Ms Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health and Medicare) Share this | Hansard source

The Health Legislation Amendment (Improved Medicare Compliance and Other Measures) Bill 2018 is a bill about improved Medicare compliance. Labor is, of course, the party of Medicare. We invented it and we will always protect it. It is our universal public health insurance scheme. It is the heart and soul of our healthcare system and the envy of many other countries around the world. It ensures that Australians can access lifesaving treatment when they need it, without worry. More than 20 million services under Medicare are billed every year. They include GP visits, vital tests and scans and hospital treatments. It is without a doubt the most important program the Commonwealth government delivers. It's fundamental, not just to our healthcare system but to our economy and to our society. That's not to say it is perfect. With a program of this size, there are always problems and always improvements that can be made. Labor is always up for sensible improvements to Medicare.

This government bill implements a 2017 budget measure to improve Medicare Benefits Schedule compliance and debt-recovery practices and will result in an estimated combined savings over the forward estimates of $103 million. That money should, of course, be reinvested straight back into Medicare in a transparent way rather than returned to the budget bottom line, but that is an issue I will return to later. This bill amends three acts: the Health Insurance Act 1973, the Dental Benefits Act 2008 and the National Health Act 1953. These technical changes will hopefully enable improved compliance by better targeting unusual business billing and improving the consistency of administrative arrangements.

I do want to say, at the outset, that the vast majority of medical and allied health professionals that bill Medicare for services to their patients do absolutely the right thing, and provide amazing and excellent service throughout our entire community. But we also know that there are increasingly commercial interests at play in some areas, so compliance is something that we have to improve. Only 40 per cent of Medicare debts are currently recovered, meaning there is over $50 million in outstanding debt. So, obviously, there is a need for action in this space.

The changes in this bill clarify that the Professional Services Review, which investigates Medicare and PBS compliance concerns, has jurisdiction over corporate medical practices that contract health providers, as well as practices that employ providers and the providers themselves. The bill introduces compulsory offsetting and garnishee provisions for providers who do not voluntarily agree to repayment plans within 90 days. At present, these providers are still able to claim full Medicare benefits, even when they owe significant debts. Where a compliance debt is issued, both the employer and the contracted provider will be responsible for part of the debt, reflecting their shared responsibility for accurate billing.

This bill also makes record-keeping requirements consistent across different health professions. In particular, allied health providers will be required to keep copies of referrals for two years, just like doctors; pharmacists will be required to produce prescriptions to justify queried claims; and dentists and pharmacists will face the same administrative penalties on unpaid debts as other Medicare providers. I understand that further detail will be set out in the regulations, and that the new arrangements will start on 1 July 2019. But for now, I can say that Labor will be supporting this bill.

Like I said, we are always willing to support sensible improvements to Medicare. But we don't support the government's overall approach when it comes to Medicare, and I'll be moving a second reading amendment to that effect. It took two Labor governments more than two decades to shape and embed the Medicare that we know today. Many Australians take Medicare for granted, and that is as it should be. They should be able to rely on Medicare whenever they need it, without worry and without a second thought. But let's never forget that the conservatives opposed Medicare every single step of the way. Labor had a hard fight to set it up and now we continue to have a hard fight to protect it.

You cannot trust this government when it comes to Medicare. They talk about a 'rock solid' commitment to it, but we all know the truth: they deeply, deeply don't like it. They want to dismantle it. They just don't believe in universal health care like the Labor Party does. They dream of an Americanised health system where it is every man, woman and child for themselves—where people increasingly have to rely on private means to access health care. Every step of the way and every measure, that is what they have been doing. This is where people suffer for years because they cannot afford to see a doctor or go to hospital.

Every time the conservatives get into power they attempt to dismantle Medicare, either up-front or, more lately, by stealth. That is what they do. We have a system in this country now where, increasingly, you have to rely on your private means to access health care. That is what this government has delivered to the health care of this nation.

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