Page 3886 - Week 15 - Tuesday, 15 December 1992
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Mr Kaine: He does not know basic health, either.
MRS CARNELL: That is true. Under so-called progressive tax systems, the tax rate would increase as you went through the various tax brackets, unlike the Medicare levy, which will be a flat 1.4 per cent, regardless of your income. This is a technically regressive tax - quite the opposite of what Mr Berry said. The Australian Health Insurance Association has said:
We question the equity of a situation which applies progressive taxation to higher income levels as the basis of funding most Government programs, but applies flat rated taxation in respect of the Medicare levy.
MADAM SPEAKER: Mrs Carnell, your time has expired.
MS ELLIS (4.29): Over the years we have witnessed a steady improvement in the health status of Australians. Life expectancy has progressively increased, with a reduction in death rates over all age groups and for a wide range of conditions. The improvements can be attributed to the effectiveness of health and hospital services and to the fact that access to health care is guaranteed by Medicare. Australians are committed to a universal system of health care coverage - a system where access to public health services is based on clinical need rather than financial status, which those on the opposite side openly support. Medicare has proved an efficient format for bringing health services to all Australians.
There have been some changes to Medicare since its inception, but the principles of universality, equity and choice are still integral parts of Medicare. Perhaps I should explain what these mean. Choice of services means that an eligible person must be given the choice of receiving public hospital services - which might include in-patient, outpatient, emergency services and day services - free of charge as a public patient. Access to public hospital services is to be on the basis of clinical need, which means that it should not be influenced by a person's financial status or place of residence or whether people have health insurance. Equity in service provision means that States will ensure that eligible persons, regardless of their geographical location, are able to have reasonable access to public hospital facilities. The result of Medicare has been to enable ready access by Australians to free health care based on clinical need.
Australia's level of health expenditure as a proportion of gross domestic product falls in the mid-range of other OECD countries, remaining relatively steady at about 8 per cent. Australia has a quality hospital service, with a skilled work force, modern technology and good standard facilities. However, there is recognition by all governments that, despite the quality services provided and guaranteed access, we need continually to improve the system to keep up with the times and changing demands. Medicare, so long as it is not destroyed by the Liberals, will continue to guarantee access for all Australians to these services.
However, at times there is still discrimination against patients based on financial status. We have all seen the misleading ads run by private health insurance companies that use purely emotional blackmail against fellow Australians. These ads make you believe that without private health insurance you will not have access to hospital treatment. Let me assure you, Madam Speaker, that
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