Graham Perrett (Moreton, Australian Labor Party) Share this | Hansard source

I rise to speak on the Health Insurance Amendment (Safety Net) Bill 2015. This bill is the result of the Abbott-Turnbull government's infamous 2014-15 budget. Who could forget it? Who could forget that budget? I remember the booklets being handed around in Moreton before the election—the Real Solutions booklet, with the photo of the coalition's frontbench; Malcolm Turnbull sitting in there smiling. That budget completely repudiated what was in the Real Solutions booklet, and the promises made by the leader of the coalition—surely the most blatant case of false advertising that anyone has seen.

Lionel Hutz would have more chance of arguing the false advertising case against the Abbott-Turnbull government than when he sued against the movie The NeverEnding Story. It is unbelievable—all the promises contained in the Real Solutions booklet were completely thrown out by the 2014 budget, and this piece of legislation is a direct result of it.

It is put forward by the government as a potential saving of $270 million. Of course, if there is a saving to the government it must also mean that there will be a cost to someone else. That is the reality of economics. We know with this government that the cost is always to be borne, sadly, by those in Australia, who are the most vulnerable, and this legislation before the chamber is no different.

Medicare is one of the great legacies of the late Gough Whitlam, and I particularly acknowledge him today, on the 40th anniversary of his dismissal by the Queen's representative Kerr. Medicare, introduced by the Whitlam Labor government in 1975, was originally called Medibank and was renamed Medicare when it was reintroduced by the Hawke Labor government in 1985. In the nine months after Medibank/Medicare was implemented on 1 July 1975, the staff increased from 20 to 3,500, and 81 offices were opened. Medicare today is accepted and loved by all, particularly on this side of the chamber, as Australia's universal healthcare scheme. It ensures that all Australians can access our world-class healthcare system.

The savings from this bill arise from changes to the Medicare safety net by the Abbott-Turnbull government. The Medicare safety net can be a confusing system to navigate, so I will just give a brief description by way of background. I want to preface this brief description by taking people back to a Four Corners interview on 6 September 2004 with the then health minister, a bloke called Tony Abbott. The interviewer, Ticky Fullerton, asked:

TICKY FULLERTON: Will this Government commit to keeping the Medicare-plus-safety-net as it is now in place after the election?

TONY ABBOTT: Yes.

TICKY FULLERTON: That's a cast-iron commitment?

TONY ABBOTT: Cast-iron commitment. Absolutely.

TICKY FULLERTON: 80 per cent of out-of-pocket expenses rebatable over $300, over $700?

Tony Abbott replied—and this should be underlined and put in bold:

TONY ABBOTT: That is an absolutely rock solid, iron-clad commitment.

That was the minister for health, as he then was, in the lead-up to the 2004 election, when the member for Adelaide was elected, on a tough day for Labor. Medicare was a big issue in that election campaign, but we saw the health minister make that rock-solid, ironclad commitment, and then—by March the next year, I think it was—he did a backflip. So he had form. We should have realised, when it came to the 2013 election, that the commitment that was made before the election was not going to be something that he would hold true to. And we saw that with the 2014 budget.

There are currently two safety nets in operation: the original safety net, which applies to all Medicare card holders; and the extended safety net, which has two limbs, one applying to concession card holders and families eligible for family tax benefit part A, which has a lower threshold than the second limb, which applies generally to all Medicare card holders. The two safety nets operate quite differently. Under the original safety net, once the threshold of $440.80 has been met, the patient would receive 100 per cent of the schedule fee for out-of-hospital services. Under the extended safety net, once the threshold of either $638.40 for the concessional threshold or $2,000 for all other Medicare card holders is met, then 80 per cent of out-of-pocket costs will be covered. At present, all out-of-pocket costs for out-of-hospital Medicare services contribute to the safety net threshold. I repeat: at the moment, all out-of-pocket costs contribute.

Under this cruel bill, the out-of-pocket costs that contribute to the threshold will be capped at 150 per cent of the MBS schedule fee. On first inspection, this bill appears to be the patient's friend. But the devil is in the detail. It does decrease the safety net threshold and, ordinarily, that would create savings for the patient, but, because this bill also places restrictions on the out-of-pocket costs that contribute to the patient reaching the safety net, this makes the task of reaching the threshold more difficult for the patient. These changes will have a huge impact on thousands of patients in Moreton—from Chelmer to Kuraby, from Fairfield to Oxley, from Annerley to Willawong and every suburb in between. Sadly, the amount that patients receive back from Medicare after they reach the safety net will also be reduced.

The Australian Medical Association, not exactly a left-wing organisation, are very well placed to comment on the effects of this bill and how it will impact on their patients, and they have criticised these cruel Turnbull changes. Professor Owler, the President of the AMA, has said:

The new Medicare Safety Net arrangements, together with the ongoing freeze of Medicare patient rebates, mean that growing out-of-pocket costs will become a reality for all Australian families, including the most vulnerable patients in our community.

Professor Frank Jones, the President of the Royal Australian College of General Practitioners, another organisation that has direct connections with the implications of this bill, said:

… coupled with the indexation freeze, the legislation will actually increase the cost of care to vulnerable groups. Safety net thresholds will increase by CPI annually while rebates are frozen.

Both of those organisations—the College of GPs and the AMA—have noted how this bill will impact particularly on the most vulnerable. It is revisiting the tactics of the 2014 budget.

This bill will particularly impact upon radiation oncology patients: cancer patients who are undergoing radiation treatment—surely people at a most difficult time in their lives. Those patients have more than enough to deal with without being exposed to more out-of-pocket expenses. By way of example: a patient with a malignant melanoma—which is sadly a reality in Queensland—who is receiving stereotactic radiation treatment could face further out-of-pocket expenses of $7,400. A patient with prostate cancer undergoing volumetric modulated arc therapy treatment could face further out-of-pocket expenses of $8,000. A patient with breast cancer undergoing radiation therapy through a private provider could face a 200 per cent increase in out-of-pocket expenses. These are not incidental amounts that these patients will be faced with. Patients will be slugged with these extra costs at the very worst possible time in their lives, normally also while they are unable to attend work. The last thing these patients need is further stress, wondering how they are going to pay for the treatment that they hope will keep them alive.

Another sector of the community that will be impacted by this bill is patients undergoing IVF. Australia has been at the forefront of IVF research since the 1970s. It has brought joy to many, many households across Australia. The first IVF birth in Australia was in June 1980. It was only the third IVF birth to occur anywhere in the world. I think it was in Adelaide actually, from memory. I would have to check.

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