Richard Di Natale (Victoria, Australian Greens) Share this | Hansard source

Before I go to the details of the issue of the GP co-payment, I want to refer to the matter of public importance, which is:

The impact of the Abbott Government's GP tax and medicine price hike on pensioners, the poor and the chronically ill.

I want to say something about that. The members of the coalition would be surprised to hear that I do not think this is a GP tax. I do not think it has any of the hallmarks of a tax. I think it is quite clearly a co-payment. It takes us closer to a user-pays system. In fact, I have deliberately avoided using the word 'tax'—and let me tell you why.

When this issue first came up, we considered calling this a GP tax and I resisted it. I resisted it because, every time we run around in this place and use the word 'tax' in this sort of context, we undermine those effective, fair and efficient taxes that allow us to fund universal health care, insurance, income support, education and so on. Taxation is the price you pay for a civilised society. I am, for one, someone who supports progressive taxation and who supports a taxation on resource consumption. I think taxes can be a good thing if collected wisely and spent wisely. That is why I think it is a mistake to refer to this as a GP tax. This is a co-payment that works in precisely the opposite way in which a fair health system should work.

A fair health system should be based on the principle of fair taxation—the more you earn, the more you pay—and, at the point of delivery, the point of access of the service, everybody should get access to that service. That is the way taxes should work. Senator Seselja is right: health care is not free. It is not free under the current system. If you are a high income earner, you pay more into the system. You pay more into our health care system, and you should be entitled to access it. So this is not a tax; this takes us away from that important principle and moves us closer to a user-pays system in health care, which is both expensive and unfair. You only need to look at the US to see that in action.

What underpins this co-payment is the notion that our health care system is unsustainable. It is simply not borne out by the evidence. We have had inquiries into out-of-pocket health care costs. We have had inquiries into the PBS co-payment. We have had inquiries into the move from private health insurers into the health space in primary care. We have heard the same story over and over again: we have a good health system, it is sustainable, and by world standards people get access to one of the best health care systems in the world.

Let us look at some of those facts. We spend about nine per cent of our GDP on health care. By OECD standards, that is below the average. It is below the OECD average. Health care spending at a Commonwealth level has been stable for more than a decade. I say that again: health care spending by the Commonwealth has been stable as a proportion of GDP for more than a decade. We are on track to have a very small increase in our health care spend over the next 10 years.

The government would have you believe that that is due to health care costs spiralling out of control. Not at all. The small increase—maybe a half to another per cent of GDP on health care over the next decade, taking us to the OECD average—is because people are getting access to new, life-saving treatment. Health care technologies continue to develop all the time and we are in the enviable situation where we are providing people with the means to live longer, healthier and more productive lives. That is not a crisis. That is something to celebrate. If the whole proposition we all believe in, which is that we should strive for economic growth and development, is not going to provide the dividend of better health care, then what the hell are we doing in its place?

When you ask people time and time and time again what they want their governments to be spending money on—