Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

Seven months ago, when the government first introduced the Fairer Private Health Insurance Incentives Bill 2009 [No. 2] and cognate bills, I told the parliament that with these bills Australians knew for certain that they had a government that they could not trust, a government that would say one thing and do another, a government that was a fraud. The bills were a direct repudiation of firm commitments the now Prime Minister and the Minister for Health and Ageing gave to the Australian people time and time again that they would not change the rebates regime for the 11 million Australians who take responsibility for their own healthcare needs by taking out private health insurance and thereby relieving pressure on the public healthcare system in this country. No matter how the Prime Minister, the Treasurer or the health minister try to spin it, the effect of these bills, this new tax on private health insurance, is to break a promise the three of them made to the Australian people.

There are no ifs, buts or maybes about what this government committed to before the last election. It promised not to change the existing arrangements for private health insurance rebates introduced by the Howard government. The coalition opposed these bills then and they oppose them now. Nothing has changed in that regard. The bills remain a clear breach of promise on the part of this government, a breach it now tries to cloak as a major reform in health. What has changed, though, is the confirmation of those sentiments of seven months ago in the intervening period by the actions of the Prime Minister and the health minister in relation to this matter. The most spectacular attempt to justify the imposition of this new tax, this means test on health insurance rebates, came from the Prime Minister just days ago. If ever confirmation was needed that he is someone who will say anything, with little regard to fact, to further his political ends, then it came last Sunday with the Prime Minister’s interview on the Nine Network with Laurie Oakes. To try to justify the broken promise that these bills represent, the Prime Minister drew on the latest—but as of then unpublished—Intergenerational report, he told Laurie Oakes:

What the Intergenerational report tomorrow will reveal for the first time is that the cumulative impact of knocking that major reform back is in the order of one hundred billion dollars over the next several decades.

That was an amazing claim, though perhaps what you would expect from this Prime Minister, who plucks figures out of the air to back up his arguments.

As everyone knows, the Intergenerational report was released publicly on Monday and the hunt began for the mythical $100 billion figure. Guess what? It was not there. No-one could find it. Nowhere in the 164 pages of the 2010 Intergenerational report did that figure exist. You have been caught out, Prime Minister. The Prime Minister later changed his story to say the figure was in the underpinning data—a qualification, of course, that he did not make to Laurie Oakes when he looked Laurie Oakes in the eye. This was barefaced misleading of not just Laurie Oakes but also the Australian people, and the Prime Minister should stand condemned for it. The simple fact is that this Prime Minister misled the Australian people in relation to private health insurance. This is a great big new tax on those 11 million Australians with private health insurance because it is going to drive up private health insurance premiums. This Prime Minister should come clean and he should apologise.

But that is just part of the deception that is going on here, a matter I will turn to in just a moment. But before I do—before we leave the Prime Minister’s mythical $100 billion—let us recount some other figures surrounding this broken promise. When the Minister for Health and Ageing, Ms Roxon, initially introduced the bills in the earlier part of last year, she told the parliament they would provide savings of $1.9 billion over four years. It was a figure the minister and the government repeated in the parliament and in the media. By late in the year, the Prime Minister, a serial offender in the field of exaggeration, was putting another figure out there. On September 10, when questioned about the government’s changes to the private health insurance rebates on the ABC’s 7:30 Report, the Prime Minister said:

… in the case of that one measure, PHI, that you mentioned, that’s worth some $9 billion in the decade ahead.

Now we are at $100 billion—$100 billion that was not in the report the Prime Minister cited. This is yet another exaggeration about savings over some several decades.

Let me turn to the other aspect of the prime ministerial ruse: that the savings from the rebate means test, this new tax, will be directed at additional investments in health. It is a ruse that the health minister has also tried to perpetuate—although, as usual, she is all over the shop. In two years as minister, Ms Roxon has lurched from one disaster to another, and this is just the latest example. In August last year, the minister told the CEDA Health Reform Forum in Sydney:

… that the private health changes alone save enough to fund the Commission’s—

she is referring to the National Health and Hospitals Reform Commission—

proposed e-health investments.

Three months later and the minister is quoted in the Age as saying:

This measure is part of the Government’s reform of the health system, will save about $1.9 billion over the next four years, and allow the Government to invest more in better services, new medicines and improved technology.

This $1.9 billion over four years has become the magic pot and used for a number of purposes. But it does not stop there; there is actually a different story here and it is this. When the Treasurer foreshadowed these bills in his last budget, he made it clear exactly where any savings from these measures would go. He said they were:

… to support the longer term sustainability of our pension system …

That is, not to support health generally, as the Prime Minister says, nor e-health, as the health minister said in August, nor better services and new medicines, as the minister said in November—and who knows what the minister might say this month! No, at that stage, according to the Treasurer, the savings were to fund the pension system changes.

Given the Prime Minister’s comments on Sunday, the Treasurer was asked to clarify the situation on Monday. This was put to him by Malcolm Farr at the National Press Club on Monday of this week. Malcolm Farr said:

In your Budget speech you put the means testing of the private health insurance rebate under the heading of pension sustainability. You listed it as one of the structural changes that you wanted made so that Australia could keep affording to pay pensions to the growing pension receiving group. Over the last month or so, that money, those savings have suddenly been switched to paying for health.

This is where the government’s deception was exposed yet again. The Treasurer gave his answer:

It’s true that the private health insurance means testing that we put in there along with a number of other measures we had in the Budget, offset the cost of the pension increase, right out, right out past the forward estimates and well into the future

The coalition backs additional support for pensioners. We have made that very clear and we have advocated alternative savings measures to offset any impact to the budget arising from rejection of these proposals. The government has point blank rejected these sensible alternatives, which shows that this is more about ideology than good policy.

The changes the government wants to make to the health insurance rebates have nothing to do with investments in health. They do have everything to do with an entirely different budgetary and ideological agenda. Yet the Prime Minister and the health minister have no hesitation in misleading the Australian people and saying on one day that the savings are for one thing and then the next day saying that they are for another thing and plucking figures out of the air to claim savings of $2 billion, $10 billion or $100 billion depending on which day you listen to them. They should stop this subterfuge and admit that what they propose in these bills is simply bad public policy.

If these measures are passed, there is no doubt that they would, firstly, put further pressure on public hospitals—the complete opposite of what Labor promised at the last election and what this Prime Minister most insincerely has banged on about over the last two years. Secondly, they would increase the cost of private health insurance for millions of Australians, including those on lower incomes. What the Labor Party does not understand is that there is a pool of people who have private health insurance. If you take out some of those people, if you force out some of those people—particularly younger ones—and they leave that pool, it makes the insurance more expensive for those who remain. So by driving people out of private health insurance, particularly the younger people, and leaving the burden to older Australians—in particular, the millions of people who have private health insurance who are on incomes of $26,000 a year or less—you are going to drive up the premiums. But it does not stop there. Families who have private health insurance will, under Kevin Rudd’s proposed new tax on private health, face higher premiums. Families in Australia will face higher premiums as a result of these changes. The fact is that the government agrees that those outcomes will result.

The government have stated that a total of 40,000 people will drop private health cover as a result of these measures. Again, these figures from the government are all over the shop. It is hard to pin them down, because they change their position regularly. According to the government, that figure of 40,000 is made up of the following: 25,000 people who are expected to drop their hospital and general treatment cover; 10,000 people who have hospital and general treatment cover and who are expected to keep their hospital cover and drop their general treatment cover; and 5,000 people who have general treatment cover and will drop that cover. Catholic Health Australia commissioned research by Access Economics which showed that the number of people who will quit private health insurance could be significantly higher. So all Australians will pay a price for these proposed changes if they are passed. Those who have insurance will pay more through higher premiums.

These bills introduce three new tiers to the health insurance rebates. As a direct result of the changes in these bills, the cost of private health insurance will increase for millions of Australians by between 14.3 per cent and 66.7 per cent. These are people who earn above $75,000 as singles or $150,000 as couples. All of the 11 million privately insured Australians will be faced with increases in private health insurance premiums, and it is something that is not able to be counted by those opposite. Those who opt to have no insurance will pay more through the Medicare levy. Those who rely on public health treatment can expect longer waiting lists with more people seeking treatment. As people drop out of private health insurance they will be joining public hospital queues. That is an unquestionable fact.

What does this mean for our health system? It will increase the patients, treatments and costs on the public side of the ledger. The Prime Minister said, whilst all of this was happening, that he was going to fix public hospitals. The private health sector estimates that, over a year, this ‘fix’ could transfer almost 75,000 extra treatment episodes from the private sector to the public sector, meaning that public hospitals would have to accommodate an extra 190,000 bed days per year at a cost of some $200 million. This is a transfer to the states and territories, who operate Australia’s public hospitals, of $200 million—a shameful act by this government that is in direct contravention to what they said they would do, which was to relieve pressure on public hospitals. They are doing the complete opposite.

Four million allied health services would no longer be covered by private health insurance. That is another outcome of this failed health policy of the Rudd government, and it comes at a cost of over $200 million. Almost two million dental treatments, for which private health insurance would have paid almost $100 million, would also no longer be covered. So there is no argument about whether there will be more pressure on the public health system; it is about how much additional pressure will flow from these ill-conceived measures.

Under the Hawke and Keating governments, the last Labor governments that left this nation mired in debt, the number of people with private health insurance fell to just 30 per cent of the population. The previous coalition government reversed that fall, through rebates and a series of other measures, to a situation where around 45 per cent of Australians were covered by private health insurance. If that were to change, the consequences would be grave. Our public hospitals have already been stretched to breaking point by the mismanagement of successive state Labor governments, and there are no better examples than Queensland and New South Wales. The corruption and the failed public policies that exist in both of those administrations are something for which they should be condemned at the next state elections. For more than a decade, a succession of Labor premiers in New South Wales, from Carr to Keneally, have been promising to fix health. With every promise, the situation in health only gets worse under Labor. In Queensland, from Beattie to Bligh, they not only promised to fix hospitals but, at one point, they declared them fixed—only for the data to show the complete opposite.

One thing we know about Labor in this country is that you cannot trust them when it comes to health. We are talking about the administration of a multibillion dollar sector, and Labor do not have the capacity to manage money and they do not have the capacity to manage the health system. The worry for all of us is that Kevin Rudd is starting to look like those premiers, promising to fix health at every election but sitting on his hands in the intervening periods. After all, the Prime Minister learned his tricks first hand when he was the chief bureaucrat in Queensland under the Goss Labor government, which began widespread hospital closures and the removal of more than 2,200 hospital beds. Many people in Queensland say that that was when the rot in Queensland health started; that was the start of the demise of a once great and successful health system that is now on its knees. That is how the Prime Minister fixed hospitals in Queensland, where the health bureaucracy has ballooned—filling its ranks with spin doctors rather than real doctors and its hospitals with desks rather than beds. That is a formula that the Prime Minister now seems intent on repeating at a federal level.

The Prime Minister was the decision maker in a state system where he is now laying the blame. He is now repeating the process federally, hiring bureaucrats to review, discuss, study and monitor all of those problems in the health system. Whilst he is doing all of that he is not fixing a single thing in hospitals. Of course, this follows this Prime Minister’s grand success of Fuelwatch and GroceryWatch. I am guessing that we are not far away from seeing the Prime Minister unveil a new ‘hospital watch’ website with a suitably-sized army of bureaucrats rather than doctors and nurses in our hospitals. Imagine just how much worse things would have been over the last decade if there had been a federal Labor government driving people out of private health insurance, putting additional pressure onto the public hospitals. That is exactly where the Rudd government is headed now.

This is not the government’s first attack on private health and—I make this prediction with great certainty—it will not be the last. Australians should remember that the Rudd government do not have a mandate to pursue the measures proposed in these bills. They specifically told voters that they would not make changes to the health insurance rebates. The matter was extensively canvassed before the last election. In a speech to the annual conference of the Australian Health Insurance Association in 2007, prior to the election, the now Minister for Health and Ageing said:

This is why we have committed to the current system of private health insurance incentives—including the package of rebates, the Lifetime Health Cover and the surcharge. Labor understands that people with private health insurance—now around 9 million Australians—have factored the rebate into their budgets and we won’t take this support away.

How disingenuous! When the coalition questioned the sincerity of Labor’s commitment, the now minister accused us of being dishonest, firing off a media release which said:

Federal Labor rejects the Liberal scare campaign around the Private Health Insurance rebates.

              …              …              …

The Liberals continue to try to scare people into thinking Labor will take away the rebates.

This is absolutely untrue.

The Howard Government will do anything and say anything to get elected.

It is easy to see who was dishonest now, and the Australian people are seeing that every day with this Prime Minister. Who would doubt that this Prime Minister and this health minister would do anything or say anything to get elected? It was not just the minister who pledged not to make changes—so too did the Prime Minister. In a letter to the Australian Health Insurance Association dated 20 November 2007, only days out from the federal election, opposition leader Kevin Rudd, as he then was, wrote:

Both my Shadow Minister for Health, Nicola Roxon, and I have made clear on many occasions this year that Federal Labor is committed to retaining the existing private health insurance rebates, including the 30 per cent general rebate and the 35 and 40 per cent rebates for older Australians.

Labor has been absolutely and continually dishonest on this issue throughout. As late as February last year the government was maintaining the falsehood that it had no intention of launching this attack on private health. Asked by the media whether the government intended to scrap the rebates, the minister responded with these words, and people should take note of these words:

The Government is firmly committed to retaining the existing private health insurance rebates.

Yet during Senate estimates it was revealed that, whilst Minister Roxon was giving that public assurance behind closed doors, she and other senior members of the government were seeking advice on how to progress changes to those private health insurance rebates. They were ‘firmly committed’ to retaining the existing rebates in public, whilst secretly working on plans to reduce and to scrap them. We now know Minister Roxon first obtained advice from her department on 12 January 2009. Advice on how to change the rebate had been sought by the health minister’s office as early as December 2008. Treasury provided advice on means testing the rebate on 20 February 2009 at the request of the Treasurer, the Department of Finance and Deregulation provided advice on the same measure on 22 February and the Prime Minister’s department did so on 23 February.

They say one thing and they do another—a hallmark of the Rudd government. How could anyone believe the Rudd government when they say or make commitments on private health insurance—or anything else, for that matter? Remember that it was the government that told us public hospitals were broken, would need fixing and would be fixed by mid last year. If Australians ever needed more evidence that they cannot believe the Prime Minister, that deadline to fix public hospitals, which came and went without making one iota of difference, delivered it. The Prime Minister must explain how this deadline went unmet. After all the other big promises he made, was there any other promise that was more significant than his promise to fix public hospitals? Over and over he said that he had a plan to fix hospitals. It is 2010, Prime Minister, if you had not noticed, and Australians are yet to see your plan. What they have seen over the course of the two years since the government were elected is a continual deterioration in our public hospitals. Things have not improved as Labor promised.

It is clear that public hospitals are not a health issue for the Prime Minister; they are an electioneering issue. The Prime Minister wants to recycle the same old rhetoric and promises for the next election. He is not interested in taking on his state Labor colleagues. According to the AMA and their public hospital report card in 2009, Australia’s public hospital system continues to deteriorate and waiting times for elective surgery have been getting longer. Major metropolitan teaching hospitals typically operate at an average occupancy rate above 95 per cent. Eighty-five per cent is considered a safe performance benchmark. Only 60 per cent of emergency department patients classified as urgent were seen within the recommended 30 minutes. In November 2008, as part of a COAG agreement, the Prime Minister stated that the government’s funding could support additional hospital beds. The AMA found:

To date, there is no evidence to show that these new beds have been opened.

In response to the government’s so-called ‘blitz’ on waiting lists and the minister’s assertion that it had delivered 41,000 additional elective surgery procedures in 2008, the AMA concluded that:

The “blitz” did not occur in the first half of 2008 … waiting times are still increasing and waiting lists are still too long.

We continue to see the reality of those AMA report card findings on a daily basis as the media detail the horror stories that people experience in a stressed system, particularly in rural parts of our country, and it is unacceptable. The continuing attack by this government on private health insurance—this new tax represented by these bills—will result in people moving from their private health cover into the public system, creating yet more stress and strife. It is an ideologically driven attack with little thought for the consequences.

A striking example of that was another budget measure that the health minister pursued with unbridled zeal: the decision to savagely slash Medicare rebates for cataract surgery. This directly affected privately insured patients trying to seek treatment in the private system. Most of those patients were pensioners and self-funded retirees, people on tight budgets who could not afford the extra costs this minister was intent on imposing on them. With absolutely no concern for these people—patients—Ms Roxon was determined to press ahead, despite the coalition, all crossbench senators, doctors and seniors and pensioners groups warning her of the harm she would inflict.

At various times the minister attempted to obfuscate the issue by introducing a new higher rebate for a smaller number of patients; resorted to scare tactics, claiming the rebate would drop to zero; fuelled media reports about doctors’ incomes and then blamed them as greedy doctors and the reason rebate cuts were necessary; and refused to produce any evidence to back her claim that technology had made cataract surgery quick and easy. In some media reports she even attempted to compare the cost of cataract surgery here to that in Third World countries, as if there were some sort of a comparison to be drawn with Australia’s health system and the provision of that very important surgery by professionals in the 21st century.

As some people, mostly the elderly, were forced to postpone their treatment and others were slugged with hundreds of dollars in additional expenses, the Minister for Health and Ageing was eventually forced into talks with the ophthalmologists, who carry out cataract surgery, and the result was a humiliating backdown by this minister. Medicare rebates would no longer be slashed by 50 per cent, instead a more modest 12 per cent decrease would apply. One wonders why it took eight months for the minister to see common sense.

This government talks loud and long about preventative health measures. If ever there were one, it is cataract surgery. It is a life-changing surgery particularly for older Australians who will suffer blindness without the surgery and give up driving their cars. They will lose their independence and they are more likely to suffer a fall if their eyesight deteriorates, bringing additional cost and burden onto the public hospital system when those people need to be treated for hip replacements or other surgery. It is shameful, this pursuit that the minister has embarked upon over the course of the last months.

Those people who have paid additional money between the time that the minister first announced this rebate change up until the effective change announced by the minister only a week or so ago should contact their Labor members of parliament and complain long and loud about the fact that they had to pay to facilitate the involvement of the Prime Minister and the health minister in some sort of a political trickery game with the Senate which ultimately resulted in some people not having cataract surgery done and some services, particularly in rural areas, actually closing. This was in addition to that out-of-pocket additional expense that people suffered. It is a pity that the government is so blind to the impact of measures contained in these bills and the way in which they will impact on the health system if they become law.

I want to say to the Australian people today that if you have words of doubt in your mind about who Kevin Rudd is and whether or not he is actually the genuine product then look at this new tax on private health insurance. Look at what the Prime Minister has done or has not done in relation to health over the course of the last two years. This Prime Minister said in 2007—and the Australian people will remember this—that he had a plan to fix public hospitals. The Prime Minister said in 2007 that he had the ability to deliver a plan which would see Australia’s hospitals fixed by mid-2009. I say to the Australian people we are now in February 2010 and the Prime Minister still refuses even to release the plan let alone enact it or achieve the outcome that he promised to you. To the Australian people, who I think now are starting to get just a question mark in their minds about whether or not Kevin Rudd is a genuine product, I say to look no further than the issue of health.

Know that Kevin Rudd is spinning to you the same words that you have heard Bob Carr and Peter Beattie spin to you and that you have heard all of those failed state Labor health ministers spin to you over a decade. The Prime Minister has no greater capacity to deliver better health outcomes than those Labor premiers did. This is like Groundhog Day when you hear the Prime Minister making the same commitment over and over, delivering the same speech saying that he has a plan to fix public hospitals and to fix the health system when he does not. This Prime Minister will run up to the next election saying that he needs a mandate to take over public hospitals or to implement a plan, whatever his plan will be. He will say that he needs the imprimatur of the Australian people to deliver that change, but the Australian people should not believe him because that is exactly the same promise Kevin Rudd made in 2007.

This great big new tax that is being imposed on the private health insurance model right across the country is going to put more pressure on the public system because people are going to move out of private health insurance, join the waiting lists and join the emergency department waiting queues at two and three o’clock in the morning when mums and dads are waiting for a doctor or nurse to see their sick child. That is not what Kevin Rudd promised at the last election. Kevin Rudd promised the opposite and it is why today the Prime Minister should not be believed when it comes to health. When people look at Kevin Rudd, they should see another failed Labor premier because this is exactly the same formula of bluff and trickery that Labor at a state level have pulled on the Australian people over the course of the last 10 years. I say to the Australian people, we will completely oppose these bills because we do not want the same trickery, the same deception and the same spin from this Prime Minister that we have seen from state Labor over the last 10 years.

Debate interrupted.