Health Insurance (Pathology) (Fees) (Repeal) Bill 2025

Senator KOVACIC (New South Wales) (19:03): The Health Insurance (Pathology) (Fees) (Repeal) Bill 2025 removes the fees imposed on the pathology sector for certain categories of pathology applications. The coalition supports this bill. It is a response to the findings of the 2022 health portfolio charging review, addressing the misalignment of fees charged under the Health Insurance (Pathology) (Fees) Act with the charging framework, as well as providing fee relief and reducing the administrative burden on the pathology sector.

The bill will also maintain a high level of confidence in the accuracy of Medicare eligible pathology services by continuing to require service providers to meet requisite accreditation and quality assurance standards. Medicare under Labor has been quite a significant problem. We all saw the rhetoric around the election campaign, but the coalition are very concerned about the disingenuous nature of that rhetoric, particularly as we know that the current state of bulk-billing is much more dire than the government would admit.

Medicare bulk-billing has fallen 11 per cent under this government. It has fallen from 88 per cent to 77 per cent. There were 40 million fewer bulk-billed GP visits in the past year alone, and those that have to go—not just with their Medicare card but with their credit card—are actually paying more out of pocket.

Not only are there fewer services being bulk-billed; when families or individuals are going to the doctor, the gap is higher when they have to pay that gap. This data doesn't come from us. This data comes from the government's own national accounts.

This is a sad reality of our current healthcare system. It forced more than 1½ million Australians to avoid seeing their GP last year because they couldn't afford it. This was one of the regular things that I heard last year or over the past 12 months, particularly over the election campaign, when I was talking to people who were struggling with Australia's cost-of-living crisis.

There were two things that they were telling me on repeat—that it was too expensive to go to the doctor and that they were making decisions about which medications they were going to have or if they would stretch out their medications because they were far too expensive. I've spoken to a number of mums over the past year who have said, particularly as the winter cold, flu and respiratory illness season has been upon us, that they've had to make decisions about delaying their own medical appointments so they can actually afford to take each of their children to different medical appointments.

I think when somebody has to actually delay their own medical treatment or their own medical investigations it's a very sad state of affairs. For a mum to have to do that, I think, is terribly unfair. Not only looking after your sick children but having to delay your own medical visits is unacceptable in my view.

Instead of being honest with Australians about this concerning situation, Anthony Albanese has been waving his Medicare card around as a disingenuous stunt to try and distract us all from his failures. I don't think that that's quite right, and I think that Australians see past that. They want to see some action.

They don't want to see the Prime Minister waving around his Medicare card and saying, 'That's all you need.' Most people who have gone to the doctor over the past couple of years know that they needed their credit card as well as their Medicare card. I'm not sure why the Prime Minister isn't being open and transparent with Australians about the state of Medicare, but we are focused on ensuring that struggling families have timely and affordable access to the medical treatments that they need and to their local GP.

When I talk about the Prime Minister and his rhetoric around only needing your Medicare card, not your credit card, this wasn't something he just said once or twice. He actually said that 71 times. On 71 separate occasions he has said to Australians, 'You just need your Medicare card.

You don't need your credit card,' when the lived reality of Australians is very different to that. In addition to that, the Department of Health, Disability and Ageing's incoming government brief, released under freedom of information, estimates that a quarter of GP clinics across our country will not bulk-bill, despite all of the Albanese Labor government's promises.

So 25 per cent of clinics won't provide bulk-billing at all. This data from the health department shows that millions of Australians will absolutely still need their credit card as well as their Medicare card when they go to see their GP. The Minister for Health and Ageing, Mark Butler, has now tried to backtrack from the Prime Minister's promises by saying they never said there would be 100 per cent bulk-billing.

I'm not sure how you can on the one hand say, 'All you need is your Medicare card,' and then, on the other hand, say, 'We actually never said there would be 100 per cent bulk-billing.' To me, they are the same thing. They're just different words. 'You only need your Medicare card' would be 100 per cent bulk-billing. But now Minister Butler is saying that the government never said that there would be 100 per cent bulk-billing.

On that basis I'm not quite sure what 'you only need your Medicare card' actually means. The Prime Minister certainly said, many, many times, 'One card covers it all'—not your credit card, just your Medicare card. Either the Prime Minister was mistaken or it was a stunt.

I'm not quite sure which is worse. I think it would probably be worse if it were a stunt. If it were an honest mistake and the Prime Minister stood up and said, 'I got that wrong.

I was very wrong; you actually do need your credit card as well as your Medicare card,' then we could perhaps move on. While the Prime Minister was out waving his Medicare card around during the election campaign and propagating what we can only assume are these false promises, Australians paid a combined $166 million in out-of-pocket costs at the GP in the month of May alone, and I'm assuming many of them used their credit card.

Let me repeat that. During the month of May, during the election-campaign month—the election was on 3 May—Australians paid $166 million in out-of-pocket costs in visits to the GP. This was at the same time we had our prime minister holding up his Medicare card, saying, 'This is all you need.' Well, it's clear that in the month of May we also needed an extra $166 million.

In the past year Australians have paid more than $2 billion in out-of-pocket costs. That is more than $2 billion charged to Australians' credit cards or taken out of their bank accounts or charged to their debit cards or taken out of the piggy bank—but not their Medicare cards. That $2 billion did not come from anybody's Medicare card, and they paid this to access essential health care at their doctor's office.

I don't know what we can call this aside from a $2 billion lie. I don't know what we call it. Senator McAllister: Ten years of neglect from a coalition government.

Senator KOVACIC: Pardon? I didn't hear. The ACTING DEPUTY PRESIDENT ( Senator O'Sullivan ): Interjections are disorderly.

Senator KOVACIC: I might repeat it because I can't remember where I got to. That's more than $2 billion charged to Australians' credit cards over the past year. That's $2 billion that people had to pay out of their pockets over the past year because their Medicare card was not sufficient to pay for their visit to the doctor.

I think any type of falsehood is egregious, but I think when it comes to falsehoods in relation to medical treatment, where it's something that people don't choose to do but something they have to do, is actually even more egregious. Australians aren't stupid. They know that they need to have their credit card or debit card or some cash when they go to the GP because the Medicare card is not enough.

But what the Prime Minister has done here is create false expectations in the minds of Australian families at a time when they are already struggling under a cost-of-living crisis. That is quite appalling because he's giving them false messaging at a time when they can least afford it. It's not on something they may like to buy or something they may like to spend their money on but on their health care, which is something that they need to spend their money on.

But now they're having to make decisions on whether they can actually afford it or not. What he has proven by doing this is that he really does not understand the cost-of-living pressures that everyday Australians are under. That in itself is a very, very sad thing.

I'll finish by saying that the coalition's record on Medicare is something that we are very proud of. Medicare bulk-billing was higher under the coalition. Regardless of what those opposite want to say, the numbers don't lie—88 per cent is more than 77 per cent, whichever way you want to cut it.

In the coalition's last year, 167.2 million free GP services were delivered. This is 61 million more than under the previous Labor government.