Andrew Southcott (Boothby, Liberal Party) Share this | Hansard source

Medicare celebrated 30 years this year. It is a system which has stood the test of time and part of the reason it is so popular in the community is that it built on the existing system. It was a fee-for-service system. It allowed discretion for medical practitioners to continue as they had before. But it has bipartisan support. It is supported by the Labor Party and it is supported by the Liberal Party and the National Party. You only need to look at what we did when we were last in government. We had some great innovations for Medicare. The practice incentive payment was a great innovation. It allowed GPs to focus on chronic disease management. There were things that a fee-for-service system did not always lend itself to. It was a way of getting general practice computerised. That was a great success of the Howard government. We introduced the GP management plans and the team care arrangements. That expanded Medicare to allied health services, to podiatrists and more. We had the Chronic Disease Dental Scheme, an innovation of the current Prime Minister when he was health minister. He understood that it was not the checks that people needed but the access to restorative treatment. We had a great expansion, again, under the Prime Minister when he was health minister, in the area of mental health, greatly expanding Medicare there.

The issue now is the sustainability of Medicare. Whereas 10 years ago it was costing $8 billion, now it is costing $18 billion. For that reason, a modest co-payment is a good idea. This idea that it affects the universality of Medicare is simply rubbish. Medicare remains a universal social health insurance scheme. That has not changed.

Australia has a good health system. For nine per cent of GDP, we have a population which, by international standards, is healthy. We have one of the highest life expectancies anywhere in the world. We are in the top five countries in terms of survival from a cardiovascular event. We can do much better. There are areas that we can focus on doing better in, such as chronic disease management, and we must look at hospital readmissions and preventable hospital admissions. There is a lot more that can be done. But there is all of this confected outrage, over what is a very modest scheme which will allow Medicare to become sustainable.

The Labor Party understood this when they were in government in the early nineties. They understood that having a co-payment was a way of making Medicare sustainable. The principle of having a co-payment has been well established in the Pharmaceutical Benefits Scheme since the 1960s. We have a differential scheme: one for concession-card holders and one for everyone else. We have had it since the 1960s. And this is very similar.

When you look at how we stand internationally, about 17 per cent of health spending is an out-of-pocket spend by the patient. We are about average by international standards. And this measure is not a large measure. It is $7. There are protections there for people who cannot pay. There are protections there for people who are card-holders. They will have to pay on only 10 occasions. It is an important innovation to make sure that Medicare is sustainable. And it does preserve the universality of this health insurance scheme.

See this speech in context