Bernie Ripoll (Oxley, Australian Labor Party, Shadow Minister Assisting the Leader for Small Business) Share this | Hansard source

I rise to speak on the National Health Amendment (Pharmaceutical Benefits) Bill 2014. This is a bad bill. Let's not mince words. Let's not pretend we do not know what this bill is about. It is a bad bill. It is a bad bill that will hit the most vulnerable in our community—the sick and the poorest. It does this unfairly. It is disproportionate. It is not within the context of what the government should be doing for sustainability of the PBS. In fact, all of the arguments the government has put forward for the rationale behind what it is doing are just baseless. They are excuses and baseless arguments about trying to raise more funds from some of the poorest and sickest people in the community—those least able to afford the changes that the government is putting forward.

This bill increases the Pharmaceutical Benefits Scheme co-payment for general patients by $5, which is an enormous slug. On its own, $5 does not sound like a lot. But when you add it to all of the other costs for people who are the most vulnerable and need to use our world-class, world-standard PBS then it is a lot of money. This government wants to slug general patients an extra $5 to take it to $42.70 and concession holders an extra 80c to take it to $6.90 from 1 January next year. It also wants to increase the concessional PBS safety net threshold by two prescriptions per year and the general safety net threshold by 10 per cent each year for four years from 2015 to 2018. These additions are in addition to the usual increases of CPI indexation. If you take that all as a package, this is the damage that this bill will do.

How do you quantify what damage it will do to people's hip pocket and the family budget when they are sitting down and trying to work out whether they can get some medicines or not? People actually make economic decisions on the health, and they should not. We have, and should have, a very strong, sustainable, fair system in Australia, whether it is the Medicare system put in place by Labor or the Pharmaceutical Benefits Scheme—again, put in place by Labor and strengthened by Labor, not weakened. What impact will this have? This bill is expected to raise over $1.3 billion over four years. That $1.3 billion comes out of sick people's pockets. This is the point to be made. This is where the money is coming from. The government wants to raise $1.3 billion but where is it getting this money? It claims that there is a budget emergency, which I will deal with as well. It is getting that $1.3 billion out of the pockets of sick people, often the people who are least able to afford that extra expense.

The government could come in and say, 'That is the case, and we are going to justify what we are doing. There is a budget emergency and that money will go towards fixing the budget.' We hear every day this cover of a budget emergency. As long as they say 'budget emergency', they can do anything they like. So you would expect that the $1.3 billion would go a long way towards fixing this fictional and ghostlike so-called budget emergency that they have constructed. But guess what? It does not. It does not go towards that—not one dollar. The $1.3 billion does not go to any budget measure. In fact, it goes off to a medical research future fund. Noble as that may be, and nice as it may be in the future, why should the sick people of today be funding a medical research fund into the future. If the government wants to establish a medical research fund, that is good. It is a noble cause. But it should do it not out of the pockets of the sick.

Labor will be opposing this $1.3 billion new increase in medicines, which will hurt every Australian. We will be opposing it because it is a new tax, yet another broken promise. We heard ad nauseam the three-word slogan 'No new taxes' and a whole range of other things such as that in government Tony Abbott will keep his promises—I am trying to find one he has kept. This is a government that says one thing before an election and does another thing after the election. People were not expecting and were not told, and I think they really are shocked by this broken promise of a new $1.3 billion tax slug for their medicines on top of all the other extra costs, on top of all the other things this government is doing. So we will be opposing this very unfair measure that hurts Australians.

The Council of Australian Governments' Reform Council report that was released in early June found that 8.5 per cent of people in 2012-13 delayed or did not fill in their prescriptions due to cost. In disadvantaged areas this figure is even higher, at 12.4 per cent, and for Indigenous people it is as high as 36.5 per cent. These numbers are too high for people who need every assistance to be able to afford their medicines, often very much essential medicines. In fact, in 2005, the last time a Liberal government increased the tax on prescriptions for some essential medicines, the usage fell by 11 per cent. There is the rub. That is what this is about. This government is not only increasing the cost, ripping $1.3 billion out of people's family budgets, but also sending out a very strong price signal to the sick, which is, 'We are going to make it more expensive and more difficult for you to access medicines.' In some cases they are essential medicines. The government knows that some people will delay or defer their purchase of those medicines or not purchase them at all. That is simply just wrong.

We have a good strong PBS system in this country that, despite what the government tells people, is sustainable and is working in accordance with what it should be doing, which is keeping Australians healthy, able to continue to work and be productive in our economy, and able to continue to live good lives. If this really were about the sustainability of the health system, then the revenue would simply be going back to the health system, or back to the budget, or doing something a bit more than just a lofty ideal about a medical research endowment fund into the future, which will not deliver for many years to come.

I am sad to say this, because it should never be the case when it comes to health, but it is very clear from the changes being put forward that this is part of any ideological campaign to get rid of Australia's universal healthcare system and create a two-tiered user-pays system. You might think that that is an outrageous claim. How could that be possible? I think the Liberal government is long and loud on the record about its views on Medicare, the PBS and having a universal healthcare system. It is long on the record about wanting to kill it, get rid of it, stab it in the belly—just cut it and rip it away. But they learnt a lesson a little while ago. The Australian people do not support them on that view. The Australian people actually do not think it is a good idea. Australians actually like and enjoy our system. They think we have one of the best pharmaceutical benefits schemes and Medicare systems in the world, where, regardless of who you are, your status in life, your income or where you are, you get access to the best possible medical care you can get, and you get it at an affordable price.

It is not as if it is free. The government says that people cannot expect anything for free. It is not free. Let's get this absolutely clear: every Australian pays for our Medicare system and our Pharmaceutical Benefits Scheme. We all pay. We pay through our Medicare levy, some of us pay a Medicare levy surcharge, and some of us pay for full private health cover as well. It is not free at all. Australians already pay. What we are saying is that they should not have to pay more. There already is enough in the system. If the argument from the government is simply one about not being able to afford it, they are just wrong, because we can, and it is sustainable. The long-term trajectory of the Pharmaceutical Benefits Scheme is one that is sustainable.

This, unfortunately and sadly, is just a deep ideological view that the Liberal Party has on how health care should be provided—who pays for it and how they pay for it. It is much more akin to the often criticised United States medical health system and the problems associated with that, where often people do not get any care at all because they simply cannot afford it, or are forced to sell their home to get medical care. We do not want that in Australia. We do not want to be like the United States or other countries in the world when it comes to provision of good-quality medicines or health care.

We should look to the future and look to strengthen what we have in place—the Pharmaceutical Benefits Scheme, the Medicare system, proper training for our doctors, working closer and closer with the hospital system through the states and territories, and looking at better cooperation and efficiency. These are all the things Labor did when it was in government. It is not easy to do. It is not expected to be fixed overnight or even in a matter of a few short years. It requires a long-term plan and the right intent and motivation, which is to strengthen the system, to cooperate with the states and territories and to find answers to the complex problems of administration and costs within our health system. There is a way forward. This government has taken a very different approach. This Liberal government has learnt its lesson in only one aspect: that it cannot openly and honestly tell the Australian people what it wants to do to either the PBS or Medicare. It has changed its language but it just has not changed its ideology. It has changed the approach but has not changed its motivation. It has changed what it tells people about what it does, but it has not changed what its intentions are and how it will do it.

The evidence is here in this bill, which disproportionately targets sick, the elderly and the vulnerable. We already know through evidence that this will mean that fewer people, some of whom will need essential medicines, may not get their medicines because of the increased costs. We hear all sorts of excuses from those on the Liberal and Nationals side, who say, 'Labor had put in place a co-contribution payment and that if they did it it is okay if we do it.' The reality is that you have to go back a long way and look at the reasoning and the rationale for it being done and the proper context in which it was done at the time and accepted by the Australian people. We did it in a proper manner and in a manageable way, which meant we continued to have a sustainable and affordable health system. What is being proposed here today and, sadly, what will pass the lower house at least, is retrograde.

Those listening to this debate might think that this is just a Labor member speaking, but some of Australia's most senior doctors have been very loud about this. They have already warned that the changes in Tony Abbott's budget will put Australia's health system back by 50 years. That is what doctors think. Doctors are not happy with this. You would think that if you deferred your views and asked for advice, you would at least listen to what some of Australia's most senior doctors and practitioners have to say. They say that this sets back Australia's health system by 50 years.

The price increase comes off the back of cuts. You are copping it in the neck on the left and the right; you are copping it in the neck twice. There are $80 billion in cuts to Australia's public hospitals, doctor visits and schools. There are great big new taxes on everything. There is a new petrol tax. I do not recall that being a highlighted policy principle before the election. There are cuts to preventive health, to dental health, to Australia's health workforce. Again, you might think it is just Labor that is not happy with this, but I can assure you that the Liberal states have been very loud in their protestations against this. They are saying: 'How can you cut $80 billion out of state health systems and hospitals and not expect to have some sort of adverse impact?' That money will have to come from other places. The states will not be able to afford this. If the federal government cuts away $80 billion over the coming years from the states' hospital systems and schools, the states will have to either provide fewer services or do something else—raise more taxes. The reality is that there will definitely be fewer services because of those unfair, cruel cuts.

This is another cruel ideological policy motivated by all the wrong reasons. The $1.3 billion raised through this slug on ordinary people does not go to fixing any fictional budget emergency. If it did that we could say that at least it is going into the budget. Those opposite would have something they could hang their hat on and say, 'We're doing it for this reason. We know it's tough. We know it's cruel'—which they admit; they know it is tough and cruel. But it does not actually do anything. They are blown out of the water by their cruelty to Australian families, the sick and the elderly. And the money raised does not go anywhere near fixing this fictional budget emergency that we supposedly have. I think this is a really bad bill, really bad policy, from a cruel government, and it should not be supported in the House. (Time expired)

See this speech in context