Brian Mitchell (Lyons, Australian Labor Party) Share this | Hansard source

I rise today to support the Treasury Laws Amendment (Medicare Levy and Medicare Levy Surcharge) Bill 2017. It makes a refreshing change to be able to debate a bill by this government that involves Medicare without the bill including a cut of some sort—and no, that is not an invitation for an amendment. This bill modifies the income threshold by which the Medicare levy and the Medicare levy surcharge kick in to keep pace with the cost of living. With the vast majority of workers in my electorate earning wages well below the national average, any measure that keeps money in my constituents' pockets is fine with me.

I am pleased to say that Labor has a strong record when it comes to improving the health of Australians. Labor's Gough Whitlam introduced Medibank, but the Liberals' Malcolm Fraser killed it. Labor's Bob Hawke introduced Medicare; the Liberals' Andrew Peacock and John Howard tried to kill that but failed. But Mr Howard did wound Medicare, with one of his first acts upon his election of '96 being to axe dental care from Medicare—a great shame for the dental health of this country. But, on ending Medicare itself, the Liberals did seem to give up. One day they just stopped going to elections pledging to kill it.

But what they really did was play doggo. They waited until Medicare stopped being an election issue, until all Australians believed Medicare was safe, irrespective of who was in government, and then they struck. In 2014, having gone to the previous year's election promising no cuts to health, those opposite went to town on Medicare. They sought to introduce a $7 GP fee on top of already-widening gaps between the Medicare schedule and doctor's bills, and they hacked away at hospitals. When doctors, nurses, Labor and patients yelled, 'Stop! Your cuts are killing Medicare,' those opposite yelled, 'No, we're making it stronger.' 'There's never been a better friend of Medicare,' they cried maniacally as they drilled holes into its roots and poured in the poison. Well, with friends like those opposite, Medicare does not need enemies.

In Tasmania between July 2016 and March 2017, bulk-billing fell by 2.2 per cent—more than three times the national average. Tasmanians' out-of-pocket costs to visit a GP have risen by $5.90 per appointment since December 2014, up from $30.79 out of pocket to $36.74 out of pocket for each visit. So it will come as no surprise that I do not really believe this government when it says it has no plans to get rid of Medicare. I keep looking for that crossed pinky finger, because history tells us that by whatever means possible this government will do what it can to dismantle Medicare and all it stands for. And if it cannot dismantle Medicare in one go, it will chop and hack and saw away, bit by bit, until it achieves the same aim.

And we will be there to defend it. We will not let our guard down again, because Labor understands that Medicare is more than a logo; it is an ideal, a statement of Australian values. Medicare has come to be shorthand for Australia's universal health system, the ideal of which is simple: to provide quality health care to any Australian who needs it irrespective of their wealth or where they live in Australia. But we are failing the ideal. A properly functioning universal health system requires the proper resourcing of preventive health programs, primary health care, hospitals and more. But health care is getting more expensive, and increasingly the quality and timeliness of treatment depends on the capacity to pay for it.

When we have people on waiting lists that are so long that they died before getting the treatment they needed, we must admit that we are not just failing but have failed. Stories of men dying of bowel cancer that was caught too late because they could not see a public specialist in time are becoming too common. Stories of women who require surgery to save their sight being told that Medicare will pay $700 of their fee but that the gap payment is $2,000, none of it claimable on private health insurance, are unacceptable. It is my great hope that when Labor is next afforded the privilege of governing this nation the full repair and restoration of the principles and practices of our universal health system will form a major element of our policy suite.

So yes, this indexation relief, however minor in the grand scheme of things, is welcomed. But let's not forget that this bill is part of a regular process. It is not a generous gesture on the part of the government. It is something that happens whoever occupies the benches opposite. The process of regularly reviewing income levels and indexing them to protect the most vulnerable Australians is a lasting testament to the framework that Labor put in place when Bob Hawke created Medicare in 1984. It is a framework that is being undermined by this government, and nowhere is that more obvious than in Tasmania.

My state has been left off the map by this government when it comes to securing long-term health outcomes. Last year, for example, we suffered a diabolical failure of government with the botched switch of federal funding from preventive health programs to chronic care across Tasmania's regions, particularly in my electorate. The rollout was so bad that even Tasmanian Liberal senators, who are usually notorious for their silence, were lining up to complain. Well supported community based programs were axed, replaced with programs to address chronic care needs, such as diabetes. While I have little doubt that chronic care needs deserve attention, it beggars belief that well supported community programs were axed to make way for them. Less than two per cent of the federal health budget goes towards preventive health—and when we know that every dollar spent on preventing ill health pays massive dividends down the line. Keep one person out of hospital, keep one older Australian out of care for another year of their life, and the minuscule investment required now more than pays for itself. So when I see that this government is prepared to flush away $65 billion in its big corporate tax cashback but is not prepared to invest in community preventive health, I shake my head.

It has been six months since the changeover in my regions, and it has hardly been a painless process. Good people have lost their jobs, and people in the community are reporting gaps in services. We are hearing reports of people who used to enjoy social engagement being increasingly isolated. They do not suffer chronic illness, so they now stay home alone instead of being picked up for an activity. Perhaps they will get some attention when they end up getting sick. Others are reporting long travel times to see a health worker or long waiting times, and people are falling through the cracks. It is fair to say that any changeover will be accompanied by some painful adjustment, but let's remember that it is people who are already vulnerable who are experiencing the pain. And let's not forget that these new regional health contracts are, in the main, for a short period of time. Some expire in as little as 18 months. Are these communities expected to suffer this upheaval all over again? It is just not good enough.

I have not even started on Tasmania's public hospital crisis. Yes, the state Liberal government must carry the can for the crisis engulfing Tasmania's hospital system, but the Turnbull government's lack of coherent leadership has been disappointing to say the least. Waiting lists are out of control, ambulances are ramped for hours, and sick patients are being sent home because the hospitals are over capacity, and we are not even in peak flu season. The long lines in emergency departments have undoubtedly lengthened as the Medicare rebate freeze continues into its fifth year, when it was only ever meant to have lasted less than one. Extending it for so many years has ensured that bulk-billing is almost impossible to find across my electorate, despite the lower than average incomes. Doctors have their books shut, and people are avoiding seeing doctors because they just cannot afford it. Even doctors who try to hold out on charging anything above the bulk-billing rate have had to introduce fees this year as their own cost of living increases under state and federal Liberal governments. Every day the freeze remains is a day that the cost of a visit to the GP increases. The government has announced that the freeze will be lifted in three years time, but that is too long to wait. Every day it remains is a day when a visit to the doctor costs more.

I am pleased to report that my Labor colleagues in the Tasmanian parliament are fighting the good fight for Tasmanians by putting strong plans on the table to address these concerns. The state Labor leader, Rebecca White, has rightly identified health as the No. 1 issue of concern to most Tasmanians. Tasmanians are tired of the underinvestment, the efficiency and the ideology. They just want a health system that works, and that really should not be too much to ask for.

It is fair to say that this government's treatment of Medicare reflects its treatment of the Australian value of fairness more generally. Under this government, when you earn $55,000 a year you pay $275 more tax by way of an increase in the Medicare levy, but when you earn $1 million a year you pay $16,000 less tax. That is not fair. Under Labor's fairer tax policy alternative 80 per cent of Australians are protected from a tax increase and the budget is still $4.5 billion better off over the next decade. It says everything about the priorities of Prime Minister Turnbull, a former merchant banker, that he is so determined to give a tax cut to his millionaire friends while increasing taxes for the vast majority of Australian workers. It says everything about the priorities of Prime Minister Turnbull, a former merchant banker, that he is so determined to give a $65 billion handout to banks and corporations while doing nothing to stop wages being cut for millions of Australian workers, many of them already on low incomes and most of them women.

Alternatively, a Labor government will protect 10 million working Australians from paying more tax. Labor's plan is fairer. The Medicare levy will go up for those earning above $87,000 and the deficit levy will be kept for those earning more than $180,000 a year, including everyone in this chamber. It makes no sense that the Liberals introduced a deficit levy when the deficit was lower, and they are removing it now that the deficit under them has tripled. Labor's proposal will raise $4.5 billion more than the government's tax changes will raise, and it will be fairer.

The government claims that the Medicare levy needs to go up across the board to pay for the National Disability Insurance Scheme. It goes without saying that Labor is fully committed to the rollout and delivery of the National Disability Insurance Scheme. Labor created the NDIS, and we bitterly regret the way this important national initiative has been politicised by this government. The Prime Minister's misuse of people with disability and their loved ones, including in this House today, as political human shields has frankly been in nauseating. Let's be clear: the government is not raising the Medicare levy on working Australians to pay for the NDIS, as it so often claims. The government is raising the Medicare levy on working Australians to pay for its $65 billion tax cut to corporations and banks. If the government abandoned its $65 billion handout it would have more than enough to fill what it claims is a gap in NDIS funding. There is no need for a tax rise on most working Australians when you have a $65 billion bucket of money sitting there that you are going to hand out to corporations and banks. It really says something about this government that it would rather tax working Australians more than abandon a corporate giveaway to pay for what it claims is a funding hole to address the needs of Australians with disabilities.

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