Wednesday, 12 May 2021
Health Insurance Amendment (Prescribed Fees) Bill 2021; Second Reading
The Morrison government always has a view to the future. Whenever there is an opportunity, no matter how small, to make an efficiency gain and improve the lives of hardworking everyday Australians, we take it. This legislation exemplifies this in a very small way. It removes a minor but impractical administrative measure that burdens medical practitioners and ultimately their patients. This is in line with the Morrison government's commitment to delivering an even better post-COVID-19 healthcare system. We should be ambitious for our healthcare system. That is why I served on the board of Cabrini hospital before coming to this place. The only hospital in Higgins, it is a not-for-profit Catholic-based private hospital. As I said in my first speech, our healthcare system is undoubtedly one of the best, if not the best, in the world. It is a unique and effective blend of public and private, where the private sector provides innovation and choice and the public sector provides a safety net for all.
This bill simplifies the administrative processes for recognition of specialist and consultant physicians for Medicare purposes under the Health Insurance Act 1973. I note the member for Macarthur in the chamber here today. I know he will welcome this small addition to the changes we're rolling out. It will remove the requirement to pay a $30 prescribed fee for specialist and consultant physicians for Medicare purposes. This benefits practitioners and also Services Australia, who are tasked with processing this fee. Ultimately, it helps patients.
Currently the pathway to be recognised as a specialist or consultant physician requires a medical practitioner to apply to Services Australia for access to higher Medicare rebates. This process requires a medical practitioner to pay a prescribed fee of $30 by a cheque or money order to have their application processed. The issue with this payment is that it is fundamentally outdated, an issue heightened by the COVID-19 pandemic. Movement restrictions and in-person services quotas meant that practitioners had trouble paying the fee, while Services Australia had trouble processing the fee. As a result, patients missed out on receiving higher Medicare rebates.
The cost of requiring a new modern system to take digital payments—and it is pretty hard to believe that we are talking about this in the 21st century—is far in excess of the $200,000 in revenue this payment generates over four years. Put simply, this is a prime example of red tape. It does not contribute significantly to government revenue, it doesn't help doctors and, with the COVID-19 pandemic, it is now unfairly hurting the hip pocket of patients. This bill corrects this issue. This small but important tweak is just one of the Morrison government's efforts to ensure a modern and efficient healthcare system post COVID-19.
The impact of COVID-19 means that we have been required to become more sophisticated and flexible in the use of technology and to think differently about how to solve problems that everyday Australians face. For the short term, we will have to continue to be agile and creative—and I welcome the fact that Australia has been very good at pivoting across many different aspects, including our healthcare sector. One of the great developments coming out of the COVID-19 pandemic, one of the great pivots of 2020, has been the rapid expansion of telehealth services. I welcome the comments from the member for Hindmarsh, but I have a point of difference with him about the rollout of telehealth services.
The uptake of new technology has been challenging for the best of us. However, as they so often do, our medical and healthcare practitioners have taken this in their stride. They should be congratulated for their adaptability and responsiveness. Due to the program's success in telehealth medicine, and in the interests of safety in protecting both our doctors and patients, this has now been extended to 30 June 2021. The government has consulted extensively with peak bodies and members of the medical and health profession to ensure the staged and proportionate integration of healthcare services.
Last year on 27 November the Minister for Health and Aged Care, Greg Hunt, flagged that telehealth in the long term will become a permanent addition to Australia's Medicare system. I look forward to this commitment being secured and I congratulate the Minister for Health and Aged Care, Greg Hunt, on the excellent work that he has done in initiating a very rapid rollout, in 10 weeks, of something that could have taken 10 years in a normal period of time to be rolled out. I understand that he is working very hard with the sector to make sure that the rollout goes smoothly and that it is sustainable in the long term. But certainly with 3.3 million video consultations and 41 million phone consultations provided last year it is clear patients and medical practitioners alike have taken up telehealth with enthusiasm.
While telehealth will never replace the more attentive and important care given in an in-person consultation, it fills a key gap in our health system. Whether you are travelling hundreds of kilometres, if not thousands of kilometres, across this wide continent to see your medical practitioner or in particular, your specialist, or whether you are sitting for hours in congested traffic in our major inner cities, telehealth provides an efficient and rapid way for patients to connect with doctors. We know this will improve the effectiveness. As a paediatrician, I know that parents sometimes have to take time off work in order to take their child to an appointment and to sit for hours in a medical practitioner's rooms—and, yes, I would say that I was responsible for some of that sitting as, even though you do try to be effective and efficient as a medical practitioner, sometimes the wait can be long. Telehealth provides the ability for people to be able to care for themselves and their families and to be able to do this in an efficient and effective way.
I do however think that it is important that we focus on telehealth utilising video technology. At the moment, telehealth is predominantly phone based, with 80 per cent of services being provided by phone. This is where my views differ from those of the member for Hindmarsh, in that I think that percentage should be 80 per cent videohealth. The reason for that is that we know many cues come from a video experience. By not allowing that to be the most important aspect of the telehealth services means that medical practitioners are potentially missing out on some important cues that they may receive via videoconference.
I do understand that older Australians may not be as technology savvy as some might believe, but I think that older Australians have been enthusiastic with their uptake of things like telehealth and that, once they have seen the light, so to speak, with regards to videohealth, they will enthusiastically embrace it. We need to make sure that this is transitioned carefully and that there is support to ensure that the videohealth links are secure and safe and that privacy is also maintained. But I do believe that these things can be addressed and certainly should be addressed.
Access to bulk-billed appointments via phone or video don't just benefit Australians in accessing their regular appointments in a pandemic but also help ensure that people, who perhaps have depression or are unwell, who do not wish to or cannot wish to leave their homes—particularly in cold winter months in Melbourne—are more likely to access health care. That is very important for early intervention and is very important for secondary prevention to prevent readmissions when people have been home from hospital. Too often Australians, particularly those living with chronic health disease or with disabilities, and especially those with fluctuating conditions, will face delays in accessing health care and that can potentially compound their conditions.
During COVID one of the reasons that telehealth facilities were rolled out was to protect health practitioners as well. It meant that, in that swift crisis that we all faced, we were able to ensure that, when we were facing difficulties with PPE and mask acquisition, we could keep our frontline workers as safe as possible. So the use of telehealth has had a myriad of uses throughout the COVID pandemic.
The use of telehealth is about protecting the most vulnerable members of our healthcare network. It is jointly about guaranteeing that vulnerable patients can receive continuity of care and advice. The expanded use of telehealth will undoubtedly be a positive legacy piece of the COVID-19 pandemic and one that all Australians should feel proud.
The government is also implementing the most significant reforms to private health insurance in over a decade, which is making private health insurance simpler and more affordable. From 1 April 2021 the government increased the maximum age of dependants for private health insurance policies from 24 to 31 years and removed the age limit for dependants with a disability. I cannot emphasise how important this will be to ensuring that young people maintain their private health cover, particularly if they've been part of their family's private health cover. This is part of the government's commitment to ensuring private health insurance is affordable and provides value for money for its consumers. This serves the additional purpose of encouraging young Australians to continue with private health insurance when they reach the age of 31—the age at which lifetime health cover commences.
My son is an example of this. He was on our family cover. He is a young man who has epilepsy. Unbeknownst to us he allowed his private health insurance to lapse. During that period of time he was trying to access a neurological appointment and took a long time to receive an appointment. In the meantime he was on the wrong dose of his antiepileptic medication. He suffered a seizure, a generalised convulsion, which can be quite dangerous. So because he allowed his PHI to lapse he actually put his own health and life at risk. I am delighted to say that he will now be able to be incorporated into our family health cover. And hopefully as a young man, who has only just commenced employment in the workforce, he may see the benefits of private health insurance going forward.
This gap between 24 and 31 years of age is often the time that young people are going out into the workforce. They have a lot of additional expenses. They are saving, hopefully, for their first home—as a member of Goldstein would be very pleased to hear—and they also have difficulties with job security. So PHI or private health insurance is often not their No. 1 expense. I think this extension is a very welcome extension. I think it will be a benefit, ensuring that people who wish or choose to invest in private health insurance will continue that coverage from their family coverage onwards.
The Morrison government has worked hard to ensure the vitality of our healthcare system before, during and now after the COVID-19 pandemic; although, I note we're still not out of the woods yet. This minor but worthwhile amendment to prescribed fees is a welcome change, which will abolish this administrative imposition on medical practitioners. This is great news for our healthcare system, its practitioners and ultimately for patients. I commend the bill to the House. Thank you.