Rachel Siewert (WA, Australian Greens) Share this | Hansard source

As I indicated during my speech in the second reading debate, the Greens have some concerns with the Health Insurance Amendment (Extended Medicare Safety Net) Bill 2009. We are particularly concerned with issues around out-of-pocket expenses. As I articulated during my speech in the second reading debate, those expenses are $15 billion a year. We have always had concerns around the Medicare safety net, believing it to be a blunt instrument. We are concerned that this extended Medicare safety net legislation will also be a blunt instrument trying to deal with out-of-pocket expenses. We acknowledge that, as Senator Cormann articulated, thanks to the combined pressure of the community and the parliamentary process, the government have moved to address issues around IVF, for example. However, this has not dealt with the overall fact that our medical expenses are escalating. We still have very significant out-of-pocket expenses.

I articulated the Greens’ position during the second reading debate, saying that we were also concerned about the impact of the changes on the cataract cap and acknowledging that that was an interaction between the changes to the scheduled fee and the cap process. We are particularly concerned that that area of this legislation is going to have an impact on a group of people who can least afford to pay out-of-pocket medical expenses. I appreciate the fact that the government is trying to fix up what is, quite frankly, a messy situation. It is going to result in there being a group of people who will bear the brunt. They will have to either doctor shop or, as I said earlier, negotiate the costs with their medical practitioner—when they will be in the worst possible position to do that. While we appreciate that the government is trying to deal with this issue, we do not necessarily think that this has been the best approach and we believe that this parliament—both the House of Representatives and the Senate—needs the ability to review the instruments before they take effect.

So I indicate that at this stage we are in favour of supporting Senator Cormann’s amendment, because we do have those very significant concerns. I have some specific questions I would like to ask the minister about the impact of certain measures, but I will leave that until we are discussing the specific amendments. The Greens, as I said, are more disposed to support this legislation now than we were previously, but that is conditional upon the amendments presently before the chamber being dealt with. We maintain our very significant concern that we need to see evidence from the government that they are dealing with other out-of-pocket expenses overall. This is not going to fix it. It is only a partial fix and we think it is a blunt partial fix. We want to hear from the government about what they are doing about the impact this is having on those people in the community who have not had their issues adequately dealt with by the government—for example, low-income families and the impact which the changes relating to cataracts will have on them. We also want an explanation from the government about what else they are doing to address the huge issue of out-of-pocket expenses, which we believe this legislation does not adequately address.