the device. Conditional listing will require private health insurance benefits to be paid for recipients of the device where the conditions set out in the rules are satisfied. With further developments in medical technology, it is expected that there will be a greater need for listing prostheses on a conditional basis in the future.

Conditional listing of prostheses in the prostheses rules will require private health insurance benefits to be paid in relation to a high-cost life-saving device to patients who are waiting for a heart transplant. It is expected that patients will be able to maintain a high quality of life with this device, which would be prohibitively costly without private health insurance benefits.

Specifying criteria in the prostheses rules that must be satisfied in order for a prosthesis to be listed in those rules will enable listing of, for example, prostheses that are useful and cost-effective, such as insulin pumps, which will provide benefits to many privately insured families contending with diabetes. Mr Deputy Speaker Washer, we know from all the reports that are coming out, and as you are well aware, diabetes is becoming a major national and international issue. It is very much a lifestyle disease. Through the technologies of our age and through the provision of different types of food, the way those foods are made and preserved, we are seeing a steep rise in diabetes across the nation, and it is something that we do need to try to prevent. Once people have diabetes, particularly type 1, it is really disabling of their whole lives and lifestyle. It is a gross inconvenience to them and anything that we can do to make those people’s lives more contented and satisfied will be of benefit. The means and measures in the changes to these rules and the enablement of private health insurance to help meet the cost of some of these insulin pumps will be greatly beneficial to the lives of people suffering from type 1 diabetes and also the lives of type 2 sufferers who may need some help.

As stated by the minister, products will only be listed where they are clinically effective, cost-effective, provide significant health benefits to patients and can prevent the need for expensive downstream medical costs. The whole decision-making process has been based on clear evidence that it is clinically effective and that it is the best means of dealing with a diabetic situation or any other situation whether it concerns the heart or any of the other organs that I have mentioned, particularly with human heart valves and things like that. It has to be clinically effective, cost-effective, proven and provide significant, not just slight, health benefits to the patient.

At the end of the day the laws and the rules which we are putting down here are all about benefiting the patient and looking after the patient for their whole life—in the community, in the family and at work. If we can help people have a more wholesome, effective life then we have done a good thing. I believe that this legislation before the chamber right now is a good thing and that is why we are backing it wholeheartedly. The new criteria will not override any of the current legislative criteria for listing—that is very important. What it is doing is helping with medical cost. These changes will deliver significant benefits to consumers who are privately insured and seeking to use these and other devices.

Once again, I go back to the fact that as we get older so many things come along which we just do not expect will happen to us. I have just turned 50 and I am beginning to discover a few health issues myself which I never thought would occur to me. God forbid that I should have to action some of the things that need to be done in some people’s lives; there but for the grace of God go we. Good government, good laws and good rules are about thinking about other people, not just ourselves. Even though things that I have mentioned here may not be happening to me personally, or to any of us personally, they are happening to people across the nation. While they may not be occurring in massive numbers, nevertheless, they are affecting people’s lives and their quality of life. People’s health is important and legislation like this goes to that. If we can prove clearly that we have things that are clinically medically effective and that are the most cost-effective and there is clear evidence that they improve a patient’s quality of life then I think we are doing a good thing. The Private Health Insurance Act 2007, which this bill amends, and the recommendations that are before us are good. It is a good act, it is a good amendment and it makes good provision for the Prostheses List. I can not say more plainly or more clearly how wholeheartedly I back this bill and commend it to the House.

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