Cassandra Fernando (Holt, Australian Labor Party) Share this | Hansard source

Access to health care lies at the very foundation of the Australian Labor Party. It is not an optional extra. It's not a privilege reserved for those who can afford it. It is a right and it has been a defining mission of Labor governments for generations. It was the great Ben Chifley government that, in 1946, put forward a referendum to give the federal parliament the power to legislate for sickness and hospital benefits. That referendum led to what we now know as section 51(xxiiiA) of the Constitution, empowering the Commonwealth on 'the provision of maternity allowances; widows pensions; child endowment; unemployment, pharmaceutical, sickness and hospital benefits; medical and dental services, but not so as to authorise any form of civil conscription; benefits to students; and family allowances'. It was another Labor government, under Prime Minister Gough Whitlam, that established Medicare in 1974. It was the first truly universal health insurance scheme in this country. And it was a Labor government, under Prime Minister Bob Hawke, that delivered Medicare in 1984. The system remains one of the proudest achievements of modern Australia.

Medicare is more than a program; it is an expression of our national character. It says that, in Australia, your access to a doctor depends on your Medicare card, not on your credit card. Access to health care was a central pillar of Labor's re-election campaign because we know that cost-of-living pressures are real and that healthcare affordability is at the centre of those pressures. That's why, when we were re-elected, Labor committed to restoring bulk-billing for GP visits, investing over $8.5 billion so that all Australians can see a GP for free. That is the largest investment in Medicare in its history. But we know that restoring bulk-billing is only part of the solution.

Throughout my first term in this parliament, I heard from countless families across my electorate about the very real difficulties they face accessing health care. I have sat with young parents who are working two or three jobs and still struggling to cover medical fees. I have spoken with older residents who delay scans or follow-up appointments because they simply cannot afford the out-of-pocket cost. I have met with families who told me about the heartbreaking decisions they are forced to make each week—whether to put food on the table, pay the mortgage or see a medical specialist. This is not an Australian promise. Many residents have raised concerns about exorbitant specialist fees even after being referred by their GP. These fees are often in the hundreds or even thousands of dollars per visit. They are rising year after year. For many families in rapidly growing outer suburbs and communities like mine, this is simply unsustainable.

Our government is committed to fixing this, and this is why we are now turning our attention to specialist fees. This bill represents the first step in that process. This bill will increase transparency by allowing the Department of Health, Disability and Ageing to publish medical practitioner fees and out-of-pocket expenses on the government's Medical Cost Finder website. The department already holds significant amounts of this information through Medicare, hospital and insurer billing data. Once passed, this legislation will enable the department to publish that information without requiring provider consent, ensuring that patients have access to clear, accurate and up-to-date data, because transparency matters.

In a report by Private Healthcare Australia, titled Restoring affordable access to specialist care in Australia, it was found that one in two patients did not know their fee before attending an appointment. Nearly 30 per cent of Australians have delayed or cancelled specialist care because of cost. This is a situation that cannot stand. Health care delayed is often health care denied. When people put off appointments, conditions get worse. What might have been a manageable issue can turn into something far more serious and far more expensive for both families and the healthcare system.

This issue is worse in outer suburbs where people are making those difficult decisions between paying the mortgage or going to a specialist appointment. Specialist fees can vary significantly between suburbs, between providers and between hospitals, sometimes with no clear explanation for patients. By uploading specialist fees online for all providers, we are allowing consumers to check fees before they attend a specialist appointment, empowering them to make informed choices. Patients will be able to compare costs for their health care and shop around for the best prices, just as they would for groceries, household services or any other everyday expenses.

The report by Private Healthcare Australia further showed that patients are now paying a median of $270 for specialist in-hospital care. Outside of hospitals, some patients are being asked to pay up to a thousand dollars for an appointment with a specialist doctor. Rachel David, from Private Healthcare Australia, stated, regarding the reforms:

Private Healthcare Australia has welcomed the Federal Government's legislation to upgrade the Medical Costs Finder website, saying it is a critical step toward tackling Australia's growing specialist fee crisis.

Catholic Health Australia director of health policy, Katharine Bassett, said making the data publicly available 'is critical, as out-of-pocket costs for specialist care are rising and becoming increasingly unpredictable for patients'.

We know that greater transparency increases competition, and competition, in turn, places downward pressure on excessive pricing. This reform is about restoring balance in a system where patients often feel powerless. Let me be clear. This is not the end of the conversation. The Minister for Health and Disability, Mark Butler, has indicated that the Albanese government is considering how far it can go, and it will test constitutional boundaries that have long constrained government regulation of specialist fees because, to every Australian out there, this is a government that has heard your struggle, and this is a government that has your back.

There is a second and equally important element of this bill, one that goes directly to fairness for the nearly half of Australians who hold private health insurance. Around half of all Australians choose to take out private health insurance, often at significant expense to their household budgets. In Holt, 68,700 people are covered by private health insurance, meaning 35.4 per cent of all people are covered by private health insurance plans. For many families in communities such as Cranbourne, Clyde and Hampton Park, those premiums are not small change. There are hundreds of dollars a month paid in good faith, with the expectation of certainty and value.

Each year, private health insurers must apply to the Commonwealth government for approval to increase their premiums. Those applications are carefully scrutinised. They are assessed against the financial sustainability of the sector and the impact on policyholders. Often insurers seek increases that are well above the CPI, and the government's process exists for a reason: to protect consumers. But some companies have sought to get around that safeguard. In cases where the government has limited or rejected proposed premium increases, some funds have engaged in a practice known as phoenixing. Product phoenixing occurs when an insurer closes an existing insurance product, often one whose price rise has been restricted, only to launch a nearly identical product days later at a much higher premium—same coverage, same target market, different name, higher price. It is underhanded, it is sneaky and it undermines the very regulatory framework designed to protect Australian families. In a year when private health insurers have collectively made over $2 billion in after-tax profits, and when families are grappling with mortgage stress, grocery bills and rising energy costs, this behaviour is not acceptable. Private health insurance is not a luxury item marketed to the highest bidder. It is a core part of Australia's health system. When companies exploit loopholes to push through excessive price increases, they erode public trust not just in their own brand but in the system as a whole.

This bill will close that loophole. It will outlaw the practice of product phoenixing, ensuring that insurers cannot bypass government oversight by gaming the system with technical restructures and product relaunches. If a premium increase is not approved, insurers will not be able to simply repackage the product and impose it anyway. This reform strengthens consumer protection, and it sends a clear message: transparency and fairness are not optional in Australia's health system. Labor believes that, whether you rely solely on Medicare or choose to take out private cover, you deserve honesty, accountability and respect. This bill delivers exactly that. By increasing transparency in pricing and expanding consumer protections, we are making sure the healthcare system continues to work for all Australians.

I know there is much more work to be done. I know that Labor is the only party that will deliver real reform that delivers for families in communities like mine in the outer suburbs. Labor has always been the party of Medicare. We created it, we have defended it and we will strengthen it—because access to health care is not just a policy; it is about dignity. It is about ensuring that no parent has to choose between their child's health and the weekly grocery bill. It is about ensuring that no pensioner skips a specialist appointment out of fear of the unknown invoice. It is about ensuring that every Australian, regardless of income, background or postcode, can access the care they need. That is the Labor tradition. That is the responsibility we carry. That is exactly what this legislation seeks to advance. I thank the Minister for Health and Ageing, the Hon. Mark Butler, for his work on this bill and for his continued work on ensuring our healthcare system is accessible for every Australian. I commend this bill to the House.

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