Health Insurance Amendment (Incentive Payments and Other Measures) Bill 2026

Ms MASCARENHAS (Swan) (19:14): Can a parent take a sick child to the doctor without first visiting their bank balance? No-one should have to think twice about seeing a GP when they are sick or injured because of what it might cost and no-one should have to wait days for an appointment because the nearest bulk-billing clinic is booked out for a week. The Health Insurance Amendment (Incentive Payments and Other Measures) Bill 2026 gives primary care group programs like the bulk-billing practice incentive a consistent statutory basis to secure its longevity and sustain the progress that this Labor government is already delivering.

That is real progress. Since 2025, the national bulk-billing rate has climbed to over 81 per cent, and about 97 per cent of Australians now live within a 20-minute drive of a bulk-billing practice. That looks like more people seeing a doctor instead of putting it off.

The lingering cough that you keep meaning to get checked out, the blemish on your arm that doesn't look quite right or the stubbed toe that turns out to be properly broken—that is what these incentive programs are really for. It's about free and affordable care that doesn't have you second-guessing whether it's worth a visit or not. My electorate of Swan is one of the most diverse communities in Western Australia, and bulk-billing matters right across it.

It matters to the pensioners in Como, to young families in Cannington and to people working long hours and shiftwork in Belmont and Rivervale. For a lot of them, whether the doctor bulk-bills is what decides if they go at all. When it costs nothing, you go when you need to go.

When it costs $80 out of pocket, you wait, and sometimes, while waiting, a small problem becomes a big one. The reassurance of a bulk-billing practice down the road shifts you from the mindset of 'she'll be right' to 'what's the harm in checking'. This shift can sometimes be lifesaving.

I'm sure that there are many people within this House that have had lived experience of a family member visiting the GP because of a small matter that ended up being quite a big matter. For me, there's a particular story that I'd like to share with you, which relates to a phone call I got from my mum when my daughter was three weeks old. My mum said: 'We just went to the GP, and he said that we need to go get an MRI scan for Dad straight away.

I'll keep you updated.' Interestingly, sometimes you go to the GP, and they say, 'You should get this scan in the next fortnight,' but this GP said, 'You need to go straight away.' The reason why my mum made my dad go to the GP was that my mum was annoyed by the way that my dad was walking. He was walking with a limp and wasn't walking in a straight manner. So they did the MRI scan, and it turned out that my dad had bleeding on two different parts of his brain.

Then, from the MRI, what ended up happening is they said, 'You need to go to the emergency department straight away.' Dad initially went to Fiona Stanley Hospital, and they said: 'We don't do emergency brain surgery at this hospital. You need to go to Royal Perth Hospital.' Then Dad was at Royal Perth Hospital, and then it was this question of Dad needing this emergency brain surgery.

The surgeon called and told me what was happening. I live very close to Royal Perth Hospital—it's a 15-minute drive—and I'm thinking that I'd love to say good luck to my dad, but he was going in so quickly, and the surgeon wasn't with my dad. I said to the surgeon, 'What's the probability that he'll survive this surgery?' He said, 'It's a 90 per cent probability, but there's a 10 per cent probability that he won't live.' So I ask: 'Could I just wish my dad good luck?

Can I do that?' So the surgeon gave me his number. I got to call 15 minutes later and I got to say to Dad: 'Hey, Dad. Good luck for your surgery.' So that was the beginning of a GP appointment that turned out to be this very large thing.

Dad had emergency brain surgery; he lived through the surgery, but then he had to learn to walk again, so he ended up being in hospital for six months. What's fascinating is that the beginning of that story was a GP appointment. The thing I find particularly extraordinary about Australia is: who knows what would have happened to my dad if that GP appointment didn't happen?

These are Sliding Doors moments. My dad migrated from Kenya, but he had six brothers and sisters, and all his brothers and sisters migrated to California. For my cousin, who had emergency heart surgery—basically, when they got to the moment of, 'You have a leaky heart valve; we need to perform emergency surgery on you'—the question was: 'How much will this cost?

And can you afford it?' So I'm incredibly grateful for the Australian Medicare system. Universal health care is a phenomenal thing, and this bill is quite incredible. So, back to the mainstream speech: Aside from bulk-billing, this bill also addresses other primary care incentive programs that make Australia's healthcare system robust and reliable.

Together they are worth more than $1.4 billion of this government's investment in primary care every year. The Practice Incentive Program rewards practices for the quality of their care, for opening their doors after hours and for teaching the next generation of doctors. The General Practice Aged Care Incentive helps GPs keep looking after patients once they move into residential aged care so older Australians won't lose the doctor who knows them—and, interestingly, I now have my old man in aged care.

The Workforce Incentive Program helps practices bring nurses, midwives, allied health workers and doctors into rural and remote communities that have always found it hardest to attract them. In the country, one GP can be the only doctor for hundreds of kilometres, covering the clinic, the emergencies and the after-hours calls. This program helps keep a doctor there and helps bring the next one in.

These are programs that sustain care in place. It is the hardest to deliver. This bill sets out clear guidelines to maintain the quality of these programs, and it makes sure they are run properly, with the same safeguards that protect other dollars spent across Medicare.

It also gives certainty about how the program works and how decisions affecting them are made, and it gives doctors and practices who rely on them the confidence that their future is secure. In my own community, the bulk-billing incentive program is working. In 2023, the bulk-billing rate in my electorate was 67 per cent.

By March this year it had risen to 74.9 per cent. The number of practices bulk-billing every patient has more than doubled. That number was nine when the coalition left office; today it is 22.

That's 13 more practices in my electorate where a family can see a doctor and walk out without paying a cent. The minister for health said that the Labor government has stopped the freefall in bulk-billing rates, and in my community we have done more to stop the slide; we have begun to reverse it. For households in Belmont and Rivervale, that's the difference between a GP visit that costs nothing and one that makes you stop and think about whether or not you're going to do it.

This bill also renames the Health Insurance Act as the Medicare Act. Since Medicare was introduced by the Hawke government more than 40 years ago, it has shaped the lives of millions of Australians. We carry the green-and-gold card in our wallets, and we hand it over to the doctor at the hospital and at the pharmacy.

It's one of the few things in this country that belongs to all of us, no matter where we are or what we earn. It reminds me of when the Prime Minister talked about how Kerry Stokes and his mother both got treated at the same hospital. I think it's extraordinary that that's the healthcare system we have.

It's not a healthcare system that is only for some. I'm proud to be part of a government that's protecting it, and we should make sure we never take it for granted, because that's not how every country does things. In fact, I remember having a conversation at dinner in New York and speaking to some of my cousins over there, and one of their friends said, 'Socialist medicine—that sounds gross!' But think about it this way: universal medicine—does that sound sensible?

The way that you phrase things is interesting. This is where I think it's important to recognise our system. I remember another one of my friends, who was a lawyer from Melbourne travelling in the US, and he talked about going out hiking.

He basically got this massive, deep wound in his leg and he's like, 'I'm not going to see a doctor because it's going to cost me a lot,' so he continued to make sure that he kept it sterile. He let that heal very slowly over a two-month process. There's another story that I remember, which is one of my friends, who's a female engineer.

She was working for a big oil and gas company and had a miscarriage when she was overseas. For her, having a miscarriage while she was overseas was like, 'I just don't know if I want to see a health expert, because I don't know how much this will cost,' and we know that, when you have a miscarriage, having medical help is really important. These are the things that sometimes we don't recognise are really powerful in the Australian healthcare system.

We need to make sure that we continue to strengthen it, and we need to make sure that we continue to build it. What I would say is that Australians made a choice on whether we wanted this to be universal. The thing that I see time and time again is that the Australian Labor government wants to do things that last for generations and makes this country so much better compared to any other country in the world.

It's interesting because we have so many things to be grateful for, whether that relates to minimum wage, whether that relates to the superannuation guarantee, whether that relates to paid parental leave or, of course, whether it relates to universal Medicare. I remember a time doorknocking in my electorate where I was having a conversation with a family, and they were talking about how disappointed they were in the bulk-billing rates.

They were like: 'We recognise that bulk-billing exists. I've not seen a bulk billing doctor for years.' He felt like he could not trust the government to look after this. The thing that I would say about our government is that what we want to do time and time again is make sure that we listen deeply to our communities and ensure that we understand what they want.

We saw the numbers, but we also saw the effects in our community, and we wanted to make sure that we put the investment where it was needed. The additional thing that I think is useful for us to think about—and I'll put my engineering hat on—is that in the mining industry one of the things that we do intentionally is something called preventive maintenance. We do preventive maintenance because we want to make sure that expensive equipment doesn't break down, because when it breaks down, it costs a lot of money per hour, per minute if it's down.

That's what the big companies do, and the thing that I want Australians to make sure that they do is preventive health, because we know that, when we invest in preventive health, it means that we can actually catch those little things initially before they become too big. I see that the general-practice system that we have with our Medicare system and our bulk-billing clinics ensures that we can actually invest in this.

I think it's incredibly important that we continue to ensure that we look after this system, because it is something that actually helps people with the quality of their life, but it also means that we can have our family, friends and loved ones in a way that is so much more present. I anticipate that the life expectancy of Australians probably is a bit longer than other countries, and I think a part of that relates to not just our blue skies and our beautiful beaches and fresh air.

I think that a part of it also relates to our healthcare system. It's a healthcare system that we should be very proud of, and I think that this bill continues to strengthen it. I commend the bill to the House.