Q~ sNz Y4A; A
SPEECH BY THE PRIME MINISTER
HEALTH AND RESEARCH EMPLOYEES' ASSOCIATION
SYDNEY., 5 MARCH 198LI
MR CHAIRMAN, LADIES AND GENTLEMEN,
IAM VERY PLEASED TO HAVE THIS OPPORTUNITY TO AD) DRESS YOUR
AS SOCI AT IONTODAY
IS THE FIRST ANNIVERSARY OF THE PRESENT LABOR
GOVERNMENT'S ELECTION TO OFFICEAMONG
THE MANY ACHIEVEMENTS OF THE GOVERNMENT HAS BEEN THE
INTRODUCTION OF MEDICAREWITH
THIS HISTORIC INITIATIVE ALL AUSTRALIANS NOW HAVE A
NEW, SIMPLER AND FAIRER HEALTH INS! JRANCE SYSTEMYOUR
ASSOCIATION ANID ITS MEMBERS ARE PARTICULARLY WELL
PLACED TO APPRECIATE THE ADVANTAGES THIS BRINGS FOR THE
COMMUNITY GENERALLY-QUITE APART FROM IMPROVED COMMNUNITY
HEALTH STANDARDS, OTHER CONCRETE ADVANTAGES INCLUDE THE
ELIMINATIOJ4~ OF MANY COMPLEX BILLING PROCEDURES THAT HAD
PREVIOUSLY DIVERTED VALUABLE RESOURCES FROM IMPORTANT
SERVICE ACTIVITIES INTO UNNECESSARY ADM1NISTRATIVF AND /* 1
SUPPORT ACTIVITIES. UNDER MEDICARE THOSE SAME RESOURCES
WILL BE USED TO PROVIDE BETTER HEALTH SERVICES FOR ALL
AUSTRALIANS. THERE ARE FUNDAMENTAL AND COMPELLING REASONS WHY THE
INTRODUCTION OF MEDICARE HAS BEEN CLOSE TO THE TOP OF THE
GOVERNMENT'S AGENDAIT
WAS TOTALLY UNACCEPTABLE THAT NEARLY 2 MILLION
AUSTRALIANS WERE FOR SEVERAL YEARS WITHOUT PRIVATE INSURANCE
OR THE COMMONWEALTH GOVERNMENT'S COVER PROVIDED TO
PENSIONERS, UNEMPLOYED AND LOW INCOME EARNERS. MANY OF THE
TWO MILLION WERE SIMPLY ' JNABLE TO AFFORD THE COST OF PRIVATE
INSURANCE-IRONICALLY THEY AT THE SAME TIME FACED POTENTIAL
FINANCIAL RUIN IN THE EVENT OF MAJOR ILLNESSTHE
LABOR GOVERNMENT WAS ELECTED, AMONG OTHER THINGS, TO
REDRESS THIS SITUATION-WITH MEDICARE AUSTRALIANS NOW HAVE
A STABLE SYSTEM WHICH PROVIDES EVERYONE WITH COVER AT A FAIR
COSTUNDER THE PREVIOUS ARRANGEMENTS THERE WAS SOME PROVISION * FOR
LOW INCOME PENSIONERS AND FAMILIES TO RECEIVE FREE CAREBUT
THE INCOM4E TEST ON THESE BENEFITS WAS TOO RESTRICTIVE;
MANY FAMILIES WITH INCOMES JUST A LITTLE OVER THE CUT-OFF
POINT SIMPLY COULD NOT AFFORD THE $ 13 MINIMUM PER WEEK WHICH
WAS THE COST OF BASIC COVER. FAMILIES WITH INCOMES AS LOW
AS $ 200 PER WEEK FAILED TO QUALIFY FOR THE CONCESSIONA'-
ARRANGEMENTS. IF PRE\ VIOUS HEALTH SCHEMES HAD CONTINUED, rHE
COST OF FAMILY COVER IN FEBRUARY 1984 WOULD CERTAINLY HAVE
BEEN GREAT ER THAN $ 15 PER WEEK.
MEDICARE ENSURES THAT NO AUSTRALIAN NEED NOW FEAR THAT
TREATMENT OF SICKNESS WILL HAVE CRIPPLING FINANCIAL
CONSEQUENCES. ALL AUSTRALIANS ARE GUARANTEED -AS A BASIC
RIGH T PROTECTION AGAINST THE FINANCIAL IMPACT OF ESSENTIAL
MEDICAL AND HOSPITAL TREATMENTALL
AUSTRALIANS ARE CONTRIBUTING TO0 THE COST OF MEDICARE
ACCORDING TO THEIR CAPACITY TO PAY. IMPORTANTLY A MAJORITY
OF AUSTRALIAN FAMILIES ARE NOW PAYING LESS FOR HEALTH COVER
UNDER MEDICARE.
A VITAL REASON FOR MOVING TO REFORM THE HEALTH INSURANCE
SYSTEM IS T0 CURB THE INCREASE IN COSTS OF HEALTH CARE,
WHETHER THES-E COSI'S ARE BORNE BY THE COMMUNITY AS A WHOLE OR
BY INDIVIDUAL PATIENTSTHE
UPWARD TREND IN COSTS NEEDS TO BE RECOGNISED. HEALTH
COSTS AS A PERCENTAGE OF AUSTRALIA'S NATrONAL PRODUCT
INCREASED SUBSTANTIALLY DURING THE 1970' s -RISING FROM OVER
5.7 PER CENT To 8.00 PER CENT OF GDP IN THE PERIOD-
MANY FACTORS WERE RESPONSIBLE FOR TfHIS; SOME OF THESE WERE
SOCIAl-LY DESIRABLE ANT) NECESSARY FOR EXAMPLE THE EQUAL PAY
DECISION OF 1973; OTHER ELEMENTS, SUCH AS THOSE INVOLVING
MEDICAL FRAUD AND OVERSERVICING, WERE A HEAVY DRAIN ON THE
PUBLIC PURSE-WHAT IS CLEAR IS THAT GOVERNMENTS MUST TAKE
VIGOROUS AND EFFECTIVE ACTION TO CONTAIN INCREASING MEDICAL
SERVICE COSTS TO THE EXTENT POSSIBLEMEDICARE
THROUGH A SINGLE NATIONAL ORGANISATION, AIMS TO
BRING NEEDED EFFICIENCIES AND ECONOMIES TO THE
ADMINISTRATION OF THE NATIONAL HEALTH SYSTEMTHE
INTRODUCTION OF MEDICARE HAS BEEN ACC: OMPANIED' BY THE
ESTABLISHMENT OF ONE OF THE LARGEST AND MOST MODERN COMPUTER
NETWORKS IN THE WORLD. THIS SYSTEM WILL ENSURE THAT THE
STANDARD OF ADMINISTRATIVE BACKUP AND SUPPORT IS SECOND TO
N ON EIT
. WILL ALSO PROVIDE-THE MEANS TO DETECT QUICKLY ATTEMPTS TO
ABUSE MEDICARE-WHILE ONLY A SMALL MINORITY OF DOCTORS ARE
INVOLVED IN QUESTIONABLE PRACTICES, SUCH A CAPACITY IS
NEEDED-INDEED WE HAVE JUDGED IT RECESSARY TO EXTEND THE
GOVERNMENT'S ABILITY TO INVESTIGATE AND DEAL WITH ABUSES
WHERE THEY EXIST IF RISING COSTS ARE TO B. E EFFECTIVELY
CONTA INED-
WIDER APPLICATION OF BULK BILLING BY DOCTORS SHOULD ALSO
LEAD TO REDUCED COSTS. BULK BILLING, APART FROM BEING MORE
COt'VENIENT AND ZHEAPER TO THE PATIENT, LOWERS ADMINISTRATIVE
COSTS FOR BOTH THE DOCTORS AND THE GOVERNMENT. THE
PROPORTION OF MEDICAL CLAIMS THAT ARE BULK-BILLED IS
EXPECTED TO INCREASE WITHIN 3 MONTHS FROM ABOUT 30 PER CENT,
WHICH REFLECTS THE NUMBER OF PENSIONER PATIENTS, TO ABOUT
PER CENT. THE GOVERNMENT IS PLEASED THAT VIRTUALLY ALL
DOCTORS HAVE CONTINUED THEIR PRACTICE OF BULK BILLING
PENSIONERS AND THE DISADVANTAGED IN OUR COMMUNITY, AND THAT
AN INCREASING NUMBER ARE EXTENDING THIS TO ALL PATIENTS.
BULK BILLING SHOULD BECOME THE NORM CERTAINLY THIS IS WHAT
THE GOVERNMENT INTENDS.
WE ARE ALSO COMMITED TO CONTAINING COSTS ON. THE HOSPITAL
SIDE OF AUSTRALIA'S HEALTH BUDGET. UNLIKE THE HOSPITAL
FUNDING ARRANGEMENTS UNDER MEDIBANK AND IN THE EARLY FRASER
YEARS, WE WILL NOT BE SHARING THE COSTS OF STATE HOSPITAL
SYSTEMS ON A DOLLAR FOR DOLLAR BASIS. THE OPEN-ENDED
COMMITMENT INVOLVED IN THAT SYSTEM CONSII) E : ABLY REDUCED THE
INCENTIVES FOR STATE GOVERNMENTS TO CONTAIN THE COSTS OF
THEIR HOSPITAL SYSTEMS.
WE ARE INSTEAD PROVIDING A GREATER LEVEL OF ASSISTANCE TO
THE STATES FOR THEIR HOSPITALS, BUT ON A RESPONSIBLE BASIS
WHICH ESTABLISHES AT THE BEGINNING OF THE YEAR THEIR LEVEL
OF COMMONWEALTH FUNDS. THiIS ENABLES STATE HOSPITALS TO
BUDGET ACCORDINGLY AND REPRESENTS A REAL INCENTIVE TO THEM
TO CONTAIN COSTS.
AN IMPORTANT PART OF THE HOSPITAL ARRANGEMENTS ARE SPELT OUT
IN THE MEDICARE AGREEMENTS WITH THE STATES, ALL OF WHICH ARE
NOW SIGNED, SEALED AND DELIVERED-QUEENSLAND SHOWED SOME
RELUCTANCE. THERE WJAS A TEMPTATION TO BUY OUR WAY OUT OF
ARGUMENT IN THIS AREA -NEEDLESS TO SAY I DO NOT GIVE IN TO
SUCH TEMPTATIONSWHAT WE HAVE AGREED WITH QUEENSLAND, TO ENSURE THAT IT IS
EQUITABLY TREATED, IS TO. ASK THE GRANTS COMMISSION TO GIVE
SPECIAL CONSIDERATION TO THE IMPACT OF THE MEDICARE GRANTS
ON QUEENSLAND'S FINANCIAL POSITION, AND TO RECOMMEND ANY
NECESSARY ADJUSTMENTS IN THE TAX SHARING AND IDENTIFIED
HEALTH GRANTS-HAVE ASSURED THE QUEENSLAND GOVERNMENT
THAT THE COMMONWEALTH WILL RESPOND ON THE BASIS OF PROMPT
AND FULL CONSIDERATION OF THE-GRANTS COMMISSION'S
RECOMMENDATI-ONS ON THIS MATTERANOTHER
INSTANCE OF THE COST CONTMiNMENT STRATEGY BEING
PURSUED BY THE GOVERNMENT IS THE CHANGES WE ARE MAKING TO
PRIVATE PRACTICE RIGHTS FOR DIAGNOSITC SPECIALISTS IN PUBLIC
HOSPITALS.-AM REFERRING HERE TO THE RIGHT OF SALARIED AND
VISITING DIAGNOSTIC SPECIALISTS TO TREAT' THEIR PRIVATE
PATIENTS WITHIN PUBLIC HOSPTIALS, USIN4G HOSPITAL EQUIPMENT
AND FACILITIES, AND CHARGING THOSE PATIENTS ON A FEE FOR
SERVICE BASIS. THESE PRIVATE PRACTICE RIGHTS DO NOT AFFECT
THE TREATMENT OF PUBLIC PATIENTS; NOR DO THEY AFFECT THE
RIGHTS OF DIAGNOSTIC SPECIALISTS TO TREAT PATIENTS OUTSIDE
PUBLIC HOSPITALS.
RECOGNISE THAT PRIVATE PRACTICE RIGHTS ARE ESSENTIAL IF WE
ARE TO CONTINUE TO ATTRACT THE HIGHEST QUALITY MEDICAL STAFF
TO OUR PUBLIC HOSPITALS. BUT FOR SOME YEARS, CONCERN HAS
BEEN EXPRESSED BY COMMONWEALTH AND STATE HEALTH MINISTERS,
AND BY THE PREVIOUS GOVERNMENTIS JAMISON REPORT INTO
HOSPITALS, ABOUT THESE RIGHTS OF PRIVATE PRACTICE.
SEVERAL REPORTS TO GOVERNMENT HAVE HIGHLIGHTED QUITE
UNSATISFACTORY FEATURES OF CURRENT PRIVATE PRACTICE
ARRANGEMENTS, SOME VISITING DIAGNOSTIC SPECIALISTS HAVE
BEEN DRAWING INORDINATELY HIGH INOMCES FROM THE PUBLIC
HOSPITAL SYSTEM APPROXIMATELY A QUARTER OF A MILLION
DOLLARS NET IN SOME KNOWN CASES. IN SOME STATES SALARIED
DIAGNOSTICIANS HAVE ALSO BEEN EARNING MORE FROM PRIVATE WORK
THAN THROUGH THEIR SALARIED PUBLIC" WORK.
As A RESULT, LATE LAST YEAR, DR BLEWETT PROPOSED NEW
ARRANGEMENTS AIMED AT INCREASING THE PUBLIC ACCOUNTABILITY
OF DIAGNOSTIC SPECIALISTS AND REDUCING THE INCENTIVES TO
8.
REQUEST AND PERFORM DIAGNOSTIC TESTS. THESE ARRANGMENTS
WOULD HAVE ENSURED, FIRST, THAT HOSPITALS CHARGE THE
SPECIALISTS FOR THE USE OF EQUIPMENT AND OTHER FACILITIES;
SECOND, THAT HOSPITALS, RATHER THAN THE DOCTORS, WOULD BILL
PATIENTS; THIRD, THAT REASONABLE RESTRAINTS WOULD BE PLACED
ON THE INCOMES DIAGNOSTIC SPECIALISTS COULD EARN; AND
FINALLY THAT THE DIAGNOSTIC SPECIALISTS WOULD CHARGE NO MORE
THAN THE SCHEDULE FEE.
THE OUTCOME OF THE NEGOTIATIONS WHICH FOLLOWED BETWEEN DR
BLEWETT AND THE AMA WAS A VERY SUBSTANTIAL COMPROMISE ON THE
GOVERNMENT'S PART. WE AGREED THAT THE QUESTION OF LIMITS ON
THE INCOMES OF DIAGNOSTIC SPECIALISTS WOULD BE REFERRED TO A
REPRESENTATIVE INQUIRY THE PENNINGTON INQUIRY. WE
ACKNOWLEDGED THAT WHAT WAS INVOLVED WENT TO SENSITIVE AND
IMPORTANT ISSUES; WE DID NOT WANT TO DRIVE SPECIALISTS,
ESPECIALLY SALARIED SPECIALISTS, OUT OF THE PUBLIC HOSPITAL
SYSTEM. WE HAD EXPECTED THAT, AS A RESULT OF OUR COMPROMISE, THE
SPECIALISTS WOULD AGREE TO INTERIM CONTRACTS WHICH WOULD
COVER THE OTHER ASPECTS OF THE PROPOSED ARRANGEMENTS.
HOWEVER, AS YOU WOULD ALL KNOW, SOME ELEMENTS OF THE MEDICAL
PROFESSION HAVE NOW OBJECTED TO OUR INSISTENCE THAT
DIAGNOSTIC SPECIALISTSI CHARGES IN PUBLIC HOSPITALS BE
LIMITED TO THE SCHEDULE FEE-
ONE OF THE PROBLEMS WE HAVE FACED IN THIS PROCESS IS THAT
THE AMA HAS BEEN HAPPY TO OBTAIN CONCESSIONS FROM THE
GOVERNMENT, BUT HAS THEN BEEN UNABLE TO RESPOND WITH BINDING
COMMITMENTS FROM THE MEDICAL PROFESSIONTHIS
NEGOTIATION CANJNOT ALL BE ONE WAY. THE GOVERNMENT HAS
BEEN PREPARED TO DEMONSTRATE CONSIDERABLE FLEXIBILITY IN THE
INTERESTS OF SECURING AGREEMENT. ANY AGREEMENT, HOWEVER,
REQUIRES TWO TO TANGO" It; THE GOVERNMENT AND THE COMMUNITY AT
LARGE COULD QUITE LEGITIMATELY HAVE EXPECTED A LESS
UNCOMPROMISING AND RIGID STAN4D FROM THE DOCTORS, IF ONLY OUT
OF RECOGNITION OF PATIENTS IINTERESTS. THERE ARE, HOWEVER,
LIMITS TO THE GOVERNMENT'S FLEXIBILITY-IT HAS A
RESPONSIBILITY OT SECURE IMPORTANT NATIONAL INTERESTS-ONE
SUCH INTEREST IS THE CONTAINMENT OF RISING HEALTH COSTSHENCE
OUR INSISTENCE THAT DIAGNOSTIC SPECIALISTS, WHO HAVE
SUCH PRIVILEGED ACCESS TO PUBLIC FACILITIES, SHOULD CHARGE
NO MORE THAN THE SCHEDULE FEE.
LAST WEEK BOTH DR BLEWETT AND THE FOUR STATE LABOR
GOVERNMENTS INITIATED ACTION TO ENSURE TrHAT rHE SCHEDULE FEE
IS CHARGED FOR DIAGNOSTIC SERVICES IN PUBLIC HOSPTIALS. IN
THIS WAY THESE LABOR GOVERNM~ ENTS ARE SEEKING TO ENSURE THAT
THE PEOPLE IN THEIR STATES CAN RECEIV'E TIE MEDICARE BENEFITS
TO WHICH THEY ARE ENTITLED-WE WERE NOT PREPARED TO ALLOW
THE DISPUTE WITH THE DIAGNOSTICIANS TO REACH A STAGE WHERE
THE PUBLIC WOULD BE INCONVENIENCED THROUGH THE REFUSAL OF
MEDICARE BENEFITS TO PPTIENTS WHOSE SPECIALISTS HAD NOT
SIGNED AN AGREEMENT TO CHARGE THE SCHEDULE FEE. IN
QUEENSLAND AND TASMANIA, RIGHTS OF PRIVATE PRACTICE
ARRANGEMENTS ARE VERY LIMITED; THERE WE WILL REQUIRE
DIAGNOSTIC SPECIALISTS TO AGREE IN WRITING TO CHARGE THE
SCHEDULE FEE.
THERE HAS BEEN A LOT OF NONSENSE TALKED ABOUT THE MINISTER
FOR HEALTH HAVING SOME ABSOLUTE POWER TO SET THESE FEES. ON
THE CONTRARY, THE FEES SET OUT IN iHE MEDICAL BENEFITS
SCHEDULE ARE NOT DETERMINED BY THE MINISTER OR BY THE
GOVERNMENT, BUT BY AN INDEPENDENT TRIBUNAL TO WH! ICH BOTH THE
GOVERNMENT AND THE MEDICAL PROFESSION MAKE SUBMISSIONS. THE
CURRENT TRIBUNAL HEARING IS BEING CHAIRED BY THE DEPUTY
PRESIDENT OF rHE ARBITRATION COMMISSION, MR JUSTICE
MCKENZIE.
WE-MUST GET THIS DISPUTE INTO PERSPECTIVE. THE GREAT
MAJORITY OF DIAGNOSTIC SPECIALISTS ALREADY CHARGE NO MORE
THAN THE SCHEDULE FEE. AND MANY ALREADY HAVE CONTRACTS WITH
STATE HSOPITAL SYSTEMS WHICH LIMIT' THEIR CHARGES TO THAT
SCHEDULE FEE. THOSE WHO ARE HOLDING OUT AGAINST THE NEW
ARRANGEMENTS ARE DOING SO, AT LEAST IN MANY CASES, FOR
NARROW AND SELFISH REASONS-
LET ME STREES THAT THIS GOVERNMENT HAS NO INTENTION OF
NATIONALISING HEALTH CARE IN THIS COUNTRY. WHILE WE ARE
COMM ITTED TO CURB ING GROWTH I N COS TS AND ENSUR ING THE
EFFICIENCY OF THE OVERALL SYSTEM, THERE IS NO PLAN TO END
PRIVATE P RACTJCE. WE REGARD PRIVATE PRACTICE AS A
FUNDAMENTAL AND ESSENTIAL PART OF OUR HEALTH CARE SYSTEMANOTHER
IMPORTANT PART OF my GOVERNMENT'S AIM TO SECURE
RATIONALISATION OF HEALTH CARE EXPENDITURES, IS THE NEW
SYSTEM OF PRIVATE HOSPITAL SUBSIDIESTHE
CHANGES WE HAVE MADE WERE LONG OVERDUEPRIVATE
HOSPITALS ARE A VERY DIVERSE RANGE OF INSTITUTIONSAT
ONE EXTREME ARE THE MAJOR SURGICAL HOSPITALS, MOSTLY RUN
BY RELIGIOUS OR CHARITABLE ORGANISATIONS, WHICH PROVIDE A
LEVEL OF CARE AND SERVICES COMPARABLE WITH THAT IN THE MAJOR
PUBLIC HOSPITALS. AT THE OTHER EXTREME ARE MANY SMALLER
INSTITUTIONS, WHICH ARE IN EF-FECT NO MORE THAN NURSING
HOMES. DESPITE THIE DIFFERENCE IN COST STRUCTURES BETWEEN
THESE TWO EXTREMES, THE SAME INSURANCE BENEFITS AND
COMMONWEALTH SUBSIDIES USED TO BE-' PAID TO0 BOTH-MANY
PRIVATE HOSPITALS CAPITALISED ON THIS SITUATION, SOME DREW
INORDINATELY HIGH PROFITS FROM THE SYSTEM. OTHERS WERE ABLE
TO CONTINUE OPERATING WHEN THEY WERE NOT OTHERWISE
ECONOMI1CALLY VIABLE-THE PREVIOUS GOVERNMENT, WHILE
12.
DEDICATED TO SECURING EFFICIENCY IN THE PUBLIC HOSPITAL
SYSTEM, DID NOTHING TO ADDRESS THIS OBVIOUSLY ANOMALOUS
S ITUAT IONTHE
NEW SYSTEM OF CATEGORISATION OF PRIVATE HOSPITALS SEEKS
TO ENSURE THAT BENEFITS AND BED SUBSIDIES; WILL BE FAR MORE
CLOSELY RELATED TO THE LEVEL OF SERVICE AND THE COST
STRUCTURE OF SPECIFIC HOSPITALS.
WHILE CONVINCED OF THE FAIR AND EQUITABLE CHARACTER OF THE
CATEGORISATION PRINCIPLE, THE GOVERNMENT IS AWARE THAT ITS
DETAILED APPLICATION WILL REQUIRE SOME FINE-TUNING.
ALREADY WE ARE AWARE THAT SOME OF THE CATEGORISATION RULES
NEED TO BE MORE GENEROUS. WE HAVE DECIDED ALSO THAT IT IS
NECESSARY TO GIVE THE MINISTER FOR HEALTH A WIDER
DISRETIONARY POWER TO UPGRADE INDIVIDUAL HOSPITALS-ON THE
BASIS OF EVIDENCE ALREADY AVAILABLE WE INTEND IMMEDIATELY TO
UPGRADE 14 HOSPITALS THROUGHOUT AUSTRALIA FROM CATEGORY 3 TO
CATEGORY 2, AND AS A RESULT, TO INCREASE THE BENEFITS
PAYABLE FOR PATIENTS IN THESE HOSPITALS 1BY $ 30 A DAY.
SEVERAL OTHER CASES ARE UNDER CLOSS CONSIDERATION.
IN RELATION TO PSYCHIATRIC PRIVATE HOSPITALS I CAN GIVE A
CLEAR UNDERrAKING THAT THE BETTER OF THESE INSTITUTIONS WILL
BE UPGRADED AS SOON AS THE PRIVATE HOSPITAL INDUSTRY AND THE
13.
MINISTER FOR HEALTH CAN DEVELOP SUITABLE PRINCIPLES FOR
DETERMINING WHICH INSTITUTIONS PROVIDE HIGHER LEVELS OF
CARE. FINALLY, LET ME SAY THAT ANY PRIVATE HOSPITAL WHICH CAN
OBJECTIVELY PROVE THAT, GIVEN REASONABLE OCCUPANCY LEVELS,
IT CANNOT OPERATE ON THE EXISTING BENEFITS WILL BE GIVEN
SYMPATHETIC CONSIDERATION FOR RECATEGORISING. IN THIS WE
PRESUME THE HOSPITAL WILL BE PREPARED TO MAKE A FULL AND
HONEST DISCLOSURE OF ITS OPERATING COSTS. THE GOVERNMENT
OBVIOUSLY CANNOT BE EXPECTED TO BE SYMPATHETIC TO SITUATIONS
IN WHICH SOME HOSPITALS SIMPLY " CRY POOR" BECAUSE PREVIOUS
SUBSTANTIAL PROFITS ARE NOW BEING REDUCED TO REASONABLE
LEVELS. I BELIEVE THE INTRODUCTION OF MEDICARE REPRESENTS A
SIGNIFICANT ' ACHIEVEMENT OF OUR FIRST YEAR IN OFFICE. IT HAS
BEEN AN EVENTFUL AND PRODUCTIVE YEAR.
THE RAPID INTRODUCTION OF MEDICARE AND ITS ACCEPTANCE BY
MOST AUSTRALIANS ARE DEMONSTRATED BY THE FACT THAT OVER 7.3
MILLION MEDICARE CARDS HAVE BEEN I-SSUED, COVERING OVER 14
MILLION PEOPLE OR WELL OVER 90 PER CENT OF AUSTRALIA'S
POPULATION. THIS IS A TRULY REMARKABLE ACHIEVEMENT WHEN YOU
CONSIDER THAT REGISTRATION IS VOLUNTARY AND THAT IT HAS ONLY
BEEN 32 MONTHS SINCE OUR ADVERTISING CAMPAIGN COMMENCED-
14l.
BUT UNFORTUNATELY, IT IS OFTEN THE FEARS AND THE PROBLEMS
WHICH CAPTURE THE HEADLINES. THERE IS USUALLY TOO LITTLE
CREDIT FOR THOSE WORKING HARD BEHIND THE SCENES.
IT IS A TRIBUTE TO THE MINISTER OF HEALTH, DR NEAL BLEWETT,'
AND TO THE OFFICERS OF His DEPARTMENT AND THE HEALTH
INSURANCE COMMISSION THAT IN JUST ON4E YEAR THEY HAVE
TRANSFORMED MEDICARE FROM NOTHING MORE THAN A POLICY
DOCUMENT TO THE SIMPLE, EQUITABLE, EFFICIENT AND UNIVERSAL
HEALTH SCHEME WE NOW HAVE IN OPERATION. THIS IS A MAJOR
ACHIEVEMENT. THE GOVERNMENT FOR ITS PART IS MORE THAN EVER
CONVINCED OF THE ADVANTAGES MEDICARE IS BRING. ING TO EACH AND
EVERY AUSTRALIAN-WE SHALL CERTAINLY NOT BE DEFLECTED FROM
THE TASK OF CONSOLIDATING AND REINFORCING THOSE ADVANTAGESAFTER
ALL, AS I KNOW YOU WOULD ALL AGREE, MEDICARE AS WE
HAVE DEVELOPED IT PROVIDES AN EXCELLENT MODEL FOR AUSTRALIAN
HEALTH COVER WELL INTO THE 21ST CENTURY-