Tony Zappia (Makin, Australian Labor Party) Share this | Link to this | Hansard source

The Private Health Insurance Amendment (Income Thresholds) Bill 2021 continues the pause of the annual indexation of private health insurance income thresholds for another two years. The pause of annual indexation levels effectively lowers the real income thresholds at which private health insurance and the Medicare levy surcharge are applied. The net effect is that the government is collecting more money from the Medicare levy surcharge and rebating less for private health insurance. It is backdoor taxation that will raise $304 million over the next four years. It is a stealth tax from a government that preaches lower taxation.

The indexation freeze has now been in place since the coalition took office in 2013, costing Australians hundreds of millions of dollars over those years. And now the Morrison government wants to once again extend the freeze, for another two years. The shadow minister, in his contribution to this debate, highlighted the impact that will have on individual households. This is a government that, in opposition, actually argued against the introduction of income thresholds for the private health insurance rebates and the Medicare levy surcharge, claiming at the time that thresholds would cause a massive fall in people taking out private health insurance. So, at a time when private health insurance costs are straining household budgets, and private health insurance rates are actually falling, having dropped from 47.4 per cent in 2015 to 44.2 per cent at the end of the March quarter this year, the Morrison government wants to now take more money out of people's pockets.

Australia's public health system is already under stress, with public hospitals being overloaded by people who should be getting treatment in specialised mental health centres or being properly cared for in aged-care or medical rehabilitation facilities or even just going to their local GP clinic. Instead, they are presenting at public hospitals, because it is more affordable and more convenient to do so. Public hospitals are being overrun. Waiting times in emergency departments can be hours, putting lives at risk. Ambulance ramping has never been worse, with patients at times being kept in ambulances for hours and hours. At the same time, those ambulances are being tied up from attending other critical call-outs. The situation cannot continue like that. Patients are also being discharged from hospital earlier than they should be, in order to free up hospital beds—again, putting their health in jeopardy. Mental health services have reached crisis levels across the country. In my state of South Australia recently, some senior mental health doctors resigned from the public system in frustration—again, that cannot continue. We have new and effective medications in use overseas that are still not listed on the PBS here in Australia, and every year around a million prescriptions go unfilled because people simply cannot afford the cost.

One in four Australians do not get recommended dental treatment—again, because of cost. Unlike several other countries, Australia's public health system, Medicare, does not cover dental services, and the Morrison government has further reduced the limited amount of money that previously was going into dental care from the federal government. Nor does Australia have a national public vaccination injury compensation scheme, unlike the USA, which has had one for three decades—and I understand some 24 other countries have a similar scheme. Right now, in the midst of a COVID pandemic, when so many people are hesitant about taking up the COVID vaccine, a public injury compensation scheme would provide much-needed reassurance and would very likely increase the take-up of COVID vaccination.

The overlap between the federal and state governments in managing Australia's health system and the health services more broadly is failing our community. Cost shifting between both government levels is causing considerable inefficiencies, wastage and a lack of accountability, with governments blaming each other for the failures and refusing to accept responsibility when failures are, indeed, highlighted. We have seen that with aged-care funding, where the aged-care facilities will very quickly send patients to a public hospital rather than provide the medical service in-house. Again, that transfers the cost to the state. We have also seen it with public dental services, where both the state and federal government would provide some money but both blame each other for the inadequate amount of money being provided. We are seeing it with mental health services and, I have to say, in my own state, it has reached absolute crisis levels in recent times, to the point where the minister had to meet with many of the mental health professionals in order to come to some agreement about the way forward. And we have seen it with public hospital funding. Again, it's a case whereby, while people are going to the public hospitals, much of the cost is being picked up by the state and being transferred from the federal government to the states. Where possible, the states do the same and try to direct costs to the federal government wherever they can.

Right now, we are seeing it with the COVID pandemic. We have just had a matter of public importance debate on this very issue. We heard the debate not only about the lack of responsibility coming from this government but, equally, the constant blame game being passed from one level of government to the other and back again. It doesn't resolve the problems and it doesn't answer the questions that the public are asking each and every day. Whether it is to do with the hotel quarantine issues, whether it is to do with the vaccine rollout, and any other matter to do with COVID-19, the public don't want to hear about who is responsible; they simply want the issues resolved, and we're seeing that because we do not have a coordinated health system across this country.

The reality is, with COVID-19, we should be grateful that we haven't had the mass breakout that other countries have. Indeed, when I think about what the situation would be like had that happened, I shudder. Because, quite frankly, if, given the state of our public hospital system right now across the country, we had had a massive COVID-19 breakout, I doubt very much that we could have managed it. I have no doubt at all that the situation would have been absolutely chaotic. But what we see instead is the federal government—we saw it again today, particularly in respect to some of the comments about what is happening in Victoria—blaming the state governments for the problem, when the reality is that both the COVID vaccination rollout and the question of having proper places or facilities for people to go into when they come back from overseas, the quarantining system, fall fairly and squarely in the lap of the federal government. There is no denying that.

Quarantine and COVID vaccination rollout are responsibilities of the federal government. How they engage the states is their call. By all means, they should be working with the states. But the prime responsibility rests with the federal government, and we have seen failures. I will be the first to acknowledge that this is an issue that we have been confronted with for the first time in the last hundred years. I expect that problems might arise but there is no denying that things could have been done better. The government has been too slow to secure adequate supplies of the vaccine; indeed, we now here we might get some of the Moderna vaccine towards the end of this year. The government has been too slow to explore the actual manufacture of the mRNA vaccine here in Australia, has been too slow to put out an adequate public health awareness campaign with respect to the importance of the vaccine and, quite frankly, has been way too slow to get the medical professionals on board so that they can actually deliver the vaccine. In fact, many local GP clinics only came on board in very recent times and, even then, in very limited numbers.

Debate interrupted.