Senate debates

Thursday, 16 October 2008

Tax Laws Amendment (Medicare Levy Surcharge Thresholds) Bill (No. 2) 2008

In Committee

Consideration resumed.

Photo of Carol BrownCarol Brown (Tasmania, Australian Labor Party) Share this | | Hansard source

The committee is considering the Tax Laws Amendment (Medicare Levy Surcharge Thresholds) Bill (No. 2) 2008 and amendments (1) to (6) on sheet 5625 moved by Senator Siewert and Senator Xenophon. The question is that the amendments be agreed to.

1:04 pm

Photo of Mathias CormannMathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | | Hansard source

I asked a couple questions of the minister before—

Photo of Stephen ConroyStephen Conroy (Victoria, Australian Labor Party, Deputy Leader of the Government in the Senate) Share this | | Hansard source

Can you run through them again, please? You were only halfway through them when we started talking over you.

1:05 pm

Photo of Mathias CormannMathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | | Hansard source

Okay. Before we were interrupted to deal with non-controversial legislation, the minister advised me that the expected saving for the government as a result of not having to pay the private health insurance rebate to people whom the government expects to leave private health insurance is $740,600,000. The expected loss of revenue is $360 million. I want to place on record what this means. The $740.6 million is only the 30 per cent rebate. This means that the government is happy to see $2.5 billion walk out of our health system, because that is exactly the amount of money that those people would otherwise have contributed to private health insurance. They will be taking that money with them.

My very specific question to the minister, which has not been answered yet, is: what increases in private health insurance premiums does the government expect as a result of this revised measure? Yesterday, on ABC radio, the Minister for Health and Ageing told listeners that increases in premiums as a result of this measure were inevitable. So, firstly, please tell me what the government’s expectation is in terms of increases in premiums. Secondly, according to the government’s own figures, $2.5 billion will walk out of the health system as a result of this measure. In light of that fact, what is the government’s intention in terms of compensating the states and territories for this impact?

1:06 pm

Photo of Stephen ConroyStephen Conroy (Victoria, Australian Labor Party, Deputy Leader of the Government in the Senate) Share this | | Hansard source

In answer to your question around premiums, it is up to insurance companies to provide an attractive, affordable product. If they do that then people will continue to buy it. It is also ultimately up to the Commonwealth to approve premium rises, and the health minister has made it clear that she will not accept private health insurance funds using this measure as an excuse to whack working families with huge hikes. The government’s view is that the health funds will compete strongly with each other and will continue to drive down costs and that this will minimise premium increases.

I know you have stood up a few times recently, Senator Cormann, claiming you have been misrepresented, but I suspect you have seriously verballed the minister, so I do not accept what you have put forward.

Photo of Brett MasonBrett Mason (Queensland, Liberal Party, Shadow Parliamentary Secretary for Education) Share this | | Hansard source

Senator Mason interjecting

Photo of Stephen ConroyStephen Conroy (Victoria, Australian Labor Party, Deputy Leader of the Government in the Senate) Share this | | Hansard source

Senator Mason has joined us in the chamber and wants to interject and join in. He is the man who has spent his entire political life fighting international socialism, only to be merged with them.

Photo of Brett MasonBrett Mason (Queensland, Liberal Party, Shadow Parliamentary Secretary for Education) Share this | | Hansard source

Very unfair, Stephen!

Photo of Stephen ConroyStephen Conroy (Victoria, Australian Labor Party, Deputy Leader of the Government in the Senate) Share this | | Hansard source

Unfair but true. You have spent your entire life fighting those international socialists and agrarian socialists, only to find that you are in bed with them. Health Minister Roxon and the government have been talking to the Greens, Senator Xenophon and of course Senator Fielding, and all have been willing to take a constructive approach on this issue. We have come to an agreement which will deliver immediate tax cuts to 250,000 Australians and to more Australians in the years after that. For two people, each on an average income, this tax cut is worth $1,200 in the next year. We also know that many other Australians will benefit from having a real choice. When budgets are tight, Australians will be able to make real decisions about where they want to spend their money without having to fear being hit with a tax penalty. The new threshold for singles will be $70,000 while for families it will be $140,000. These thresholds will be indexed each year to reflect wages growth. This will ensure that they will remain relevant into the future rather than forever threatening to become the tax trap that the Liberal government’s thresholds had created.

The Liberals are the last men standing on this issue, refusing to accept that there should ever be any changes. Their approach to this issue is about as relevant as the Medicare levy surcharge thresholds they want to maintain—this at a time when we know we need a surplus and we know we need to provide relief to families. The senators from the minor parties have seen the need for economic responsibility.

Photo of Nick XenophonNick Xenophon (SA, Independent) Share this | | Hansard source

I’m an Independent.

Photo of Stephen ConroyStephen Conroy (Victoria, Australian Labor Party, Deputy Leader of the Government in the Senate) Share this | | Hansard source

Sorry, Senator Xenophon—minor parties and Independent senators. I was not in any way attempting to leave you out. At a time like this it is stunning that the Liberals are rejecting this bill and voting against the surplus and against relief for working families. Minister Roxon and the government thank the Greens, Senator Xenophon and Senator Fielding for their constructive approach to this issue.

I also want to make the point that our public hospitals are on a firm footing. We have already injected $1 billion this year, and they stand to benefit significantly from COAG at the end of the year. We are happy to support the amendment Senator Siewert will move for a review into the impacts of this measure on public hospitals, but we do not believe there will be any adverse impact on public hospitals as a result of this legislation that will pass through the parliament today. We would also particularly like to acknowledge the Greens’ support for using wages as the indexation factor into the future. We believe that this will lock in fairness for the future. It will make sure this surcharge will remain relevant to future incomes and will never again become the tax trap that the former Liberal government created.

We are also continuing discussions with Senator Xenophon and Senator Siewert regarding the terms of reference for a Productivity Commission inquiry into the cost of different procedures in the public and private systems. It is important to note for the record, as Senator Xenophon has done previously, that the government is already well advanced in negotiations with the states and territories to provide more transparency and accountable reporting on public hospitals. We are also in discussions with the private sector about the same performance indicators applying to private hospitals so that we will have a truly national system of reporting across public and private hospitals for the first time. The Productivity Commission will be able to draw on some of this work in its inquiry.

1:12 pm

Photo of Mathias CormannMathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | | Hansard source

Just to allay the minister’s concerns: far be it from me to verbal the Minister for Health and Ageing, even though that is something that she herself is quite up to doing when she circulates propaganda sheets which present questions asked at an inquiry as a statement of position. Let me quickly read out to you the direct quote of the answer provided by the Minister for Health and Ageing to a question by Matthew Abraham on 891 ABC yesterday morning. Mr Abraham asked a very incisive question:

And how will you stop them from putting up their rates to compensate for this, because you wouldn’t want them to go broke, would you?

Mrs Roxon said:

Well, no, that’s why I say, you’ve got to balance those things and I don’t want to pretend to the community that, you know, there isn’t an inevitability of some increases…

The reality is this—

Photo of Stephen ConroyStephen Conroy (Victoria, Australian Labor Party, Deputy Leader of the Government in the Senate) Share this | | Hansard source

Senator Conroy interjecting

Photo of Mathias CormannMathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | | Hansard source

A double negative makes a positive, Minister—I am sure that even you understand that. So the minister is not saying there is not an inevitability of some increases. The reality is this: Professor Deeble said there would be an additional five per cent increase, Access Economics said there would be an additional five per cent increase—under the original measure, I grant you that. But it stands to reason that if you expect that 500,000 people will leave private health insurance as a result of this measure—and the minister says that it is the young and healthy who will leave in the first instance, who will not access treatment to the same extent as the older and sicker and who will walk out with the contributions that they would otherwise have made—of course premiums will have to go up. That is basic logic. I do not think that anybody seriously suggests that premiums will not go up. Everybody accepts that premiums will go up. The minister accepts that premiums will go up as a result of this measure. The question is: by how much? And the real concern is that, during the Senate inquiry, Treasury told us that they had not actually included an assumption about future premium growth as a result of this measure in the forward estimates costing of that $960 million saving—which became $879 million and has now become $740 million.

I ask you the question again, Minister, because this is something that Health and Treasury officials have confirmed in the Senate inquiry. Just tell me if there is a change of position. Health and Treasury officials gave evidence to the inquiry that future premium increases as a result of this measure would be funded out of the contingency reserve. Could you please confirm for me that future health insurance premium increases as a result of this measure would be funded out of the contingency reserve?

1:15 pm

Photo of Stephen ConroyStephen Conroy (Victoria, Australian Labor Party, Deputy Leader of the Government in the Senate) Share this | | Hansard source

Senator Cormann, on a number of occasions you have taken points of order and stood up and argued that you have been seriously verballed, and you have taken umbrage about it. So I do find it a little difficult to take you seriously when you try to fundamentally misrepresent what the minister said. If I could also defend Ms Roxon, she is getting married later this year but I do not think she will be adopting the ‘Mrs’ title. Seriously, that is a serious verballing of what she has said and a serious verballing of evidence from officials. The point is: there is always money in the contingency reserve for premium increases—not premium increases caused by this. Let me be clear. You are trying to deliberately bring together two pieces of information and mislead this chamber. You should stop misrepresenting both the minister and officials, because it does not do you well to have got yourself into a situation where you want to claim you have been misrepresented and then you start doing what you claim has been done to you.

1:16 pm

Photo of Mathias CormannMathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | | Hansard source

Minister, taking you at your word, can you guarantee that private health insurance premiums will not go up as a result of this measure? Can you provide, here and now to the Senate and to the Australian people—to the one million people on incomes of less than $50,000 who have private health insurance—a guarantee on behalf of your government that health insurance premiums will not go up? Whatever you are saying, Treasury officials told the inquiry and Health officials told the inquiry that any impact in terms of future premium growth as a result of this measure will be covered out of the contingency reserve. That is black and white in the Treasury submission to the inquiry. It is black and white in the evidence that was provided. If you are now coming here and trying to play some political game and not taking those questions seriously—questions about things that have a serious impact, particularly on the vulnerable in our community who will continue to take out private health insurance—then, quite frankly, you should not be dealing with this legislation.

1:17 pm

Photo of Stephen ConroyStephen Conroy (Victoria, Australian Labor Party, Deputy Leader of the Government in the Senate) Share this | | Hansard source

I have already responded to the very point that you have made. I am happy to repeat exactly what I said, and I noted Senator Mason’s interjections—or perhaps it was the good senator behind him. I was not quite sure if you were throwing your voice, Senator Mason. Perhaps it was Senator Williams. I am not sure. Let me repeat what I said and be absolutely clear. It is ultimately up to the Commonwealth to approve premium rises. The health minister has been very clear. She will not accept private health insurance funds using this measure as an excuse to whack working families with huge hikes. It could not be clearer.

1:18 pm

Photo of Mathias CormannMathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | | Hansard source

I note that the minister was not prepared to rule out health insurance premium increases as a result of this measure. He has not been prepared to rule out that premiums will go up as a result of this measure. I will just explain the very simple maths to the minister again. The minister said earlier that the Commonwealth expects to save $740.6 million by not having to pay the private health insurance rebate to those Australians the government expects to leave private health insurance. The Minister for Health and Ageing has said that these people are going to be the young and healthy, so there is nothing to worry about. But if it is the young and healthy, then this is only 30 per cent of the total funding that will walk out the door with the 500,000 people you expect to leave private health insurance. Those people will not only take the 30 per cent Commonwealth rebate away with them; they will also take their own 70 per cent contribution away with them. That is $2.5 billion walking out of that door, Minister, and you are saying it is just going to go up in the air somewhere? Are you saying to me seriously that there is not going to be an impact on public hospitals? Are you saying that there is not going to be an impact on private health insurance premiums? Where is that $2.5 billion going to come from? Do you expect a reduction in demand for hospital treatment? Surely not.

Not one single witness at the Senate inquiry said that they expected a reduction in demand for hospital treatment. Of course not; nobody does. But there is $2.5 billion walking out that door with the people you are driving out of health insurance as a result of this measure, and you have got absolutely no idea where that money is going to come from. I put it to you, Minister: it is going to be the states and the territories that are going to have to cop it on the chin. You are setting them up for failure. Pensioners and Australians earning less than $50,000 a year are going to be among 10 million Australians who will see five to 10 per cent additional increases in health insurance premiums as a result of this measure.

Let me go back to the advice provided by your very good friend and mentor, former Senator Graham Richardson. This is what he put in his discussion paper in December 1993. He came in as the new federal health minister at the end of 10 years of failed Labor health policy—Labor health policy that was based on the same ideological misguidedness as this legislation is today. His discussion paper said: ‘Declining rates of private health insurance membership have significant implications for the public system. As more people drop out of private insurance, the demands on the public system grow.’

This is a government that told Senator Siewert there would be no negative impacts. I understand where Senator Siewert is coming from, by the way. She has a particular view. She is not supportive of the policy framework that underpins private health, and she is very clear about that. At least she is honest about where she is coming from. She does not support the private health insurance rebate, she does not support Lifetime Health Cover and she does not support the Medicare levy surcharge. I can respect her position more than the position of the government. The government are trying to pretend, ‘Yes, we are committed to a mixed health system. We are committed to a strong private health sector,’ but they are doing everything to undermine it and weaken it and make sure that it falls over.

In the media today I read:

Greens health spokeswoman Rachel Siewert said the government had assured her party there would be no negative impacts on the public hospital system.

This is like saying, ‘Trust us; we are from the government; we are here to help.’ What sort of guarantees has the government actually provided to Senator Siewert to substantiate that commitment? This is just incredible. Two or three weeks ago Senator Fielding said that he was concerned about the impact of this measure on low-income families, pensioners, older Australians and people on low and fixed incomes. He said, ‘I want some compensation for them.’ But he has now just rolled over and abandoned lower income families, abandoned pensioners and essentially sidled up to the government in the name of an illusory surplus out of this measure which will not eventuate at all due to the reasons I have given.

Minister, you are quite right. Only the Liberal-National Party coalition is standing up for the 10 million people with private health insurance. Only the Liberal-National Party coalition is standing up for the one million Australians earning less than $50,000, whom you will force to cope with increased health insurance premiums or to go into the public hospital queues as soon as they can no longer afford those increased premiums that you are forcing on them. Minister, you are absolutely right: only the Liberal-National Party coalition is standing up for sound and good public health policy. Quite frankly, the more I ask you questions and the more that you are not able to answer them, the more obvious it becomes that the government still has not done its homework, is still flying blind, still does not know what the impact on public hospitals is going to be and still does not know by how much private health insurance is going to go up as a result of this measure. Quite frankly, within half an hour, this deal has been totally exposed as a complete fraud.

1:24 pm

Photo of Nick XenophonNick Xenophon (SA, Independent) Share this | | Hansard source

I need to pull up Senator Conroy for misleading the house a bit earlier. He said that the Liberals were the last men standing on this, but the last time I checked there were a number of very capable female senators for the Liberal Party, so I think he needs to be taken to task for misleading the house in relation to that. To put this in perspective, the amendments were moved by my colleague Senator Siewert jointly with me. They relate to what I see as a healthy compromise to what the government put up. I have always been concerned about maintaining an equilibrium between the private and public systems. Senator Cormann is quite passionate in his defence of the status quo—and I respect his position—but I think it is important that we put a few things in perspective. Firstly, this is not the only measure that keeps people in the private health system. Lifetime cover, community rating and the 30 per cent rebate are all factors to be considered. The fact that there has been such a pressure on the health system is also due to the ageing population and to illnesses which are preventable. For example, we can do more to reduce our smoking rates and the level of emphysema and lung cancer.

There are things that we can do to have a healthier community and that will make a difference to our hospital waiting lists. A range of other measures need to be taken into account in the context of how our health system works. That is why I believe that this is a sensible, healthy compromise in terms of not ensuring a tipping point by having so many people leave the system and of ensuring the viability of private health insurance in keeping a downward pressure on premiums as much as possible by not having so many people exiting. But there is also the fundamental equity issue. When this surcharge was introduced in 1997 the then Treasurer, Peter Costello, made it very clear that it was intended as an incentive for higher income earners to take up private health insurance. Right now it is $8,000 below average weekly earnings. I was convinced, as a result of what was put in the chamber yesterday by Senator Siewert and from discussions with Treasury officials last night, that average weekly earnings, on the basis of all the evidence available, would be a more appropriate index in the context of this measure, because it is a threshold based on income. So, on balance, that seems to be a more sensible approach.

I want to briefly refer to the issue of a Productivity Commission inquiry, and I would like to acknowledge that the opposition was quite supportive of the motion that I had put up, which has been postponed. It seems to me that it would be much more preferable for an inquiry, pursuant to the legislation that sets up the Productivity Commission, to be coming from the Treasurer. That is how it works in the legislation. I think there are some procedural and other difficulties in it being a motion from a senator, even though that would be a second-best alternative option. I believe that, if we have this Productivity Commission inquiry, it should be broad in its terms of reference and there should be a robust inquiry that looks at, for the first time, the comparison in outcomes in the costs of the public and private systems. It should look at infection rates in the two systems and at the whole issue of fully informed financial consent in both the public and private systems, because these are things that will make a real difference to some good, long-term public policy outcomes.

I note Senator Cormann’s interest in getting a good, long-term public policy outcome on health policy in this country. I believe that the Productivity Commission inquiry into this will make a very real and positive difference that will be good for our health system in the medium to longer term. That, to me, is a very key part of what is before us today. Whilst it is not directly before us, in terms of the issue that will be voted on, it is part of the undertaking of the government, and I accept that we have some broad terms of agreement based on the motion that I have introduced. Senator Siewert is looking at the terms of reference to make sure that it is as comprehensive as possible, and that is welcome.

Notwithstanding my admonishment of him a couple of minutes ago, can Senator Conroy confirm that the Productivity Commission will also be providing advice to the government on the most appropriate indexation factor for the Medicare levy surcharge threshold, so that the concern that Senator Cormann has had in relation to this will be one of the issues that will be looked at by the Productivity Commission in making its recommendations and reporting on this very important matter? Having said that, I look forward to this matter being dealt with. I believe that this is a sensible compromise, balancing the equity issue of those who were slugged with this surcharge—given the lack of indexation for 11 years—with ensuring that there is an appropriate balance between the public and private systems.

1:30 pm

Photo of Mathias CormannMathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | | Hansard source

Yesterday Senator Xenophon asked me a few questions and I gave it my best to sincerely, openly and transparently answer them. In light of the fact that I am not getting any satisfaction from the government, and considering that the government is not prepared to provide answers to the Australian people about the impact on public hospitals and private health insurance premiums, I thought I would try my luck with Senator Xenophon. Senator Xenophon, the fact that the government expect to save $740 million from not having to pay the private health insurance rebate to people shows that they expect people to leave private health insurance. This is not us making it up; these are Treasury forecasts. Considering the $740 million is only 30 per cent of the funding that will be walking out the door, what sort of assurances have you received from the government about how they will make up that $2.5 billion shortfall in the health system? That is a question I would also like to address to Senator Siewert. She says here that she has been given assurances that there would not be a negative impact on public hospitals. What sorts of assurances has Senator Siewert received? What sort of compensation is the federal government going to offer the states and territories for the impact of this? My second question to Senator Xenophon is: what indications has the government given to you of expected future health insurance premium increases as a result of this measure? What is going to be the increase in health insurance premiums as a result of this measure that the government has told you about?

1:31 pm

Photo of Nick XenophonNick Xenophon (SA, Independent) Share this | | Hansard source

These questions are better asked of a minister. I can assure this chamber that I will never be a minister in any government—that is one thing I am certain of!

Photo of Brett MasonBrett Mason (Queensland, Liberal Party, Shadow Parliamentary Secretary for Education) Share this | | Hansard source

Oh, you never know, Nick!

Photo of Nick XenophonNick Xenophon (SA, Independent) Share this | | Hansard source

It is not going to happen! In relation to the matters raised by Senator Cormann, the policy dilemma for me has always been: what do you do with a surcharge that was put in place for high-income earners back on 1 July 1997 that has not been indexed at all and is catching more and more people in the net? That is a key factor.

I think I have already alluded to the other issues that Senator Cormann has raised. In terms of premium increases, this clearly is a compromise measure with respect to the government’s position, which I believe went too far. It acknowledges the equity issue of those who have been caught by the surcharge—which includes people on below-average weekly earnings, for instance, which I believe is fundamentally unfair. I think the health minister has been very clear that any application for premium increases by private health insurers will be looked at forensically and they will have to make their case. I would like to think that this provides that equilibrium.

In terms of the bigger picture, can I say to Senator Cormann that having a forensic Productivity Commission examination of this for the first time in terms of the comparison between the public and private systems is something that has never been done—the data has not been available. I acknowledge what the health minister has said in relation to moving on this with COAG. It is something that no previous government has actually done and that is long overdue. I believe we will get some answers that we need to move forward with in long-term health policy in this country.

I have said before that I have private health insurance. I would not give it up for quids, even without the rebate. I have been well served by my private health cover, and I intend to keep it. But I think that, if we want some long-term answers about where we get the best benefit for taxpayer dollars in the system, the Productivity Commission inquiry is the way to go forward. The dilemma is: what do you do with the threshold for a surcharge that has been left at an artificial level over so many years and has not been addressed? I do not think we would have this problem if whoever was giving advice to then Treasurer Peter Costello 11 years ago had thought to have it indexed, either to CPI or average weekly earnings. I am sure I have not satisfied Senator Cormann, but I have given it my best shot.

1:35 pm

Photo of Stephen ConroyStephen Conroy (Victoria, Australian Labor Party, Deputy Leader of the Government in the Senate) Share this | | Hansard source

If I could just assure Senator Xenophon on his query in relation to the base indexation issue: it will be addressed as part of the Productivity Commission inquiry.

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

In response to Senator Cormann’s question to the Greens, I also want to seek confirmation from the government to see if my understanding is correct. Firstly, the reason why the Greens are moving the amendment in relation to the review is to be assured that there is no negative impact on the public hospital system—and, if there is, obviously the government need to address that, since they have given us an assurance that there will be no negative impact on the public hospital system. I understand from the government’s response to me previously in discussions on this, and in this chamber in discussions on the previous bill, that the government will be supporting the review and that, if the review does identify any negative impacts, they can be dealt with through the COAG funding agreement that they are currently negotiating with the states. There will be an ongoing relationship there. I understand that that is the process, and I would seek that clarification from the government.

1:36 pm

Photo of Mathias CormannMathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | | Hansard source

I am close to wrapping up the opposition’s contribution in this debate, I assure you. Firstly, in relation to the comments made by Senator Xenophon, I place on record that over 11½ years of the Howard-Costello government we provided between $5,100 and $9,000 per annum worth of tax cuts to Australians in the $50,000 to $75,000 income bracket. John Howard and Peter Costello did that without the disastrous consequences that will result from this very bad public policy.

A very bad public policy, I repeat, was pursued by the government under the pretence of offering tax breaks when in reality it was a very thinly veiled attack on the private health sector—a policy where the government did not even seek to assess the impact on public hospitals, where the government did not even seek to assess the impact on future health insurance premium increases and where the government only sought to assess how many people would leave in order to be able to calculate how much they would save and how much it would cost them. They were not able to tell us the true and accurate estimates of the number of people they expected to leave until two or three months into the inquiry, when they finally were able to confess: ‘Yes, we expect 644,000 people to leave.’ That became 583,000. Now it is 492,000 people.

I suggest to the government that that is still an underestimate of what will happen, because of one of the fundamentally flawed assumptions this government is making—and I invite you to check it in Hansard, Senator Conroy, because I would not want you to accuse me of verballing people yet again. Essentially, Treasury and Health officials both said that they expect this to be ‘a one-off shock to the system’. ‘A one-off shock to the system’ is what Mr David Kalisch, from the Department of Health and Ageing, said in the Senate estimates process.

The reality is that it is not going to be a one-off shock to the system. This is going to push up the price of premiums, so more people will have to leave, which will push up the premiums a bit more, so more people will have to leave, and you will have a new downward spiral. That is exactly what happened in 1983, when you started off with a drop from 63 to 50 per cent. Things accelerated. Membership started to drop by two per cent per annum. Then Senator Graham Richardson said: ‘If this keeps going the way it is, it will be three to four per cent per annum in a couple of years time. If things continue the way they are, we will end up at 25 per cent private health insurance membership by the end of the decade.’

If that is what the government want, if the government are quite happy to introduce a policy that will lead us down the path of ending up with 25 per cent of Australians being privately insured, then they should say so. They should be honest enough to say so. Do not come here and pretend that this is some sort of effort to provide a tax break, because, if it were supposed to be a tax break, you would have announced it before the election and you would have made sure that it did not discriminate against people who do take out private health insurance but that it was a tax cut for people in relevant income brackets whether they take out private health insurance or not.

I also take this opportunity to make a comment about the Greens amendment on the review. The opposition will be supporting the Greens amendment on the review, but let me just make the point that this is really like having a bus drive at 150 miles an hour against a wall and saying: ‘Let’s have a review afterwards to see whether people got hurt, instead of making the decisions before we hit the wall to apply the brakes, turn the bus around or remove the wall.’ There are a whole heap of things that you can do before you end up in a situation where you know that people are going to get hurt.

This is a bus with 20 million Australians on it, and the government is driving it right against that wall at 150 miles an hour. Do you know what? Instead of making decisions on turning that bus around, applying the brakes, making some sensible changes and making a proper assessment of the risks ahead, the government is intent on keeping on driving. Even if you slow down that bus from 150 miles an hour to 120 miles an hour, as long as you continue heading for that wall, people are going to get hurt. Yes, the review will show us afterwards that people got hurt.

Once the Australian people can see where this policy is going to lead, they will change the driver. At the next election, we will be calling on the Australian people to change the driver of the bus, because the Australian people do not want you to drive that bus against that wall; they want you to apply the brakes. They want you to turn that bus around. Quite frankly, everybody knows that, if you drive a bus at 150 miles an hour against that wall, people are going to get hurt. That is why we think that the government should have done a proper assessment—the government should have done its homework—before introducing this legislation.

We will be supporting the Greens amendment on having a review, but we note that that will be a review after the fact. That will be a review after people have already been hurt. That is not the way to devise good policy. Good policy means that you make a proper assessment of the likely implications, the likely risks and the flow-on implications of a particular measure before you implement it.

That is what is fundamentally wrong with this government. This government is driven by an ideological pursuit against private health. It tries to dress it up in its spin of: ‘This is about a tax break,’ even though this will force up health insurance premiums for 10 million people, including one million Australians earning less than $50,000 who will not get a tax break—people like Mrs Judie Kearney-Wilkins, from Treasurer Wayne Swan’s electorate of Lilley. These are people that the Treasurer should very carefully listen to. I am pretty confident that Mrs Judie Kearney-Wilkins would be very concerned about where this bus driver is taking this bus. She would be very concerned about that wall over there. While we will be supporting the amendment to have a review, we think the government should have done its homework before introducing this legislation.

Question put:

That the amendments (Senator Siewert’s and Senator Xenophon’s) be agreed to.

1:50 pm

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

by leave—I move Greens amendment (1) on sheet 5606 revised:

(1)    Page 2 (after line 2), after clause 3, insert:

4 Review of operation of Act

        (1)    The Minister for Health and Ageing must cause an independent review of the operation of this Act to be undertaken as soon as possible after each anniversary of the commencement of this Act, for a period of three consecutive years.

        (2)    The review is to consider and report on the impact on public hospitals of the amendments made by this Act, including the number of episodes of care, the impact on operating costs and the impact on elective surgery waiting lists.

        (3)    The person undertaking the review must give the Minister a written report of the review, and the Minister must cause a copy of the report to be tabled in each House of the Parliament within 15 sitting days of receiving the report.

This relates to the review of the operation of the act. A new amendment has been circulated in the chamber because we slightly revised the previous amendment to ensure that it is the Minister for Health and Ageing who initiates or causes the independent review to occur. This is the review that we have been talking about of the operation of the act to ascertain any impacts of these changes on the public hospital system.

1:51 pm

Photo of Mathias CormannMathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | | Hansard source

I wish to confirm that the opposition intends to support this amendment. I have spoken to this before.

Question agreed to.

Bill, as amended, agreed to.

Bill reported with amendments; report adopted.