Matters Of Public Importance - Budget (Sep 2)

Senator SESELJA (Australian Capital Territory): I am pleased to have the opportunity to speak to this very important issue today. I wanted to address both of the central elements raised in Senator Brown's speech, which is about GP co-payments but also about changes in PBS co-payments. Both are very important. Can I make this point at the outset: this is about making both our Medicare system—our medical benefits system—and our PBS sustainable. If you look historically there has been bipartisan recognition that we have to take measures to make these things more sustainable.


I will go into some detail on how the Labor Party saw fit in office in the Hawke-Keating years to not only introduce a co-payment for GPs but also to increase co- payments for the PBS. We have seen that recognition. That has to be fundamental to this debate. Do we in 10 or 20 years time want to see the Medicare system where people still can have access to their GP or do we want to make it increasingly hard as budgets struggle to keep up? Do we want a situation where we can continue to list the medicines that are needed and people can access subsidised medicine or, where we do not take the measures and therefore see many Australians left behind? That, in fact, is at the heart of what this issue is about. That is at the heart of this debate: in 10 years time, in 20 years time, will we still have these excellent systems that we have?

We believe that the way to make it sustainable is to ask for some contribution by individuals. That has been recognised in a bipartisan way when it comes to the PBS. It has been absolutely recognised by both sides of politics that some contribution when it comes to subsidised medicines is the sustainable way to go. We believe that that also applies when it comes to GPs. So I do want to remind the Senate about the fact of some of that bipartisanship from people like Andrew Leigh and people like Bob Hawke. I will quote from Andrew Leigh. It is worth putting in context when he said this, because it was in 2003. Since 2003 we have seen a significant increase in medical benefits payments by the Commonwealth from around $8 billion to over $18 billion. It has more than doubled since he said this. So if it were true in 2003, it is more true in 2014, given the proportion of our budget that is now being paid out in medical benefits. Dr Leigh described a Medicare co-payment as 'hardly a radical idea'. He made an important point. He said:

As health researchers have shown, costless medical care means that people go to the doctor even when they don't need to—

That was one, but secondly he said:

… driving up the cost for all of us.

That is a really important point. It drives up the cost for everyone and it undermines the sustainability. Andrew Leigh had that to say back in 2003, back when we were paying out about $8 billion under the Medicare benefits schedule. Now we are doing over $18 billion. If it was true when Andrew Leigh said it in 2003, it is even more true now, in 2014.

Of course, we know about Bob Hawke. Senator Brown, I think towards the end of her speech, suggested that this was about getting rid of Medicare; this was about undermining Medicare. It is actually the opposite. I do not think there would be a Labor senator—and I challenge a Labor senator to get up and say this—who would say that Bob Hawke was interested in destroying Medicare. Was Bob Hawke interested in destroying Medicare? No. I do not think anyone could legitimately make that claim. I think people would say that Bob Hawke was committed to Medicare. One of the ways he showed his commitment was in seeking to make it more sustainable.

Senator Carol Brown: There isn't a GP tax.

Senator SESELJA: I hear the interjections from Senator Brown. I would be happy if a Labor senator did want to get up and say that Bob Hawke was seeking to undermine Medicare. I do not believe that is what he was doing; I believe what he was doing was seeking to make it sustainable. Many years ago, when we were spending a lot less than even when Andrew Leigh made his comments in 2003, he said: 'It is quite clear. I understand there is a very significant blow-out in regard to the Medicare situation in terms of servicing. What needs to be done, of course, is to ensure that both on the supply side and the demand side there be some restraint imposed because you can't have a situation where you're just going to have outlays growing as in the rate they were.' That is what Bob Hawke had to say.

Senator Carol Brown: This is about stopping people going to the doctor. That's what it's all about.

Senator SESELJA: Senator Brown interjects. Apparently, when Bob Hawke said it, it was not wrong and it was not undermining Medicare—and I do not believe he was trying to undermine Medicare. But many years later, when we are making many more and much greater payments, it is different. Andrew Leigh recognised in 2003, when we were paying out $8 billion, that this was a good idea. He recognised it in '03; Bob Hawke recognised it well before that. We take the same approach: we want to make Medicare more sustainable. This has been recognised as the way to do that. It has been recognised by Andrew Leigh, it has been recognised by Bob Hawke and it is recognised in this year's budget.

The alternative, when it comes to both MBS and PBS, is for the system to become unsustainable and for Australians to not get the kind of medical care that they deserve. That is something, on the coalition side, that do not want to see.

We hear the criticisms about co-payments for PBS. We have seen historical changes to payments for PBS. We have seen that historically. Under both sides of politics we have seen it. In 1983 we saw $2 for concessional co-payments. In 1986, under the Labor government, we saw the co-payment for non-pensioners increasing from $2 to $2.50. For pensioners, we saw it increasing in 1990 from nothing to $2.50. And we saw it under the Howard government because there is a recognition that, if we want to have a PBS system that continues to provide life-saving drugs for Australians, asking people to make a modest contribution to that is a good way to go. It is an important way to go.

It is not something that was invented by the coalition upon coming to office; it is something that was recognised by previous Labor governments; it is something that was recognised by previous coalition governments. Under the previous Labor government— the Rudd-Gillard-Rudd governments—we saw, in fact, the listing of only eight medicines every month, when we are seeing now over 20 medicines every month being listed. We want to see medicines on the PBS. We want to see Australians having access to that. That is what we are seeking to deliver. That is what the facts show—and, in fact, we were lagging behind in the last six years. I do not want to see a situation in 10 years time or 15 years time or 20 years time where members of my family cannot get access to live- saving drugs that are not listed because the system becomes unaffordable. This is an important part of the sustainability of our healthcare system that has been recognised for a long time by both sides of politics. It has been recognised by people like Bob Hawke, by people like Andrew Leigh and by people like this coalition government.


The alternative, of course, as we see the increasing costs is to pretend that there is no problem. That seems to be the Labor Party's approach to all of these budgetary issues. We do need to get the budget under control. That means taking sensible measures— measures that in the past have been supported by the Labor Party, but in fact, now, they are being reckless in not supporting it, with no alternative plan. They have only a plan for more and more debt and deficit but, importantly, for an undermining of our healthcare system as it becomes increasingly unsustainable.