Chris Bowen (McMahon, Australian Labor Party, Shadow Minister for Health) Share this | Link to this | Hansard source

I don't propose to detain the House for very long because there is not much to detain the House about; this is a very straightforward bill. This Health Insurance Amendment (Administration) Bill 2020 makes some improvements in administrative processes and improvements to Medicare. The bill's main provision is to remove the annual requirement to remake the Medicare Benefits Schedule. The passage of the Legislation Act 2003 made this process redundant, because up-to-date compilations of all legislative instruments are now placed on the Federal Register of Legislation. The government assures us these minor changes will not impact on Medicare patients or providers; they relate solely to government processes. So this bill is uncontroversial and it will receive the support of this side of the House.

It does say something about the government's reform agenda, particularly in the health portfolio, that this is the 'urgent' piece of legislation. While it does fix an anomaly, this is an anomaly which has existed since 2003. The Howard, Rudd, Gillard, Abbott, Turnbull and Morrison governments have lived with it until now. This is a government so bereft of agenda that it brings forward this sort of legislation as its health agenda. There is nothing about record out-of-pocket costs, which are the highest they have ever been; waiting lists, the highest they have ever been; nothing about the private health insurance crisis, no reform agenda there—the minister keeps talking about a second wave but we have yet to see it—and there was some tinkering in the budget; that's it. The health system in Australia needs serious reform. Whether it is the social determinants of health or whether it is an increased emphasis on prevention, whatever it shall be, there is a case for big reform in the health system. Instead, we get from the government this sort of administrative tinkering, which we will facilitate through the House.

Katie Allen (Higgins, Liberal Party) Share this | Link to this | Hansard source

I actually disagree with the member opposite's comments about major reform required for our health system, because we have just been through quite an incredible COVID crisis. If you look around the world, who is doing the best? Australia. Why is that? It is because WE have one of the best healthcare systems in the world. I would say as an Australian that all Australians should be very, very proud of our healthcare system. To the average punter, the Medical Benefits Schedule, otherwise known to most of us in the medical system as the MBS, would appear to be a boring administrative instrument. However, as someone who really cares about health, I would say that there is nothing further from the truth. The recent COVID-19 pandemic has taught us that it is anything but a boring administrative instrument. Indeed, the MBS is a key component of our broader Medicare system. This Health Insurance Amendment (Administration) Bill 2020 brings the law into line with practice and reduces the unnecessary administrative work in the MBS. That's good news for patients and it's good news for practitioners.

I would like to take the opportunity to reaffirm the Morrison government's commitment to Medicare and to the health of Australians more broadly. It is a fact that is rock solid. The total cost of all Medicare services in 2018-19 was $24 billion. This is not a small piece of legislation, a small piece of policy; this is a centrepiece of the Morrison government. There has been an increase of 3.5 per cent in benefits paid from the previous year—most important for those who may be struggling to pay their healthcare costs

In the US, where I have many colleagues, I know personally of people who struggle to even get a test for COVID because of the inordinately high cost of things like COVID testing, which is up to a thousand dollars in the private healthcare system in the US. While here in Australia, we have an ability to access low-cost health care. GP bulk-billing rates, which are a centrepiece of that low-coast healthcare system under Medicare, hit a record high of 86.2 per cent for the full year of 2018-19. Patients made some 136 million bulk-billed GP visits. That's up more than three million on the previous financial year. So Australians are enthusiastically supporting bulk-billing. The bulk-billing rate for total Medicare services reached 79 per cent for 2018-19, up 0.2 per cent compared to the previous year and up to 2.7 per cent from 76 per cent in 2012-13.

The benefits for patients are clear. Australians accessed 335 million bulk-billed services, including GP, specialist, pathology and diagnostic imaging services, in 2018-19. That is up 8.9 million more than the record set last year. The great thing is Australians are getting bang for their buck, medically speaking. When it comes to healthcare, we know that the Australian healthcare expenditure-to-GDP ratio is amongst the best in the world. As a middle-order power with an outstanding healthcare system, our healthcare expenditure to GDP was 9.6 per cent. This is lower than the UK, which is 9. 7 per cent; Canada, which is 10.6 per cent; and the US, which is a whopping 17.2 per cent.

I have worked in the UK and the US system and I know Australia takes a back seat to no-one with regards to health care and public health care. We know that. The government knows that. And, most importantly, the Australian taxpayer knows that. These figures show that Medicare is supporting the health and wellbeing of Australians more than ever before. This has only been possible through the Morrison government's continuing and increasing investment in Medicare. The MBS is central to our Medicare system. It lists a range of professional services and allocates a unique item number to each service, along with a description of the service. In broad terms, the types of services on the MBS include consultation, diagnostics, therapeutics and procedural services. It could be said that the MBS is analogous to the Pharmaceutical Benefits Scheme, which lists the medicines available to be dispensed to patients at government subsidised prices. However, this list is for health services rather than medicines. On 1 July this year the government increased the patient rebate for further GP items on the MBS, specialist procedures, allied health services and other GP services, such as mental health and after-hours services, which were all indexed.

I would like to take the opportunity to talk about a very important aspect of the MBS, and that is telehealth. The MBS has been a vehicle for the rapid expansion of telehealth services during the COVID-19 pandemic, and this has been a lifeline to patients. Importantly, it's kept our practitioners off the front line. This was important particularly when we were dealing with a crisis and shortage of PPE equipment—masks and gowns—across Australia and across the world. The telehealth item number was incredibly important for specialists, GPs and allied health practitioners. Many practitioners from right around the country contacted me to say, 'We are concerned about our ability to provide services to our patients through COVID.' You can imagine their absolute delight over the increase in the use of telehealth.

Early during the crisis the Morrison government undertook an expansion of telehealth services that would have otherwise taken 10 years. As the Minister for Health, Greg Hunt, has said, it was achieved in just 10 days. This helped to reduce the risk of community transmission of COVID-19. It was a very important new MBS item number. During this period Australians took up this new service with exceptional alacrity: 110,000 telehealth consultations were provided by GP, specialist and allied health professionals, as well as a whopping 1.1 million phone consultations. The uptake of this COVID temporary telehealth item was most pronounced for GPs, with 7.5 per cent of GP visits provided by telephone or telehealth in March. We also doubled the bulk-billing incentives to support these critical services because of the health crisis that has been COVID.

History shows that, in a time of crisis, innovation flourishes, and the expansion of telehealth is indeed indicative of this. I hope to see these services becoming a legacy piece of the COVID-19 pandemic. In fact, the Minister for Health has committed to funding them now and into the future. With these sorts of reforms, we've responded to the crisis using innovation, swiftly and in a meaningful way, for the taxpayers of Australia—and they have told us that that is what they want. Instead of having to travel for hundreds of kilometres to seek medical care, patients can now pick up the phone. Instead of having to sit through hours of traffic congestion or take time off work, patients can access their GP or specialist more easily, with higher productivity.

What does this all add up to? Medicare is the jewel in the crown of our healthcare system. We must protect it and always be striving to improve it. That is exactly what this bill today does. Its primary purpose is to remove the annual sunset period for the regulations that prescribe the table of medical diagnostic imaging and pathology services covered by the MBS. These regulations provide the legal basis for the $26 billion in Medicare benefits paid each year. So this is no small thing that needs to be assessed. The current imposition of the sunset clause means that regulation pertaining to the MBS currently need to be remade every year. This is not very practical.

The benefit of the change that is being put forward in this bill is twofold. First, it reduces the onerous and complex administrative work involved in annually remaking the regulations pertaining to MBS items. Secondly, it mitigates the risk that an error during the remake process could affect patient entitlements to benefits under Medicare. Cutting this red tape means Australians have clarity and certainty of items listed on the MBS.

The bill also makes changes to several small but redundant provisions in the act which are no longer required. This includes removing references to the establishment and operation of the Medicare Benefits Advisory Committee, which has been inactive for more than 20 years and has been replaced by the MBS review committee. It removes calculations relating to Medicare benefits which are no longer used. It also removes references to historical requirements for optometrists, which were removed in 2016 to reflect modern administrative arrangements. It removes section 18, which formerly dealt with the repayment of Medicare benefits where a person receives compensation or damages for an injury that incurs medical expenses. Finally, it removes the now defunct section 10C, which required the minister to establish an independent review of the extended Medicare safety net benefit capping arrangements.

In conclusion, ensuring Australians have access to Medicare services that are effective and appropriate for patients now and into the future is a key priority of this government. I'm proud to be a part of a government that guarantees patient entitlements under Medicare whilst cutting red tape and ensuring that the law is in line with modern practices. This can only be a good thing for health outcomes. This bill builds on the Morrison government's commitment to supporting the health and wellbeing of all Australians. We should be proud to be Australians. We should be proud of how we have addressed the COVID crisis together. You should be proud of a Morrison government that is committed to the health and wellbeing of all Australians.

Luke Howarth (Petrie, Liberal Party, Assistant Minister for Community Housing, Homelessness and Community Services) Share this | Link to this | Hansard source

It's great to rise and speak on the Health Insurance Amendment (Administration) Bill 2020. I want to thank the member for McMahon and the member for Higgins for speaking on this bill. As the member for Higgins just said, the Morrison government invested some $24 billion last year in health. We've seen, during this COVID period, bulk-billing increase and telehealth also increase. I want to take this opportunity to thank all the frontline workers, GPs and specialists and all health professionals in my own electorate of Petrie for the great job they do, day in, day out.

The bill amends the Health Insurance Act 1973 to make minor changes to Australian government administrative processes relating to Medicare. These changes do not affect the existing arrangements for patients or health professionals. The bill removes the annual sunset period for the regulations which prescribe the table of medical, diagnostic imaging and pathology services covered by the Medicare Benefits Schedule. And, in relation to diagnostic imaging, I know that, in my own electorate of Petrie, we're about to install an MRI machine at the Redcliffe Hospital that is publicly funded by the federal government. We announced this over two years ago and are just waiting for the state government to build the room, which they'll do soon.

This bill removes the requirement for the Medicare regulations to be remade each year so patients can continue to be eligible to receive benefits through Medicare. This change will reduce unnecessary administrative work and mitigate the risk that an error during the remake process could affect patients' entitlements to benefits under Medicare. The bill also removes a number of provisions in the Health Insurance Act 1973 which are no longer required as they do not reflect current administrative practices. This includes removing references to the establishment and operation of the inactive Medicare Benefits Advisory Committee, removing calculations relating to Medicare benefits which are no longer used, and removing references to historical requirements for optometrists, to reflect modern administrative arrangements.

I commend the bill to the House.

Question agreed to.

Bill read a second time.