Page 3280 - Week 12 - Thursday, 19 November 1992

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MEDICARE AGREEMENT
Discussion of Matter of Public Importance

MADAM SPEAKER: I have received letters from Ms Ellis, Mrs Grassby and Mr Lamont proposing matters of public importance to be submitted to the Assembly. In accordance with standing order 79, I have determined that the matter proposed by Ms Ellis should be submitted to the Assembly for discussion, namely:

The importance of the Medicare agreement to the health of the people of Canberra.

MS ELLIS (3.18): Fellow members, those of us on this side of the house are committed to the best health care system possible in the ACT; but the best means more than just the best staff and equipment, though that is also our goal. The best includes the most responsive, the most accessible, the most flexible and the most open health system possible within our financial constraints. Through Medicare, our goal is to develop a health system that will allow all members of our society, including the aged and the disadvantaged, to access the health care they need. (Quorum formed)

In this system, access to public health services will be based on clinical need rather than financial status, which the Liberals support. In the last 20 years there have been enormous changes in the way in which public hospitals have been funded in Australia. The introduction of Medibank by Labor saw the development of Commonwealth-State agreements which provided free access to hospitals funded through 50-50 sharing of hospital costs. This was supplemented by universal medical insurance, administered through the Health Insurance Commission.

After 1975, under the Liberal Government there were gradual changes to the way public hospitals were funded. The arrangements for cost sharing were altered and a levy on personal income was introduced alongside incentives for individuals to take out private health insurance. Hewson has already stated that he expects 1.5 million people to take up expensive private health insurance under his plans. Other changes, such as the introduction of identified health grants for hospital and community health services, led to significantly higher user charges for all except social security beneficiaries.

In February 1984 the Federal Labor Government introduced Medicare. This provided universal health cover for all eligible persons, including 85 per cent of Medicare benefits schedule fees for a specified range of services provided by medical practitioners. Medicare also provides free accommodation and treatment in public hospitals. Compensation grants were introduced which would compensate the States for a reduction in in-patient fees, increases in the numbers of patients who could not be charged, and increases in costs of medical services provided by public hospitals to public patients.

The hospital care provided under Medicare is funded by a set of agreements - the Medicare agreements between the Commonwealth and State or Territory governments, which set out the conditions of funding and the way in which the amounts are calculated. Taxpayers contribute to the cost of Medicare by paying a levy based on a percentage of their income if their taxable income exceeds


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