SKY NEWS SPEERS
THURSDAY, 26 APRIL 2018
SUBJECTS: Hospital funding, NDIS, Medibank levy backflip, private health insurance
HOST Catherine King thanks for your time today. Now for funding the NDIS, Labor and the government are now on exactly the same page, are they not?
CATHERINE KING, SHADOW MINISTER FOR HEALTH AND MEDICARE Well the government was never on the same page with Labor. Labor fully funded the National Disability Insurance Scheme and this decision by the government today to backflip on its Medicare levy hike, a tax on low and middle income Australians, just shows what a lie that was. The Government decided that it would use people with disabilities, would scare people with disabilities, by trying to tell them the NDIS was not fully funded. It was always funded and this decision by the government today shows just what a lie that was.
HOST Alright without going into previous funding, because Labor said it was funded, not all of it was hypothecated but without re-entering that, to give some assurance out there to people accessing the NDIS, right now you and the government both agree that it’s going to be funded no matter who’s in power?
KING Absolutely, we put the NDIS in place which has been a substantial reform to the services across this country. We developed it, we put it in place, we implemented it, we will fully fund it so that is certainly something that I think that people with disabilities need to hear loudly and clearly. It is funded.
HOST Hypothecated again, the word of the day perhaps, but is there any consideration of making sure all the funding is hypothecated, that is set aside specifically for the NDIS? You could do this when you’re power and it would mean there is no potential future budget emergency where a Coalition government, for example, could go looking for a saving.
KING Well the only reason we are having this debate is because this government took the decision to take Labor’s savings that fully funded the NDIS and not direct them to the National Disability Insurance Scheme. Labor will never do that. We fully funded the NDIS and that is what we will do in government. We don’t think people with disabilities should have been put through what they have been put through over the course of the last three years with this government threatening to cut the NDIS, using it as a political football, basically using people with disabilities as a shield for their cuts to other services, their cuts to social security services and their multi-million-dollar tax hike.
HOST If you think that’s the case Catherine King, and that’s a real risk, then why not look down the path of hypothecating all the funding rather than having about 5 billion or so up to the government of the day.
KING Well in general we don’t hypothecate. We don’t do that when it comes to things like the tobacco tax, that doesn’t go directly into health services, it does go into general revenue. But what I can say very clearly that the sorts of concerns that we had with this government using the NDIS as a political football will not happen under Labor. We will absolutely guarantee that it will be funded into the future well and truly. We created it, it is not something that we think should be used for political purposes in the way this government did, or that people with disabilities should be scared in the way that this government decided that they would do. We will fully fund the NDIS.
HOST Julia Gillard of course increased the Medicare levy across the board to partly pay for it, other measures did the rest of it, are you are considering at all hypothecating the rest of it in some sort of way. As I said, if you think there’s a worry about certainty, why not consider that?
KING Well there won’t be a worry about certainty under Labor. The only worry about certainty for the NDIS has come from the Turnbull government. In general we don’t hypothecate things to directly fund particular areas. That’s a decision treasurers make and have made for a long period of time, but there will be no uncertainty under Labor, the only uncertainty for the future of the NDIS has always come about from the Liberals.
HOST You did half hypothecate with the Medicare levy increase then going the rest of the way suddenly was a terrible decision, voters might be a bit confused by that.
KING Certainly we increased the Medicare levy as well as other savings measures, including in the health portfolio the means testing of the private health insurance rebate, which was partly used to fund the NDIS as well. What this government said was that it opposed that means testing of the private health insurance rebate, it claimed that it was going to reverse that decision at a cost of some $600 million I think across the forward estimates alone, they’ve been in government five, six years now and they have not honoured that promise to change that. We made those savings and we will absolutely guarantee that the National Disability Insurance Scheme under Labor is always funded and is safe.
HOST Let’s move on to hospital funding. A deal done this week, Tasmanian and Northern Territory both signing up to the Coalition’s plan on hospital funding. Do you welcome this?
KING Well again, what we have seen is that a number of states have signed the government’s inadequate hospital funding deal and they have been telling us very clearly that is because they are in need of budget certainty as they head in to their budgets in the coming months. What we do know however is that this government has over the next three years alone cut over $715 million out of public hospitals. That means less service available in emergency departments, less outpatient appointments, less surgeries whether that’s knees, cataracts, you name it, that there will be less available to be able to be funded through our public hospitals. The government has then put again that same inadequate funding model onto the table for beyond 2020. States are of course wary, having already had the experience of a government when Tony Abbott came into power ripping up an agreement where hospital funding was going to be secure for them. They are very wary about this government and I’m not surprised that some of them have signed this inadequate deal. They are telling us very clearly that the demand in public hospitals, the acuity of patients heading into our public hospitals, is going up and up. The government has put a cap on the amount of funding growth that is going to occur and we know that that means even under this agreement that there are going to be further cuts down the track as well.
HOST I want to focus though on the split, this unfair funding model that you claim it is. Now the government wants to go 45%-55%, 45% federal government. You say 50-50 is fairer. Whatever the debate is though, under both plans the same amount of money goes in the public hospitals doesn’t it?
KING That’s not true. What it actually means is that the share that the Commonwealth funds goes up. It does also mean there are services that hospitals provide that are not part of that agreement that the states and territories can then decide if they want put more funding from their share of money that goes into health into other things that in fact, for example, prevent people going into hospital in the first place. This has been a significant cut to public hospitals from what they were expecting to get under the agreements they signed with Labor and no amount of sugar coating on behalf of Mr Hunt can hide the fact he’s cut $715 million out of the agreement that Labor had with the states and territories.
HOST But on the 50-50 versus 45-55, yes states could choose to put more in but that part of it doesn’t alter how much money actually goes into public hospitals.
KING What it actually means is that we’ve got a Commonwealth government actively engaged in ensuring that we fund a proper share of our hospitals. What we also did and the government cut as well, was two extra agreements, the agreements to increase the amounts of money going into emergency departments and elective surgery waiting times, they were called the neat and nest targets to try and make sure people weren’t waiting beyond clinically-approved times to get elective surgery or to get into emergency departments. That of course has been cut as well. What this government hasn’t done is instituted any sense of agreement between the Commonwealth and States about how we actually reform our public hospitals. We know under this government, they are now being asked to do more and more with less and less funding. Our hospitals, our doctors, our nurses are all saying that public hospitals can barely keep up with demand now.
HOST Now on this proper share you mention there. What is proper because New South Wales, for example, a huge budget surplus of $5.7 billion, Tasmania, even seen as struggling, $54 million in the black. The federal government is in the red. So when you say the proper share, is there any evidence it has to be 50-50 if states’ budgets are better than the federal government’s?
KING This agreement that we had with the states and territories didn’t just come out of nowhere. We spent a year with health experts across the country having a look at how you ensure you get substantial reform in your public hospital system for the dollars that you’re spending. The Commonwealth’s share had been declining substantially in terms of its contribution to public hospitals, certainly under Liberal governments. So what that health and hospitals commission recommended is that the Commonwealth needed to have more skin in the game in order to drive reform in our public hospital system, and it came and we reached the agreement of that 50-50 share of public hospital funding as the way in which you would actually start to drive some of that reform.
HOST Does that actually look at who can afford it more Catherine King, because surely that’s a focus as well?
KING It looks at in fact what the best policy outcome is to drive reform to get improvements in our public hospital system. What it also needs to do is make sure that we lock states into their contributions and ensuring that they continue to grow and develop their services at the same time. And that’s what those agreements were about, both putting more money into public hospital, putting more money from the Commonwealth into public hospitals, but also driving reforms so you haven’t got people languishing on elective surgery waiting lists, you haven’t people not meeting clinical guidelines in emergency departments, and you’re actually starting to deal with the big waiting lists we have outpatient appointments. All of those things this government has completely dropped the ball on.
HOST If every state and territory signs up to this deal do you still pledge a different one?
KING We will certainly continue to campaign for the government, in the lead up to the budget and beyond, to put the $715 million back into public hospitals. We will then work with the states and territories on a post-2020 agreement. But what I can absolutely guarantee is Labor will always put more money into our public hospital system than the Liberals do and we will have a better reform agenda for public hospitals because Australian patients deserve it.
HOST I just want to ask you about private health insurance as well, you’ve got a policy to cap increase at 2% for two years, what’s to stop that ballooning in year 3?
KING Well, what we’ve said is it’s not just a policy to cap private health insurance at 2% for two years. We also want the Productivity Commission to have a root and branch look at private health insurance, particularly from the view of its value and its affordability to patients across the country. We know that people are leaving private health insurance, are downgrading their cover, and the number of complaints that there are about private health insurance, and particularly gaps people are paying for services that they need, that those complaints are skyrocketing. So we are expecting the productivity commission, it’s the first time in 20 years that they have had a look at this industry overall, to provide some recommendations to government to allow us to deal with that.
HOST But it seems to me that you’re either going to get a ballooning premium in year three, and that will obviously cost consumers, or the companies themselves would have to make not as much money for their shareholders, keeping in mind Medibank Private, this was genuine mum and dad type privatisation because it was offered first of all to policyholders. So those shareholders, do you say to them you might not get the returns you were expecting but we need to help out consumers more?
KING Well, the intent of the Productivity Commission enquiry and the reason we have actually gone down this pathway is about affordability of private health insurance. I’m the shadow health minister, my concern absolutely and utterly is to ensure that patients can continue to have a choice in terms of the fantastic universal health insurance scheme we have that is Medicare, and also have a choice if they choose to take out private health insurance and that they are getting value for that product. That’s the focus of the Productivity Commission enquiry. They obviously will look at where are the costs and inefficiencies are across the entirety of the system. We are working on the terms of reference at the moment with private health insurers because we want that to start on day one if we are fortunate enough to form a government after the next general election.
HOST And if that means less money for shareholders down the track then so be it?
KING It’s certainly our view that this sector has been a very profitable sector, we’re seeing profits increase. We had the government tell us when Medibank Private was to be privatised, something that we did not support, that premiums would be going down, that it would put downward pressure on premiums. We of course knew that was a lie, we have not seen that occur in our view, and our view very firmly is that this sector has become, and is very profitable, and is continuing to save its profits increase but unfortunately what we have seen is that people’s premiums have been going up and up and up and no downward pressure on premiums at all.
HOST Thank you for your time