Health Insurance Amendment (Incentive Payments and Other Measures) Bill 2026
Mr TIM WILSON (Goldstein) (18:40): Everybody in this parliament believes in Australians being able to have affordable, accessible health care. There's a truism of health care, like any other service though, where you have ways you can ration access if there's more demand than supply. It's a pretty basic principle of economics.
You have one of two options: you can ration by price, or you can ration by queue. While I hear a lot of the Labor members on the other side of this chamber wax lyrical about their deep and abiding commitment to health care, and I respect that they have a genuine and serious commitment to health care, they shouldn't ignore the fact that they've chosen rationing for price over rationing by queue.
So when grandparents can't get access to what is deemed under the system—different types of surgery, for instance, hip replacements, knee replacements or those sorts of things, are essentially considered to be cosmetic as opposed to lifesaving. As a society, we've made a choice about the limitations of how much access to health care people can have because we have to ration by the price or by queues.
In the great state of—in fact, in pretty much all states now. In the Commonwealth we have an ongoing problem, whether you call it ramping or queues, with access to ambulances to be able to get into hospitals. That's a literal demonstration of a queue that occurs.
When we talk about health care, we face a choice: do we want a 'one size fits all' system, where we tell people to wait in line and in some cases live with pain because we don't believe that people should be able to make the choice to opt into a system to improve their welfare or to get ahead, or do we actually believe in a system that encourages people to take responsibility for their health care?
We do that by preventative health, of course, but we can also do that by making sure that people choose to contribute to their health care so they take a sense of ownership, which actually frees resources for those least capable of being able to afford it themselves. That's, in one sense, the great divide that sits between at least the Labor members and some members on this side of the House.
There's a licorice allsort in the corner over there, and I don't really know what they stand for, but we believe in a system that has a universal support for those who need it while those who have decided to prioritise their health care or who are of means take a higher degree of agency and responsibility for doing so. That's in everyone's interest. It means you get better investment in facilities and different types of clinical care.
You have people who are able to operate between the private system and the public system. We're in a position where they can contribute to each other, not just in a competitive sense—though there is a component of that—but to make sure that we get access to world-leading technology and the specialist services that may not exist in a system solely driven by a public system or a 'one size fits all' system, as the Labor Party would like.
I always find the conversations about health care, just like education and other essential services, in this chamber insightful, if nothing else, because on the Labor side there's a dogged view of only having a universal system without any understanding of the consequences that flow from having only a universal system. The truth is Labor would get rid of private health care if they could.
They slowly strangle it every time they're in office in different ways to try and disincentivise people from making choices and taking ownership and responsibility, because at the end of the day they don't really want a private health system. We've seen this in the recent budget, where they've scrapped rebates for private health insurance for people over the age of 65.
We actually know that people's health care becomes disproportionately more expensive as they get closer to the end of their life. Deputy Speaker Freelander, you'd acknowledge that! It's been well established in the Productivity Commission's reports.
People pay about a third of their entire healthcare costs in the very last stage of their life. They tend to spend a lot less in the early stages of their life. Why?
Because their bodies generally hold up better. While there's occasionally a broken knee or something like that—playing sport might infirm them—it doesn't change the fact that, overall, people are healthier in younger stages of life. As people move through different stages, they develop comorbidities.
They have parallel challenges with the healthcare system. It goes all the way through to very acute challenges in the latter stages of life. This is unsurprising.
The research has established this well. Basically anyone who has grandparents could tell you this. We're very fortunate in that we have life-saving medications that actually help people manage chronic conditions.
But these are increasing, so the costs of the Pharmaceutical Benefits Scheme go up in the latter stage of life. The cost of Medicare also goes up in the latter stage of life. And, of course, the need—potentially—for more significant treatments through private health insurance also goes up.
It raises the very obvious question, which I don't think anyone on the Labor side of the chamber has answered for any of us yet: why on earth are you then taking away the private health insurance rebate for people over the age of 65? At the point at which you actually want people to have private health insurance and carry the responsibility of their health care—and actually contribute more to the rest of the system than just the individual—why would you turn around and say to those people, 'We're just going to encourage you to go into the public system and increase the cost to the taxpayer and increase the volume of demand on the public system at the most expensive stage of life'?
Maybe it's that they don't want to provide health care to that section of the community, or maybe they understand that there are serious consequences when people at that age are delayed in accessing health care. They're not pretty. The priorities of this government really shock me, actually, on so many levels.
This isn't the only one, but it's a pretty substantial one. They're not interested in how they grow the economy. They're not interested in how they incentivise growth to improve welfare.
They're not interested in aligning tax policy to incentives to grow the economic pie. It just seems to be a constant and rapacious fight to distribute resources amongst the few, to the advantage of a government that wants to basically be in control of everything. Some of us don't have that vision for this country.
Some of us believe that agency, ownership, responsibility and choice are the foundational principles that make Australia not just a great country but a wonderful place for people to live and have a pathway to live out their best lives—where they can choose to go to a hospital; where they can decide to prioritise their health care or allocate more of their resources towards doing so; where they can have the choice of getting elective surgery as required, based on their clinical need.
If they decide to make decisions for how they want to take greater ownership, agency and control of their lives, we should respect that. It's not about the government controlling everything or the government telling everybody how to live their lives. It's actually about how we empower people to make the best decisions to be able to run their lives.
Some of us in this building—shock, horror, Deputy Speaker; I know you're going to be horrified by this proposition—don't believe that parliament or bureaucrats know how to run people's lives better than they do themselves. Nor do we believe that they know how to run communities better than communities do themselves. And we certainly don't believe that Canberra bureaucrats know how to run small businesses better than businesses do themselves.
We don't just believe in ownership, agency and choice. We believe in empowerment, lifting people up and encouraging them to have that sense of control in their own lives. It's quite a radical world view in human history to believe that, but it shows that, no matter how radical a proposition it is, it's never really penetrated the minds of the Australian Labor Party, whose only objective has always been: How does it universalise?
How does it control? How does it have the levers to be able to dictate and determine how people live their lives? You just need to look at it because, despite the promises and the rhetoric that come from Labor's approach to health care, they consistently fail the public.
They sell a story to the public of how wonderful their beautiful Medicare destination is going to be, but they fail to acknowledge that it comes at a cost—the cost of it being harder to attract people to become GPs or stay GPs. It's harder because people are compelled to wait in queues to be able to access basic services. My fear is, unfortunately, that it's a problem that's going to continue to get worse, as we've seen with the other ideological approaches to health care, in places like the United Kingdom and Canada.
We still have a private system, and, so long as we have that, at least there is some component of choice. But, as I said before, the Labor Party isn't a big fan of that. Of course, despite their promise of the utopia that they wish to create, they fail even by the standards they set for themselves.
So many times the Prime Minister has stood about two metres from where I am presently, waving around his Medicare card and saying how—apparently, we're up to 71 times; I've forgotten how many times I've had to deal with these theatrics—all you need is your Medicare card and not your credit card to go and access a doctor. Well, I don't know about you, Deputy Speaker, but not a single person in my electorate would believe that.
We already know he's got lots of other tattered histories, with broken promises and everything else. Trust doesn't come naturally to this prime minister. But it's compounded when he continues to engage in the delusion of suggesting that all you need is a Medicare card to access health care.
I've got the data here. In the Goldstein electorate, people continue to pay a co-payment. Every year, out-of-pocket costs go up.
In 2023, it was $44.31. In 2024, it was $48.07. In 2024-25, it was $49.91.
Mr Repacholi interjecting— The DEPUTY SPEAKER ( Dr Freelander ): Order! The member is entitled to be heard in silence. Mr TIM WILSON: Thank you, Deputy Speaker.
We rationed things in parliament by giving cues about when people can stand up and speak. I'm sure the member would like to do that. He's welcome to get up and speak when it is his turn.
The DEPUTY SPEAKER: Member for Goldstein, you know this is a not a two-way conversation, so— Mr Repacholi interjecting— The DEPUTY SPEAKER: please deliver your speech. The member for Hunter has already been spoken to. Please do not interrupt the speaker, Member for Hunter.
Mr TIM WILSON: Thank you, Deputy Speaker. I can assure you I didn't think it was a two-way conversation. My understanding was that I got to talk and they sat there in silence.
We saw the increase in cost. It was $44.31 in 2022-23. In 2023-24, it was $48.07.
In 2024-25, it was $49.91. In 2025-26, it was $52.94. So, despite all the rhetoric and all the palaver that goes on in the chamber about how all you need is your Medicare card, that is in the lived experience, I can assure you, of the Goldstein electorate.
In fact, most people I speak to now are paying somewhere between $60 and $100 to access a doctor. It just seems to me that we're at a tipping point of trust with the Albanese government. Even before the budget, we were teetering, but now we've completely fallen off the cliff.
The reality now is that Australians simply do not believe what this government is saying. Even worse than that, if they go and plan their lives on the basis of the expectation, they're going to find it increasingly difficult to trust the government. I used those data points because they're Goldstein ones, but, basically, they reflect what's happening across the country.
Nationally, we've now hit a record of $50.77 per service, for a GP non-referred attendance. Co-payments are now, shall we say, alive and well under the Albanese government, despite the rhetoric. Of course, there are some states that experience it worse, and Goldstein is definitely at the top of that pack.
Again, I come back to a simple point. If you're paying $56.98 a co-payment in Bayside, $53.07 in Glen Eira and $50.70 in the City of Kingston, at what point does the Albanese government turn around and say: 'Actually, we don't want to push more costs onto the taxpayer for the health system. We actually want to encourage people to take ownership and choice'?
They clearly like to do it with the sort of—what do you call it?—smoke and dagger arrangement that they've currently got with Medicare, but now they're trying to cannibalise and eat into the very equity that exists with private health insurance. Coming from an electorate that has more private health insurance policies than voters, I can tell you this has not gone down very well in the Goldstein electorate.
More importantly, people are increasingly seeing the gap, the gulf, the distance between truth and Albanese government rhetoric. They're living in the gap between truth and Albanese government rhetoric. At some point, we are going to see the full consequences of it.
The DEPUTY SPEAKER ( Dr Freelander ): Member for Goldstein, I didn't want to interrupt your speech, but the Speaker has spoken about respect in parliament, and I think some of your comments during your speech were deeply disrespectful, including calling the crossbench 'licorice allsorts' and the phrase 'distrustful government'. I think you should reflect on that.
Mr Tim Wilson: A point of order. Can I seek clarification on this? The DEPUTY SPEAKER: Sure.
Mr Tim Wilson: I said 'licorice allsorts of crossbench'. That means that there's different colours. I don't think that that's a disrespectful thing to say.
And saying that it's a distrustful or 'distruthful' government—I'm sorry, Deputy Speaker, there is no basis for which I would withdraw that, because unfortunately it is quite simply the truth. The DEPUTY SPEAKER: I'm not asking you to withdraw it. I'm asking you to reflect on your speech.
Mr Tim Wilson: I will happily reflect on it and happily double down on saying this government has no trust with the Australian people.