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Legislative Assembly for the ACT: 2003 Week 3 Hansard (13 March) . . Page.. 1046 ..



the Commonwealth has been that the goal of their private health insurance policy is to relieve pressure on the public hospital system. This policy, however, has substantially failed in its objective. In fact, it has almost totally failed.

States and territories have experienced little, if any, reduction in hospital demand since the rebate was introduced. This is probably more related to the transfer of services from inside hospitals to outpatient or community-based settings, rather than anything to do with the private health insurance rebate.

Mr Speaker, the rebate is incredibly inefficient. Independent economic analysis has shown that, if the money that has gone into the rebate had been allocated to public hospitals instead, public hospitals could not only have treated everyone currently waiting for elective surgery, but a substantial proportion of people currently receiving care in private hospitals as well.

The Commonwealth has to do better with its use of public money. The next AHCAs provide an opportunity for this. A first step would be to allow public hospitals to charge the same rates from private health insurers as private hospitals can charge for private patients. At the moment, public hospitals can charge only a low rate for private patients. So, even if someone uses their private health insurance in a public hospital, the public system has to pay a large part of the cost.

Another problem is that private health insurance covers only a limited range of services. The Commonwealth regulates private health insurance and can use that power to require private health insurance providers to cover a broader range of services. This would make private health insurance more useful and increase its use.

Finally, the Commonwealth should properly address the problem of gap payments. The Commonwealth solutions to date have not been effective, and gap payments are still a major disincentive for people using their private health insurance cover.

Mr Speaker, beyond the areas we have talked about above, there is a range of other reform areas that the next Australian Health Care Agreements need to address. These include the health of Aboriginal and Torres Strait Islander people who still have, on the whole, much worse health outcomes than other Australians.

The next Australian Health care Agreements should include a strategy for improving access to elective surgery. The last agreement gave the ACT $16 million to reduce elective surgery waiting times. This money was provided as a one-off amount and has run out, putting renewed pressure on elective surgery waiting times. Rather than one-off payments, the Commonwealth should work with us to develop a comprehensive and ongoing strategy to improve access to elective surgery in our public hospitals.

We also need to do something about the growing work force shortages among groups such as doctors, nurses and pharmacists. We also need to continue the efforts to improve mental health services and service quality that have been progressed under the current agreement.

Members of the Assembly would all be aware that the Commonwealth Health Minister's response to the renegotiation of proposals put to her by state and territory Health

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