Bruce Billson (Dunkley, Liberal Party, Shadow Minister for Small Business, Deregulation, Competition Policy and Sustainable Cities) Share this | Hansard source

The Chief Government Whip’s encouragement is appreciated. I have been ‘Rogered’. He could not rustle up any of his own people to speak in support of this horrendous piece of legislation. I must say I am not surprised. I just wonder how many Labor members, as they return to their electorates after being heroic in their compliance with the government line on whatever the speaking notes are, look forward to then facing the tens of thousands of people in their communities that have private health insurance. It is not surprising that the Labor Party is comprehensively AWOL in defending this measure. It seems to have learned nothing from the last time the Fairer Private Health Insurance Incentives Bill 2009 [No. 2] and cognate legislation were debated. It seems to have a very poor, in fact nonexistent, grasp of the dual pillars of Australia’s health system. The public system is valued and does a sterling job under difficult circumstances, ordinarily with underfunding and with poor administration and leadership from state governments. The private system complements the public system. We see in our community in the Mornington Peninsula many of the outstanding health professionals actively participating in both the public and the private system. This is good. The public health system is important but the private health system is equally important.

The measure we are talking about today is to remove an incentive for Australian families to provide for their own health needs and to get a little bit of encouragement from the government to do so. This is a little bit of encouragement that then results in many times that incentive being contributed to the health system through private health insurance premiums. This is a little bit of support for people who choose to provide for their own healthcare needs through their private insurance, who make choices about their discretionary income and decide to put a share of it towards their health costs, complementing the resources that are provided through governments. That would seem a good idea. It seems such a good idea that tens of thousands of Australians in each of the electorates right across the country think it is a good idea. It was such a good idea when the current Prime Minister, the then opposition leader, Kevin Rudd, was in me-too mode—remember that, colleagues, when I think the term was that there was not a cigarette paper between what the then Howard government did and what the then Rudd opposition claimed it would do if it were elected; not a cigarette paper’s difference.

In my electorate people were very interested in urging me to secure clarity about the Labor Party position on private health incentives because the electorate knew that private health insurance ran against the DNA of the ALP. They wanted to know, and there was question after question on talkback radio, at press conferences, even in this chamber here, in an effort to draw out what the true position of the Labor Party would be if it were elected to government. Many people were falsely reassured and many people were, frankly, misled by the Rudd Labor team into believing their words that nothing would change about the private health insurance incentives and that people could confidently stride up to the ballot box on election day not having to worry about that incentive that encouraged them to provide for their health needs being messed with should the Labor Party be elected. That has proved to be a very misleading statement by Prime Minister Rudd and his health spokesperson, and Labor members and senators have parroted those assurances right across the country. They were parroted in my own electorate. People went to ask the ALP candidate what was going to happen with private health insurance and he said: ‘Don’t worry, rest assured nothing will change. Let’s go and talk about something else.’ That was the tactic of Rudd Labor, and now in government we can recall those immortal words attributed to Peter Garrett, the Minister for the Environment, Heritage and the Arts, ‘Once we get elected things will change,’ and that is exactly what has happened. Now we see a second assault on the private health insurance incentive.

This is so troubling because I have explained briefly the complementarity between the public and private systems. I have touched on the fact that medical professionals often practise in both systems. They are able through that practice in both systems to provide optimal care for their patients. They recognise that the waiting lists and scheduling challenges of the public system are one thing and they do a herculean job to try and address the difficulties that the administration of the public hospital system presents, knowing that in the private system they can pursue quality patient care and respond to individuals’ decisions to provide for their own health through private health insurance with a commensurate level of support and assistance. That is a good model.

You take away that incentive, and you take away encouragement for people to provide for their own health needs. You take away a modest incentive, a portion of private health premiums, and you risk losing the whole premium. So, whilst you might save some cents in the dollar, you lose the private, personal contribution through health insurance premiums. You quickly see a net reduction in the health resources available to support the care, the wellbeing and the treatment of the Australian population. You also see a shift of the demand, where those who once provided for their own retirement, able to pursue care in the private hospital system, join the waiting lists in the public hospital system. What you end up seeing is nothing more than a draining of resources, a discouragement for individuals to provide for their own healthcare needs and net disadvantage to the healthcare system as a whole. These were clearly articulated concerns last time this private health insurance legislation was discussed. These are the reasons why the opposition has been consistent in not supporting this damaging measure that the Rudd Labor government is proposing, and that is why the bills were comprehensively rejected in September 2009.

The government originally claimed that only 25,000 people were likely to drop out of private health insurance because of its proposal, with estimates of 40,000 degrading their cover. According to research from Roy Morgan, Ipsos and the Private Hospitals Association and other analysis from the health industry, nearly a quarter of a million people are likely to drop hospital cover, three-quarters of a million will downgrade their hospital cover and more than three-quarters of a million are likely to drop ancillary cover. This is what the practitioners, those in the field, are saying. And yet the government seems ideologically driven to keep that pressure on. The last time I spoke about this I highlighted the shift of demand from the private system to an already stretched and strained public hospital system, and how it would be to the detriment of not only those who currently have private health insurance but also those who do not.

I have highlighted how the cost increases to those who retain their private health insurance will flow from fewer people being in the insurance pool providing that care. But I also highlighted in the Mornington Peninsula example how the Frankston Hospital, the hospital that the state health minister recently recognised for its outstanding care—a recognition well earned and deserved in my view; a hospital that has, frankly, worked its tail off trying to respond to a growing population and an ageing population with increasing complexity and volume of health presentations to services—will lose as well. Frankston Hospital got a bit of a touch up a few years ago—they were told they were not bringing in enough private revenue. Private revenue is when a privately insured patient attends the public hospital for treatment and care. They are invited—they are not obliged, but they get plenty of encouragement—to reveal the fact that they have private health insurance. Why? Because then the cost of their treatment gets built into the health fund rather than absorbed by the operating budget of the hospital. The Frankston Hospital was apparently, according to the state government, underperforming in sucking in additional revenue from privately insured patients attending the hospital. They were told that they had to lift their game. The last time I spoke on this bill I outlined the revenue impact of that directive from the state government and how it had caused considerable disquiet in the local community. They are resources funded by the private health system supplementing the resources available to the public hospital.

So myopic is this government in its ideological hatred of private health insurance, it does not join up the dots. If you take away the incentive for people to take out private health insurance and to provide for their health care, you see a reduction in people making that personal choice; you see a reduction in the resources available to the health system as a whole; you see an increasing demand on a public hospital system already stretched with long waiting lists and, in the state of Victoria, waiting lists to get onto waiting lists—so clever is the management of that significant public hospital challenge—and you see a diminished opportunity for those public hospitals to draw in additional resources through revenue from privately insured patients.

It is almost like a perfect storm. It is almost like the government is setting about creating more of a health crisis than we have right now. Prime Minister Rudd said the buck stopped with him and promised so much about taking over the hospital system. What is he trying to do? Is he trying to nobble it first, so whatever it does it cannot look any worse than it is now? Is that the cunning plan of the Prime Minister? That seems to be what he is doing. This is a Prime Minister who forgets history. I was reminded by my friend and colleague Mr Tuckey, when he was reflecting on his time as shadow veterans’ affairs minister recently, and from my own time as veterans’ affairs minister, how there was a time when the Commonwealth ran hospitals—they were veterans hospitals; repatriation hospitals. A former Labor government thought it was such burden that they did all they could to unload them. They thought it was too expensive. There was a handful of them; that is all. There were not hospitals all across the country, just a handful of them. They were repatriation hospitals caring for our veterans community, who deserve our great respect and our great commitment to their health and wellbeing needs. But a former Labor government thought, ‘No, let’s not do that,’ and they unloaded the repatriation hospitals.

As the veterans’ affairs minister I was pleased to be able to introduce more private hospitals into the system that provides veteran health care, recognising that that was supporting the responsiveness of the system to the care needs of our veterans community and, together with the health system, we could increase the quality and the responsiveness and the convenience of the care provided to people. That is the history. But we have a Prime Minister thinking about going back to the future, when he could not handle a handful of repatriation hospitals—this was the Labor Party then—and they thought it was too expensive and they could save a lot of money by not being directly involved in operating hospitals. But, no, the Rudd Labor government is talking about going there again and I fear that these measures, such as removing incentives for private health insurance, are simply making a rotten system now, working under duress, worse, so all those concerns are exacerbated and then he will say, ‘Well, things aren’t flash but they are not as bad as they used to be,’ after he has made decisions of this kind to put added pressure on the public hospital system.

12:15:07

But it is not just this measure. I have spoken before in this place about the Frankston Medicentre. This is an after-hours GP clinic that has been around longer than the Prime Minister has been in this parliament. It has been proven to be a successful model, it had support from the former Howard government and yet we have learned that the Rudd Labor government is withdrawing that funding support. They have been told they will have to do less. We have the Rudd Labor government running around saying, ‘Let’s have these after-hours GP clinics’ et cetera, we have members talking about them being partially operational—which sounds like they are not quite what they are supposed to be—and we have a perfectly viable and enduring model, which has been with us for many years, being defunded by the Rudd Labor government. This is another decision that is simply putting more pressure on the Frankston Hospital.

At the moment people can attend the accident and emergency area and be advised of the existence of an option, if they choose to take it, of an after-hours GP service collocated in the same facility. Some funding to support that was provided by the Howard government, yet the Rudd government is defunding it. They have been told, ‘No, we are not going to provide the level of support you need—see how you go on less.’ The medicentre have informed me that that will make the system unviable. They have put to me good ideas about either a restoration of the funding being taken from them by the Rudd Labor government or alternatively some thoughts about Medicare benefits schedule billing arrangements. This is by definition an after-hours GP clinic, yet for at least an hour a day when they are open they are not able to access the after-hours GP Medicare Benefits Schedule item. As it is an after-hours clinic—that is, it is not open during normal hours—you would have thought they could access that benefit. That would at least provide some support, but we have seen no action on either of those two issues. Inactivity on those issues is putting greater pressure on the Frankston Hospital—a hospital that, as I said, I admire for the way it provides care under great pressure from a growing population, under-resourcing and many challenges that are being made more difficult by the Rudd Labor government.

I invite people to think carefully about this measure. It is not a $64,000 question for the electorate of Dunkley; it is a $64,000 Dunkley residents’ issue, as they will all be paying a heavier price for this Rudd government’s ongoing attack on private health insurance. It is not just an issue for those people that hold that care; it is also an issue for those that are looking for support from our health system. This ill-conceived measure will put up the price of private health insurance, discourage people from providing for their own health costs and add pressure and waiting lists in the public hospital and health system. In addition, as I have illustrated, privately insured patients bring additional revenue into the public hospital system. That opportunity, being encouraged in hospitals in Victoria by the state Labor government, will be diminished and disadvantaged as a result of this change.

It does not matter where you are in the health system or whether you are part of the public or the private system—in fact many people are active in both and contribute to both—the incentives to encourage the participation of those in the private system should not be changed, because the Rudd Labor government said they would not. Even on the most basic issue of honour, this should not be supported. At a policy level, with its impact on the health system, this is a silly move. In terms of preparing for our future and the population projections in the Intergenerational report that get selectively dragged out to support some ideological adventure that the Rudd Labor government is on, how can it be helpful to discourage people from providing for their own retirement at a time when we have an ageing and growing population? It is just another example from this government.

Prime Minister Rudd used to boast about a big Australia, as all diplomats do—they like being a representative of a bigger country—but he could not talk about a coherent strategy to support that projected population explosion of 60 per cent through to 2049. It is no good talking about a big Australia if you do not have the plans and the strategies to successfully settle and support a growing community in a sustainable way. Taking away encouragement from people to provide for their own health needs, with a growing and ageing population, is just downright dopey. It is wrong, it is dishonourable and it is a breach of faith and promise from the Rudd Labor team. They should hang their heads in shame and see that this is bad public policy. It is appallingly deceitful politics and it is going to undermine health care regardless of whether you are privately insured or not in electorates including Dunkley.

I am very pleased to be able to oppose this again because this is one of the silliest things we have debated. We proved that point last time. I do not know what is motivating this—the Rudd Labor government seem to learn nothing from their mistakes. It is just pure ideology and I invite the House, and particularly those members as they scurry back to their electorates after the parliament closes tomorrow, to have a chat to the tens of thousands of people in their electorates and explain why they are being done over by this bill today.

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