In a speech to the Australian Council of Trade Unions Medicare Summit, the Leader of the Opposition, Simon Crean, has said the Prime Minister, John Howard, is fulfilling a long-held goal to destory Medicare with the changes announced this week.
Crean said: “For all of its words, John Howard’s policy will destroy Medicare in this country – it can’t do anything else. He is introducing a two-tier system. A two-tier system that even won’t be adequate for the persons on a lower tier that he says that he wants to look after.”
Text of speech delivered by the Leader of the Opposition, Simon Crean, to the ACTU Medicare Summit.
Well thanks very much, Sharan (Burrow), for not just the introduction, but the initiative in convening this coalition. I think it’s a great effort to get together people who individually are opposed to what the Government is proposing in relation to Medicare. The key message that I want to leave today is that individually we are opposed, but collectively we can defeat it.
And that’s what has to come out of this meeting. Not just words, not just resolutions that say that we oppose but a strategy that defeat this. And I’ll say something about the parliamentary strategy that Stephen and I have talked about and we will have further discussions with the minor parties about.
But, can I just say from the outset, you said that this is the first time that a coalition of this sort has met in this room, that’s true. It’s not the first time we have met in this room as a trade union movement or the Labor movement to defend Medicare.
And it’s amazing how history repeats itself with the Liberals because back in 1982 I was part of the campaign, when John Howard was Treasurer of this nation and he and Malcolm Fraser were continuing to destroy Medibank. He, as you’ve indicated, in 1987 as Opposition Leader, nailed his true flag to the mast when he said bulk billing will not be permitted for anyone except pensioners and the disadvantaged. Doctors will be free to charge whatever they choose. That’s what his package of initiatives on Monday will achieve – make no mistake about it.
This is a Prime Minister that genuinely believes that he has got the ability now to implement that policy. He’s never gone to an election arguing that policy since the 1987 statement. But now he wants to implement it, in fact. And he’s doing it as Prime Minister today.
I remind those that are involved in the trade union movement what we did in 1982. We took the view that Medibank was going to be dismantled and what we would have to do was to defend the ability of working people to pay for their health care. We had no option in those days but to take it as an industrial campaign – and we did. I was part of those negotiations that met in this room and campaigns that achieved claims against employers, successful claims against employers to pay for what the Government was taking away. We achieved it in the oil industry in 1982.
The interesting thing is that in 1983 when we got in a Government that was committed to universal health care through Medicare, we gave up what we gained. We were prepared to drop the claim – and a successful claim against the employer – on the basis of achieving it for the whole community.
But not only did we do that by way of sacrifice, there was a further sacrifice in 1983 when we traded off wage increases through the Accord in return for getting Medicare. You might recall, there was a downward adjustment against CPI in those early years of the Accord that reflected the fact that the Government had introduced Medicare and the costs went down in the CPI.
We took that hit in terms of wage claims. And the point I’m making is that what Howard is seeking to destroy, working people in this country have earnt. They paid for it, they paid for it back in 1983 and subsequently in terms of reduced wage claims, on the basis that the Government of the day, a Labor Government, was prepared to introduce a health system whereby people had access to free medical treatment by a doctor, on the basis of bulk billing and they had free access to hospital care in a public hospital. That was the contract that we forged and it’s a contract that’s got to be honoured. And it’s a contract that this group today has got to be reminded of.
What it also needs to be reminded of is the fact that what this Government is seeking to do is to destroy Medicare. For all of its words, John Howard’s policy will destroy Medicare in this country – it can’t do anything else. He is introducing a two-tier system. A two-tier system that even won’t be adequate for the persons on a lower tier that he says that he wants to look after. Why? Because the $1 increase in the patient rebate still won’t be sufficient for doctors to bulk bill in metropolitan areas. So even his concession card holders, when they live in metropolitan areas won’t find this package of advantage to them.
But if in fact Howard has recognised that as part of restoring bulk billing to concession card holders you’ve got to increase the patient rebate – why won’t he do it for everyone? If he accepts the principle that what’s destroying Medicare at the moment, what’s driving bulk billing down is the fact that the patient rebate has not kept pace in the community, then there’s only one solution to that and that is to lift the patient rebate.
It’s very instructive if you look at their seven years of office, in every one of those seven years bulk billing has declined under the Howard Government. In the seven years that preceded their term in office bulk billing increased in every one of those years.
That’s the difference between a Government that believes in Medicare and one that doesn’t. One that understands that you don’t just mouth the words in terms of saying, `we support Medicare’, but you actually do something about it. You make the hard decisions in terms of budgets; you make the hard decisions in terms of where the resources have to go and where the incentives have to go.
This is a Government not prepared to take the hard decisions. And you’ve got to ask yourself, why can’t it do it? It’s the highest taxing government in our history and it can’t afford to save Medicare. Where is the money going? Where is it going? It’s not as if people are getting it back, they’re not. More is being taken out of their pockets, but, at the same time the services have been cut away.
It’s not just the end of bulk billing that’s an issue here. It’s the fundamental Americanisation of the health system that’s involved. Because what he’s doing is driving everyone to a position in which the doctor will continue to charge a co-payment, an additional amount, an amount above the rebate.
Sharan made the point before – and she’s absolutely right – people are going to be paying three times for the same service. They’re going to be paying first through their taxes, secondly through the Medicare levy and third they’re going to have to pay through another charge for the doctor – three times for the same service. Where’s Alan Fels when you need him? This is a rort.
And the Government’s trying to say that it’s saving Medicare. It’s charging people three times for the same service and it’s not on. And that’s what we have to fight. And we have to determine here today, as I said in the beginning, not just to carry resolutions, Sharan, about the need to defend this, but to actually campaign around it.
Now so far as Stephen and I are concerned, we as a Labor Party will oppose any legislation in the parliament that destroys Medicare. And what I want to seek today is the same commitment in terms of the Democrats and the other minor parties. There are aspects of this health package that can be supported, but we will not support those measures that destroy Medicare. And if they can’t get it up in the parliament, it doesn’t pass.
They need to change the legislation, this Government, in relation to enabling the co-payment to be taken in addition to the rebate – automatically being swiped through. They need legislation to do that. Because, the mechanism that we had in place to keep cost pressures down was the doctor couldn’t charge additional unless he charged the total fee that the rebate then was claimed against. You can just imagine what they’re going to do. In circumstances in which the rebate is swiped and you go into the doctor’s surgery and he says `well I’ve got news for you, last week you were paying $35, you now only have to pay $20. Isn’t that a good deal? No, it’s not a good deal because if the doctor thinks he can get away with saying he’s halved the fee, how long do you think it will take before the fee then starts to rise?
That’s why this system will blow out of all control and that’s why we will still head to an American system, an American system in which those costs that you talk about in here, in which they’re paying a fortune, much more than our system of public health will just get out of control. We have the best system in the world. Why would you destroy it? Why would the Government embark upon a campaign that seeks to destroy it?
Let me just say this in terms of the issue as well. One of the other pressures is the hospital system. The health system is in crisis because of what the Government is doing in terms of bulk billing, but also because it’s not prepared to adequately fund hospitals. But it’s putting more pressure on hospitals by running down bulk billing because where do people go when they can’t get a doctor that bulk bills? They go to the emergency ward in the local public hospital. It adds additional pressure.
But here’s a Government that can’t even negotiate a five-year deal with the state hospitals. It might sound familiar because Fraser tore up the five-year funding package for hospitals that was introduced by the Whitlam Government. It was reintroduced by the Hawke Government and it’s now being torn up again by the Howard Government. They don’t believe in the cooperative relationship with the states to address hospitals either.
So, this isn’t just the defending of Medicare, this is the defence of our health system in this country – the world’s best health system that this Government is hell bent on destroying. We will be looking to the parliament when this legislation is brought forward, to defeat it and we can defeat it because this Government hasn’t got the numbers in the Senate.
But what has to be mobilised is the community campaign that says it must be defeated. Individually we are opposed and collectively we can defeat this package. And that’s what I’m urging you to get behind today. All of us here believe in a public health system that should deliver a doctor that bulk bills and free treatment in a public hospital. That’s what I believe in and that’s what I’ve fought for all of my working life. I’ve fought for it from a trade union movement perspective and I’ve fought for it from a political perspective. And I’m not going to give up that fight now.
And we are facing the biggest challenge since Fraser tried to do this back in the late 1970s and early 80s. We got in there, we changed the Government, we’ve got to do that again. But, in the meantime we have to defend the legislation that gives them the opportunity to start to implement this. We have to mobilise the community campaign that says `Save Medicare’. That political choice is very stark. Under John Howard, Medicare is destroyed, under Simon Crean and the Labor Party, Medicare is saved.
That’s a battle we’ve got to all join and I’ll be here today to campaign around. So I look forward to you through all of your groups in the community, through the trade union movement, ways in which that campaign can be supported, ways in which we can campaign in the community, on the job, in the work sites, look at ways in which we can defeat this. This is the priority issue for this nation, saving Medicare. It can be saved, it must be saved and under my leadership of the Labor Party, Sharan, I will save it.
