Topics: Private health insurance; COAG hospital agreement; Medicare and bulk-billing; Medical Research Future Fund; listing medicine on the PBS; rare cancers
Joining me now live from Canberra is the federal Health Minister Greg Hunt. Thank you for your time, Minister.
And good evening, pleasure.
Now, I’m sorry to do this to you, and don’t give me the usual line that it’s not your portfolio, but obviously one of the big stories of today continues to be this issue regarding Barnaby Joyce. I’ll get into health matters just shortly.
I don’t know if you got the tail end of my conversation with Dennis Shanahan, but I make the point, if the Prime Minister, in Question Time today, said that he’s basically allocated positions to the National Party and they can adjudicate them as they will across their staff, that leaves the leader of the National Party in a great deal of power deciding where the staff go.
Now, if Vikki Campion moved out of his office in the April and then moved around other ministers, decided, let’s say, by Barnaby Joyce – how is that any different than with the issue with Roman Quaedvlieg, who has been on leave now for nine months?
He’s the CEO, or the head, of Australian Border Force. There is an allegation, he says it’s unfounded, but there is an allegation he acted improperly in helping his girlfriend, who is also a junior in Border Force, get a job at the Sydney Airport.
Now, he has been in front of the Law Enforcement Integrity Commission, investigated, as I said, for nine months over potentially having something to do with a girlfriend getting a job in another area.
If the Prime Minister gave these positions to the Nationals, and Barnaby Joyce is the leader, and this woman is Barnaby’s partner, girlfriend, call her whatever you like, and she’s been moved around offices by Barnaby Joyce’s office, well, how is that any different?
Sure. Look, there are two issues here. One is a moral question, and throughout my career I’ve made a decision not to try to give opinions on other people’s private lives, whether that’s Liberal, Labor, Nationals, Greens, independent.
Then the second one is a rules question. Those rules are always subject to the oversight of the Department of Finance, and if anybody at any time has done anything incorrectly, they’ll identify it. The advice coming out of the Prime Minister’s office is there’s no evidence of that.
I don’t have anything beyond that, but I draw that distinction, and I think it’s an important distinction for many and most of us in public life to have.
The moral questions are ones for individuals, the rules-based questions are one for the system. If anything improper in this or other cases has occurred, and I can’t and shouldn’t comment on the individual in Border Force, then the system will determine that.
But one is a system, Greg, where there is an investigation by the Law Enforcement Integrity Commission underway, and it’s a thorough investigation that’s nine months in. The other is a prime minister, and indeed a deputy prime minister, both of them say there’s nothing to see here.
Varying discussions about whether she’s a girlfriend, partner. She’s still not listed on Mr Joyce’s pecuniary interests as a partner, but they’re living together and she’s certainly having his child.
I’m not asking about the morality. My question is, and you know I know this as well as anybody in terms of the code of practice.
You know it better than me.
My question is it doesn’t smell right, and I suspect if there is an open and transparent investigation, this stuff just does not stack up. But I suspect you’re not going to give me much more than what you’ve said.
Okay. Let’s get into some health questions, which is where we’re both more comfortable. I want to ask you about this announcement the other day that the Labor Party had.
On the face of it, it sounds very attractive to cap private health insurance cost increases. It’s often not well understood that a lot of the people that keep their private health insurance do so on very low or fixed incomes, particularly older Australians, so it is attractive when you see these increases go up and up and up.
But the real threat is there, that there could be some change in the dynamic of the system and, at worst, we lose some of these lower-fee funds.
So, private health is incredibly important to 13.5 million Australians, peace of mind, choice, choice of doctor, the ability to know that they’re safe if they have a chronic or a debilitating condition. We’ve just introduced real and profound reform.
We took more than $1 billion out of the cost of the system, arguably the biggest reforms in over a decade. The result, the lowest premium changes in 17 years. But we still want to do more.
Labor’s approach, of course, is – as you would know – they slashed the rebate when they came in, the private health insurance rebate, and now rather than reducing costs, they have a proposal to take away the lowest cost group of policies, which would drive up the average cost by 16 per cent. So in pricing terms, it’s actually catastrophic.
They’ve been caught out with that, so they say, well, we’ll just preserve the rest of it with a 2 per cent cap. Except the industry says no consultation, disastrous, and in particular it would push some funds to the point of bankruptcy according not just to us, but in particular both the large and the small private health insurers.
In the end, it would mean bigger out-of-pockets for the lowest income earners and longer waiting times. So, it’s a genuinely catastrophic policy, described by Joel Fitzgibbon’s brother, the head of NIB, one of the biggest insurers in the country, as a thought bubble and economic madness. In other words, they don’t care about private health. They don’t like it and they basically want to break it.
You made a point there about out-of-pockets and I just want to stay on that point. So, most Australians obviously pay a Medicare levy.
They front up to a hospital, there can be gaps in the payment, they pay their taxes and they expect a service. Other Australians who have private health insurance do all of those things, they still pay for Medicare even if they’re privately funded, but increasingly the out-of-pocket costs to have private health insurance, the gap is so large that people are really questioning whether it's worth staying in the system. What can the Government do to reduce out-of-pocket costs?
So, there are two big things. One is we've just commissioned the Chief Medical Officer, Professor Brendan Murphy, to lead a group with the medical bodies focusing on out-of-pockets or gap payments. The second is to give people absolute knowledge, transparency, and choice.
So at the moment, most people understandably would struggle to get through the detail of their policies, and that's because they're not consistent.
So, within that, we're going to create consistency. Secondly, we're going to have clear categories: gold, silver, bronze, and basic. And then thirdly, within that, we're going to have a very clear one pager, what's in, what's out.
So the most important point is, no surprises, you really know what you're buying, and you know what you're not buying.
That has been largely lacking in my view and, on my watch and in our time, that's something that not only are we determined to do, we're doing. So, no surprises, and then putting pressure on through the transparency process that the Chief Medical Officer is leading.
Just on bulk billing, this is also a bugbear with people. I mean, bulk billing rates are increasing and they're strong.
That's been a lot of work by Coalition governments, I have to say, as much as they are Labor, but there's very little bulk billing by procedural specialists. What's the Government doing here to increase those numbers?
So firstly, in GP bulk billing the rates are about 85.9 per cent, so that's 3 per cent higher under us than under Labor, and that's a combination of the work, as you say, by successive prime ministers under the Coalition and the health ministers, as well as the profession.
In terms of GP bulk billing, precisely the thing that we are doing is we are ending the freeze that Labor brought in. In specialist bulk billing, we are ending the freeze that Labor brought in.
We started last year. There are more changes this year for GPs and specialists as of 1 July, and again next year on 1 July.
So you have two large specialist groups which will be transformed. So, on our watch we're ending what they started, and most importantly, add that in with working very cooperatively.
We are, to the best of my knowledge, the first government to have simultaneous agreements with the College of GPs, the AMA, Medicines Australia, to reduce $1.8 billion out of medicines costs, and the Pharmacy Guild all at once.
So, all of that is about structural reform, reducing costs in return for faster access to medicines and devices, and better transparency.
On Friday, at the COAG press conference with the Prime Minister and the premiers, I watched that age-old health dance, reminded again when I saw Kevin Rudd today.
I remember the referendum, he said the Commonwealth would take over health, which never happened of course.
But I looked at the premiers, and of course you had WA indicate that they would support, New South Wales saying it was a terrific deal, South Australia saying they were violently opposed, Queensland saying she'd have to look at her numbers.
It was the usual mixed bag, and of course we'll now go through with this posturing that goes on and it will end up just being a bigger cheque going to the states.
When I was on the ERC, the budget committee, looking at these issues as a staffer, I remember thinking it was such a complex interplay of cost shifting between the Commonwealth and the states and, you know, one side not wanting someone to go into a day procedure because that meant they bore the cost, others wanting to get them out of hospital so they wouldn't have to pay the costs.
You are out of McKinsey, you've had a career as a consultant, you've got a brilliant mind, if you don't mind me saying so. What can you do? You know, you could stand back and look at this and say, how on earth can we make it more rational and more efficient?
So, the starting point with the GPs, the specialists, medicines and then private health is always to find something that works for the profession, and something that works in terms of patient outcomes and reduced costs. We've been able to do it in all of those four areas.
With hospitals, the critical thing is that, with a shared payment system, so for every new $1000, the states pay 550, we pay 450. So, we contribute to the growth, and so they have an incentive not to grow because they'll have to pay out of their own pockets. We assist them. So, that that model is very important.
Then the second thing is there is deep reform embedded in the health agreement, which was released this afternoon, and that reform is about, wherever possible, taking patients out of hospital. Most patients want to stay out of hospital and not to be in there.
If they have to be there, then we are enabling that, but if you can keep people out of hospital with what's called preventive health, and if you can ensure that they're able to recover quickly, and there are incentives for both of those things built into this agreement, then it's good for the states, it's good for the patients, and it's good for the Commonwealth.
Now, the result from Friday, to my mind, was outstanding. It was better than I dared hope. We had New South Wales and WA come on board, but Queensland, Victoria, Northern Territory, the ACT, all indicated that they're heading that way.
Jay Weatherill in South Australia, they're just going to an election, so obviously he's posturing in advance, but he can't keep the lights on in his own hospital.
So, I am very confident that we will get this sorted. We were meant to do it by the end of 2018. I'm confident that we will get the vast bulk of states far earlier than that, and with deep reforms to give patients better outcomes, and that's a good day.
I know you've got to go, Minister, you've got a commitment, but I want to just touch on something that has come up in the past and it's still obviously an issue at the moment.
Under the Gillard-Rudd Government, they changed the rules in relation to the way in which drugs came onto the PBS.
Previously expert committees would decide, the drugs would come on, and they were always then funded; government and politicians didn't get in the way of the pharmacological experts. They changed it and they held back drugs on account of budget constraints because they got themselves so far into the red.
When Tony Abbott became prime minister, he reversed that. It became very much if the experts agree the drug should be on the PBS, the drug became on the PBS.
Melbourne's just recently lost Ron Walker. I know I dealt with him and his family a lot on Keytruda, the drug that was a rare cancer drug that he fought for to be available in Australia.
How can you give people hope that have these sorts of rare cancers, particularly brain cancers and things, that there is a process, even if the drugs aren’t available for absolutely everybody?
Is there a way that they can come into trials or be looked at closely in Australia, with a chance that they become widely available to people who need them, and of course that we fund them?
You're absolutely right. The first and most important thing is that Tony Abbott reintroduced the commitment to fund every drug that is listed by the Pharmaceutical Benefits Advisory Committee, and Malcolm Turnbull and myself have recommitted to that.
That is Coalition policy and we've done that. The previous government rejected seven drugs that were fundamental, including pulmonary disease, including asthma, including schizophrenia, that were approved by the medical authorities – unprecedented, unacceptable, and frankly immoral. That's changed.
The second thing is we've already established an Australian Brain Cancer Mission. I've dealt with some families with just, you know, tragic circumstances, and through that we've decided that we need, in our time, through the Medical Research Future Fund, to create a $100 million program.
We put in $50 million of Commonwealth money. We thought it would take three years to get 50 million of private money. We're almost there barely three months after announcing it. So, the philanthropic sector has come to the party.
And then the third thing is, as part of the Medical Research Future Fund, obviously established in 2014, and you and others were deeply involved in that, we've created a major program, a Rare Cancers, Rare Diseases Clinical Trials Program.
What does that mean? It means that people who don't have access to medicines, that haven't been through the approvals process in Australia, will get access to new trials that might save their life, that might improve their life, for glioblastomas, for Huntington's disease, for cystic fibrosis, really profoundly important, life-changing opportunities.
Well, that's good news for a lot of families around the country. Thank you for your time, Minister. I know you've got to go, but I much appreciate it.
Thanks a lot. Cheers, Peta.