Julie Owens (Parramatta, Australian Labor Party, Shadow Parliamentary Secretary for Small Business) Share this | Hansard source

The astonishing thing about the bill we are discussing today, the National Health Amendment (Pharmaceutical Benefits) Bill 2014, is that it absolutely flies in the face of logic. It assumes that a saving made today, in the health area, will automatically lead to a saving tomorrow. Yet we all know that when it comes to health, the earlier we act on our health, the cheaper it is in the long run. And by cutting health assistance at the early stages of a person's illness, we quite often increase health costs, not decrease them.

Every January, my Chinese, Vietnamese and Korean communities wish me a happy New Year. They say to me and my community that they wish us health, wealth and prosperity. Health, not fitness; wealth, not riches; and prosperity, in this greeting, means family and community that sustains you in the bad times and with whom you share the good times. There is great wisdom in that greeting. They are the things that lead to a good life. You can talk about the three of them in exactly the same context. You build them with good habits and you lose them with bad. You can save them up. You can accumulate health, such as a good immune system. You can accumulate friendships that are strong. You can accumulate wealth. They can sustain you in the bad times. You can spend them or you can lose them through an accident, like figuratively being hit by a freight train of tragedy. They are the things that sustain a good life. Each of them is accumulated by good habits every day. In the case of all three, the earlier you build them, the cheaper it is to build them. It is cheaper to build savings for retirement if you invest early. It is cheaper to be healthy if you invest in health early in your life. You build far stronger relationships if you put that work in early.

It is almost universally true that what is best for the patient is cheaper for the taxpayer. It is almost universally true that it is better to immunise so that people do not get sick. Doing that is cheaper for the taxpayer. Early intervention is cheaper than late intervention. Keeping a person healthy is better than treating them for an illness. What is best for the patient is almost universally cheaper for the taxpayer. Yet we have a government that, in this budget, are cutting support for the early stages of health treatment. The GP tax, for example, is likely to dramatically affect the number of people who go to the doctor for health checks. Pathology will attract an additional cost. There will be fewer people taking the regular blood tests that they should take, particularly as they get older, even though it is cheaper for the taxpayer if they take them. Radiology will incur an extra cost, so that things like mammograms will cost more for people who are not on the priority list. Going to the doctor to get a referral will cost more. Fewer people will do all that, even though it is cheaper for the taxpayer and better for the patient if they do that early.

This bill will increase the pharmaceutical benefits scheme co-payment for general patients by $5 to $42.70 and by 80c to $6.90 for concessional patients from 1 January 2015. It will also increase the concessional safety net threshold by two prescriptions a year and the general safety net threshold by 10 per cent each year for four years. It will also dramatically increase the cost of medicines. We all know that the medicines people take early in the onset of an illness or that keep them from infection dramatically reduce later health costs. This is a government who fundamentally do not understand that early intervention in primary health care dramatically decreases the cost to the taxpayer and improves health outcomes for the patient.

When it comes to health, it is true that a stitch in time saves nine. It is absolutely true that, when it comes to health, early intervention is best for the patient and absolutely cheaper for the taxpayer. We have heard the Treasurer speak at length in an incredibly loud tone, as he usually does, saying that Labor introduced a co-payment. It is true that we increased the PBS co-payment in 1986 and that we were the first to introduce a PBS co-payment for pensioners in 1991. There are two fundamental flaws in the Treasurer's argument. Firstly, he makes the assumption that if one side of politics introduces a co-payment it is okay to increase it exponentially, because any subsequent increase is the fault of the first people that did it. That is like saying that whoever first invented tax is to blame if the government increases the lowest tax rate to 60 per cent. It is a nonsense argument. Secondly, and more importantly, he totally ignores the context in which the Labor government made that change and the compensation that it introduced for lower income earners in order to compensate them for the increase in costs. We did not increase a co-payment as part of ripping away money from primary health care and early stage intervention. We did not do that in the way that this government is doing it. This government is increasing the cost of primary and early stage care for people. It is taking that money out of primary care and moving it elsewhere. In other words, they are weakening our health system by making these changes.

Labor introduced a PBS co-payment in 1986 in order to move money within the Pharmaceutical Benefits Scheme, from one area to another. It was about increasing the range of drugs. It was done in the context of very strong negotiations, which Labor has always done, to increase access to pharmaceutical benefits, never to decrease it. That is a fundamental difference between the two actions. The Labor government made changes to the PBS to make it sustainable, which is what the government claims to have done. But Labor moved the money from one area to another and increased the range of drugs that were available. The government is simply pulling the money out of the Pharmaceutical Benefits Scheme. It is cutting the assistance available for people who need medicines in the treatment of their illness or to maintain a lifestyle of relative health. We did not make that change in the context of ripping more than $50 billion out of hospitals, as this government is doing. They remove money from primary care, making it more likely that people will be ill down the track, then they rip the money out of the very hospitals that those sick people will need. It defies logic that you would make it more likely that people will need help further down the track and then reduce the availability of that help.

We did not do it in the context of the GP tax and raising the prices for basic X-rays and pathology. We did not do it in that context. In fact, as I said, we did it in a context of improving access to medicines, not reducing it. We did not do it in a context of cutting pensions and family payments that will see pensioners and families between $4,000 and $6,000 worse off, scrapping senior concessions or raising the tax on petrol. We did not do that. Ours was a modest impost designed to increase access; theirs is one to cut the health budget and move that money into their other priorities of paid parental leave, abolishing the mining tax et cetera. Their priorities are really clear here. It is not about health. Their priorities are absolutely in other areas.

The other thing is that when we introduced the co-payment on the PBS we increased the pharmaceutical allowance so that concession holders received the equivalent of the cost of a script per week to compensate them. We did not leave the people who are most vulnerable out in the cold, as this government has in almost every element of its budget. We did not do that. Being a Labor government, we naturally moved to ensure that the lowest paid people in our community received the health care they needed by increasing the pharmaceutical allowance so that concession holders received a payment the equivalent of the cost of a script per week to compensate them. Every time the PBS co-payment went up, the pharmaceutical allowance went up as well. It was John Howard who broke that nexus in 1997.

So when the Treasurer talks about the history of the PBS co-payment he is being a little bit naughty, shall we say.

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