Debate resumed from 22 October 2024.

The Hon. AILEEN MacDONALD (14:35): I resume my contribution to the Health Insurance Levies Amendment Bill 2024. Before I address the broader flaws of the bill, I feel compelled to respond to my colleague from The Greens, Ms Abigail Boyd. She gave us quite the Robin Hood fantasy, but I think we need to be brought back to reality. Ms Abigail Boyd seems to think the bill is some sort of Robin Hood act, taking from greedy insurers to give back to the public. What she forgets is that Robin Hood did not rob from the poor to give to the government, but that is exactly what the bill does.

It is a joke to believe this additional levy will be absorbed by the insurers. It will not. It will be passed on to hardworking Australian families from day one. What is Ms Abigail Boyd's solution? She suggests families can "shop around" for better insurance deals. Perhaps that is possible for someone living in the city, but for those of us in rural and regional New South Wales, that is not how the real world works. Families in Armidale, Inverell and Moree do not have the luxury of shopping around for health care. We rely on private insurance to avoid being left on public waiting lists for months.

Then there is her misleading comparison to the United States. Let's not be ridiculous. Nobody is suggesting we adopt a healthcare model that requires a second mortgage just to have surgery. Painting our private health system as some kind of American nightmare shows how far removed the member is from the real struggles of Australian families. We are not America, and we do not need scare tactics imported from across the Pacific. Ms Abigail Boyd says that private health insurance is a rort. I challenge her to tell that to the families in rural and regional New South Wales who rely on the private health funds to access health care in a timely manner. They are not wealthy elites; they are everyday Australians doing their best to provide for their families.

While Ms Abigail Boyd spins her Robin Hood tale, the reality is that the bill will make life harder for ordinary people. It is time we stopped entertaining those fantasies and started dealing with the real consequences the bill will have for the people of New South Wales. And let's not forget the real culprit: the Minns Labor Government, which is a deceptive government trying to break its promise to not raise taxes. It is trying to bring in a levy which is essentially a health tax.

The Treasurer can spin it as a cost recovery measure all he likes, but I am calling it what it really is: a health tax. It is not just any tax; it is a tax that will increase the levy on private health insurance by 85 per cent. What will we get for it? We will get 70,000 people forced out of private health insurance, which is 70,000 more people flooding into our already overburdened public hospitals. That means longer waiting lists, more overworked healthcare staff and, ultimately, more suffering for patients. This Government is pretending that insurers can simply absorb those costs. But anyone with basic economic sense knows that those costs will be passed straight on to policyholders. We are not talking about the wealthy; we are talking about families struggling under the weight of rising living costs.

The Government would have us believe this is just like what happened under Mike Baird in 2013. But there is a key difference. The levy increase then was 45 per cent. Now it is 85 per cent and we are in the middle of a cost-of-living crisis. People are already struggling to make ends meet, and this Government thinks it is the perfect time to raise taxes on health care. Let us not be mistaken about the consequences of the bill. People will drop out of private health care and wait longer for surgeries. They will be forced to wait longer for the care they need, and some may even die waiting. That is not just an inconvenience; it is dangerous.

The bill is a gamble with people's lives. Instead of fixing the real issues in our health system, the Government is betting on this tax to cover its budget shortfall. But that is a bet the people of New South Wales cannot afford to lose. Let us be clear: This is not just a broken promise; it is a betrayal of the families who rely on private health insurance to avoid being stuck on long waiting lists, a betrayal of the voters who believed this Government when it promised no new taxes and a betrayal of the trust that people place in government to protect them, not make life harder. I urge this House to reject the bill before it does irreparable damage to our healthcare system and the families we represent.

The Hon. MARK LATHAM (14:41): I oppose the Health Insurance Levies Amendment Bill 2024 on several fronts. The first, and most financially responsible, is that I will not support any revenue grabs by this Government until it gets serious once again about expenditure cuts. The budget is in crisis. There is too much debt and deficit, but the soft, easy way of doing things is to raise revenue instead of the real task of bringing down expenditure. At a time of a cost-of-living crisis, when the Government has so many demands on it by citizens, organisations, lobby groups and the like for further expenditure, there is no solution to the budget deficit unless this Government has an expenditure review process that brings down outlays.

On the substance of the matter, I have a bit of history in how to deal with private health insurance from time in Canberra. I have a white flag to raise, in some respects, and a few lessons for the Government in how Labor Party members might handle this. There are things they might not want to hear, but they are certainly verified and franked in history. The Minns Government has a problem with its health budget, so it is trying to dramatically increase charges for a private room in a public hospital. Government members know they have no legislative power to force the issue so, instead, through this bill, they threaten to increase the compulsory ambulance levy imposed on private health insurers and their members in New South Wales—all four million of them. It is not about a fair go for public hospitals, efficiency or good public policy. Rather, it is an attempt to tax New South Wales residents who have private health insurance.

Interestingly, it also represents a fiscal transfer from the Federal Labor Government to the New South Wales Government, given that the private health insurance rebate—a $7 billion subsidy on premiums designed to drive higher public health insurance participation—is still in place in Canberra. I can remember a few attempts to get rid of that rebate. Back in the day, we were all in on trying to get rid of the private health insurance rebate in Canberra. There were a couple of memorable attempts, and much more discussion and agitation behind the scenes.

The Hon. Daniel Mookhey: Didn't you lead one?

The Hon. MARK LATHAM: I am coming to it. You don't need to get agitated. You will sit there and take the history lesson, young man, and understand what has gone on. Perhaps the most memorable attempt was on the day of Cathy Freeman's 400-metre race at the Sydney Olympics in 2000. Kim Beazley announced that Labor would just abolish the whole private health insurance rebate and hide it under the great and glorious run of our Olympic athlete. How did that go? We lost in 2001. The next attempt in 2004 was perhaps cleverer and more nuanced. Stephen Duckett and Julia Gillard brought to me the idea that we would have Medicare Gold. We would make the oldies eligible for Federal payments for private hospital beds and make private insurance less necessary. The Medicare Gold scheme would help to pay for itself by dropping the level of the private health insurance rebate. That was the arrangement. The Treasurer nods and indicates that he went doorknocking in favour of the policy. How did that go? We lost then as well.

The Hon. Penny Sharpe: I was knocking on doors for you too.

The Hon. MARK LATHAM: Good on you. I am sure you will never do it again. Your days of having to wear out your shoe leather on my behalf are well passed. All that is established in history as well. But what I am saying about the private health insurance rebate is there was an up-front, and then a more covert, attempt to get rid of the thing, or at least weaken it. It all failed and the subsequent Labor governments—Rudd, Gillard and Albanese—have kept it. The lesson is that people like it; they vote for it. It is embedded, with a sense of equilibrium, into the resourcing of the health system.

The four million people with private health insurance in New South Wales already pay for the right to have treatment in public hospitals in the form of their State and Federal taxes. I could not have said that 20 years ago, but we have to learn from history and understand the equilibrium and the broad resourcing—public and private—that we have for a viable health system. In effect, public hospital charges constitute those people paying twice. Nevertheless, in order to improve hospital access generally, private health funds have traditionally made a significant contribution. In New South Wales alone, in the last financial year, NIB kicked in $37.4 million. Another irony is that when the Whitlam Government started Medicare in the form of Medibank in 1973‑74, it deliberately limited private health insurance funding to private settings. Since then the States have tried to make an artform of getting their members to pay twice.

Members will not read this inThe Daily Telegraph, but I think the New South Wales Government has a sense of how blatantly unfair that is for those who are privately insured. As mentioned, the Government lacks the legal right to force the insurers to pay more for a hospital room, so it has its own covert, nuanced plan to do it through the ambulance levy. This is an attempt to increase the private health insurance costs to members from $1.77 to $3.77 per annum. The increase, if approved by this House under the bill, will increase premiums for the average family by about $156 per annum. That's equivalent to a 4.1 per cent increase, in the middle of a cost‑of‑living crisis. If the Government is serious about dealing with the cost-of-living issues in New South Wales, it would cut expenditure. It would not slug middle-class families doing it tough with their family budget by an amount of $156 per annum. The Government would do better to tackle massive inefficiencies, such as ambulance ramping, and support private health insurance affordability.

Access to the private healthcare system can only reduce the enormous cost and pressure on public hospitals. That is the equilibrium I mentioned earlier. Not without self-interest, the funds themselves estimate that an increase of this magnitude will drive a lot of people out of private health insurance, reducing the overall citizen contribution to the health system. These are big figures. There are four million people in New South Wales with private health insurance. I am advised that in the Federal seat of Macarthur, near where I live in south-west Sydney, nearly 17,000 extra people have come into the private health insurance system in the past three years. These are Federal electorates but we know the State equivalents.

In the seat of Chifley, which is based in Mount Druitt and is pretty working class, it is 15,000. In Hunter, where Labor's Fitzgibbon family produced a very fine, recently retired executive of NIB, there are 8,500 extra people. In Parramatta it is nearly 7,000. Those are big numbers that a government traditionally finds hard to ignore but, in this case, the Minns Government will add to the cost-of-living crisis for those four million people in New South Wales and will slow or even reverse the rate of private health insurance take-up. People like it for the obvious reasons of the faster, more direct and more comfortable care that it makes possible to achieve in private hospitals and privately funded public beds.

Coming to the fiscal realities of why the Government is doing this, my position, supported by other members, is that we will not support revenue increases until such time as the Government gets serious about cost savings. The Treasurer inherited a fiscal crisis brought on by a former Government notorious for giving up on cost savings. The last two Perrottet and Kean budgets made 362 policy changes involving expenditure, but only three of those involved cost savings. At the end of the Coalition's 12 years, less than one per cent of the policy changes in their budgets were cost savings. I do not know what the finance Minister at the time was doing. He was probably reading all of that legal advice about transaction charges and sorting out other matters in the Liberal Party.

The Hon. Damien Tudehope: I'd like to see a copy of it, I have to tell you.

The Hon. Daniel Mookhey: You had years to read it.

The Hon. MARK LATHAM: I have sparked a side debate that is of some interest, but let's get back to the budget analysis here. Labor's first budget, it has to be said, was a refreshing change. I give full credit to the new finance Minister and Treasurer for reversing the pattern of Keanism. Among its 179 policy changes, 33 per cent—a huge increase on the Kean period—or 60, were actual savings, netting the Government $6 billion. Unfortunately, that was one of those one-hit wonders. It was up there with Patrick Hernandez and others who only had one hit. I hope the Hon. Daniel Mookhey does not end up in that category and he comes surging back in the next budget with cost savings and renewed enthusiasm. If he needs any help, he knows that the Hon. John Ruddick is always here, although that advice is perhaps too extreme. I will chip in as best I can with some ideas about savings of tens of billions of dollars across the forward estimates. We are always here to help; the Treasurer knows that.

He should not wave the white flag and surrender to the easiest and most indulgent form of budgeting, which is tax-and-spend. In the most recent 2024-25 budget, among the 109 policy changes there was only one that was a cost saving, and that is a generous concession. That was the transfer of responsibilities from the wretched, failed Public Service Commission to the Premier's Department. It was not much of a saving, but I will give it to them. The new Labor Government started with a burst, and it looked like it was going to have a string of hits like ABBA, The Beatles, The Rolling Stones—

The Hon. Daniel Mookhey: Taylor.

The Hon. MARK LATHAM: —and other favourites of the Treasurer, but it has turned out to be a one‑hit wonder. The Government needs to get back to cost savings and not go down the path of upsetting the equilibrium between public and private health insurance in this State. It needs to learn the lesson that that is not wise policy and that driving private health insurance out of the system or even diminishing it has never been achieved in substance. It is here to stay. It should be acknowledged by the Parliament, and this bill should be rejected.

The Hon. SCOTT FARLOW (14:52): I contribute to debate on the Health Insurance Levies Amendment Bill 2024. Unlike the Treasurer or the Leader of the Government, I have been pretty consistent. I was out there doorknocking against the Hon. Mark Latham and such policies in 2004. I support the comments of the Hon. Damien Tudehope and other members of the Coalition in opposing Mookhey's mega tax. Again, in a cost‑of‑living crisis, this Government's answer is to go after all of the people who have made provision for their own private health insurance with a $78-a-year tax on individuals or a $156‑a‑year tax on families. In the middle of a cost‑of‑living crisis, one would think that that would be the Government's last resort, but it is its first instinct. We always appreciate the Hon. Mark Latham's fine work as a Labor historian and, as he has revealed, tearing private health insurance apart is in Labor's DNA.

During the Government members' contributions, particularly the Hon. Cameron Murphy's, we heard the loathing of people taking out private health insurance. The result of this policy will be that 70,000 fewer people in this State will have private health insurance. As the Hon. Damien Tudehope outlined, people will be making decisions and logging on to the Cost of Living hub, and the advice they will receive is that if they are in a cost‑of‑living crunch the first thing they should do is get rid of private health insurance. What does that mean for the taxpayers of New South Wales? That means they are going to be paying more.

The Hon. Daniel Mookhey and members opposite like to talk about the big private health insurance companies, and that is fine. We on this side of the Chamber have no great love for private health insurers or the like, but we do have a great love for those who take out private health insurance and make their own provisions for their health care. That is exactly who will be slugged by this Government, because this is not a means of recovering costs from private health insurance companies; it is a means of recovering costs from those who hold private health insurance policies. This will be a levy on their accounts. It will be a $156 increase or a $78 increase for all of those across New South Wales who hold private health insurance.

When she was alive, my grandmother was a pensioner, and she used to always hold on to her private health insurance. I remember she would sit down every month with a piece of notepaper and write down her pension amount and all of her costs. Every month she would write down the amount for MBF—it may be BUPA now, I think—and she would work backwards from there. If the cost of her private health insurance went up, the money would have to come from somewhere else. That would mean that maybe the silverside would have to last another day or that she would have honey on her toast instead of a slice of meat. Those are the sorts of decisions that people across the community are going to be making because of the members opposite and their tax on private health insurance.

We have heard their debates about the silvertails. As the Hon. Mark Latham said, four million people across New South Wales have private health insurance. There are four million people who have made the decision to provide for and secure their families in their hour of greatest need by having private health insurance. That is not just in Liberal Party or National Party seats; it is in Labor seats as well. I invite the Treasurer to knock on some doors in Riverstone and sell his policy, because 73,907 people in the electorate of Riverstone have a private health insurance policy and, thanks to the Hon. Daniel Mookhey, Chris Minns and the entire Labor Party, those people will all be paying $156 more.

The Hon. DANIEL MOOKHEY (Treasurer) (14:56): In reply: I thank all members who made a contribution to the second reading debate, including the Hon. Damien Tudehope, Ms Abigail Boyd, the Hon. Cameron Murphy, the Hon. Chris Rath, the Hon. John Ruddick, the Hon. Susan Carter, Dr Amanda Cohn, the Hon. Aileen MacDonald, the Hon. Mark Latham and the Hon. Scott Farlow. I listened very carefully to the contributions made by all the members. It was a spirited and fascinating debate. I will address some of the points made throughout the debate, and I might do so thematically.

I listened very carefully to the contributions of all of the Coalition speakers, and I have separated out the rather generous character reflections that were made and focused on the substance of what was being said. Listening to all of the members, one would think that somehow, tomorrow, we are abolishing private health insurance, that it will all be over and everyone's policy will be cancelled. Apparently that is what the Government is doing as it introduces legislation to ask that people simply pay their bills. But if that is true today, then it was also true in 2013 when Mike Baird introduced the same legislation. Mike Baird introduced exactly the same law, but I think it would be quite a surprise for him to hear that he is somehow a radical socialist with an ideological vendetta against private health and that he was pursuing socialism when he introduced the exact same bill with the exact same clauses, word for word, back in 2013.

I am sure it would be a surprise to the Leader of the Liberal Party, Mark Speakman, that he was voting for socialism in our time when voted for it in 2013. When the Hon. Natasha Maclaren-Jones voted for the exact same bill in this House, I am sure she would be surprised to learn that, apparently, she was embracing the secret plan to abolish private health funds that was introduced by that radical Treasurer, Mike Baird. Somehow, I do not think it was true then, and I do not think it is necessarily true now.

That brings me to the second point. Opposition members have said that the bill will have a devastating impact on policyholders. I point out two facts. Since the private health funds stopped paying the correct bed rate to the New South Wales Government, they have also cut the amount of benefits they provide to their members. Miraculously, that happened to coincide with an explosion in their profits. I argue that those things might be related. When the health funds stopped paying the bed rates, they did not cut premiums for their members; they hiked them. Just last week, the funds launched a campaign to hike premiums by another 6.6 per cent. Throughout this debate, I have not heard the Opposition take a position on that campaign.

I take the shadow Treasurer at face value when he says that he cares. I have had the job of shadow Treasurer. I have sat in the same seat and railed against the former Government's legislation. However, when I did that, I also committed to repeal that legislation. I have not heard the shadow Treasurer make the same commitment. If he is true to his word and believes that this is really the end—and he is not a passive player; he is the alternative economic manager of the State—the Hon. Damien Tudehope should make a commitment that if he is to become the next Treasurer of New South Wales, he will repeal this legislation. He will cut the bed rate and he will say to the private health funds, "You are entitled to this money back. The public will subsidise your profits, and presumably you will pass it on to your members."

But amidst all the outrage from the member, we have not heard him make that commitment. If he was sincere in his purpose, he would absolutely say that under a Tudehope financial administration, this policy would go. Over the next two years, I look forward to seeing whether that becomes the policy position he intends to take to the people of New South Wales. I remind the House that the fundamental issue is this: These four big funds reached an agreement with Mike Baird that they would pay to use New South Wales public hospitals—that they would pay $872, now $928, per night, even though it cost taxpayers $1,075. The agreement Mike Baird reached with those funds meant their members were able to access public hospitals with a 17 per cent subsidy from the public. Those funds each walked away from that agreement, year after year, from 2019 onwards.

When he was the finance Minister, the shadow Treasurer turned a blind eye to that. I leave it to him to explain why he allowed the funds to walk away, when he was in a position of responsibility. That is for him to explain. Nevertheless, we find ourselves in a situation where it is not fair and appropriate for the public to continue to subsidise the health funds. The legislation simply enforces Mike Baird's agreement in exactly the way Mike Baird proposed in 2013. I only ask the House to re-adopt the exact position it took a decade ago when the legislation was presented by those opposite and supported by the Labor Party at that time. The position is the same. The only thing that has changed in the intervening 10 years is the Liberal Party.

The issue is the same. The policy is the same. The problem is the same. The difference is that the Liberal Party has now decided, remarkably, to back the big four health insurers over private health policyholders and over the New South Wales public health system. That is a position that the Opposition is entitled to take. I was looking forward to a more sophisticated argument for that position, rather than the talking points of the lobby group that is promoting the interests of the big four firms; but each to their own. The Opposition is on the side of the big four funds and their lobbyists; the Government is on the side of private health fund policyholders, public health and New South Wales dollars. That is the choice before the House. I commend the bill to the House.

The PRESIDENT: The question is that this bill be now read a second time.

The House divided.

Ayes21

Noes17

Majority4

AYES

Borsak

Faehrmann

Mookhey

Boyd

Graham

Moriarty

Buckingham

Higginson

Murphy (teller)

Buttigieg

Houssos

Nanva (teller)

Cohn

Hurst

Primrose

D'Adam

Jackson

Sharpe

Donnelly

Lawrence

Suvaal

NOES

Barrett

MacDonald

Munro

Carter

Maclaren-Jones

Rath (teller)

Fang (teller)

Martin

Roberts

Farlow

Merton

Ruddick

Farraway

Mihailuk

Tudehope

Latham

Mitchell

PAIRS

Kaine

Ward

Motion agreed to.

In Committee

The CHAIR (The Hon. Rod Roberts): There being no objection, the Committee will deal with the bill as a whole. I have two sheets of amendments: Opposition amendments Nos 1 to 3 on sheet c2024-219B and Greens amendments Nos 1 and 2 on sheet c2024-215. The two sheets of amendments do not conflict with each other.

The Hon. DAMIEN TUDEHOPE (15:12): By leave: I move Opposition amendments Nos 1 to 3 on sheet c2024-219B in globo:

No. 1Exempt organisations

Page 3, Schedule 1[1], lines 6 and 7. Omit all words on the lines. Insert instead—

(a)for an exempt organisation—$1.77, or

(b)otherwise—

(i)the base rate declared by the regulations under Schedule 3, clause 9, or

(ii)if no base rate is declared—$3.27.

No. 2Exempt organisations

Page 3, Schedule 1[1]. Insert after line 7—

exempt organisation means an organisation that is declared to be an exempt organisation by the Minister by order published in the Gazette.

No. 3Exempt organisations

Page 3, Schedule 1. Insert after line 18—

[3A]Section 4(2A)

Insert after section 4(2)—

(2A)The Minister must declare an organisation to be an exempt organisation if the Minister is satisfied—

(a)a scale of fees under theHealth Services Act 1997, section 69 specifies a fee for the use of a single room in a public hospital, and

(b)the organisation will pay the fee when a single room is used by a contributor to a health benefits fund conducted by the organisation in the person's capacity as a contributor.

These amendments are quite simple in nature and should be supported by the Government. The bill has been primarily drafted to ensure that private health insurers pay the gazetted single room rate and that they provide policies to ensure that private patients who are admitted to a public hospital and occupy a single room pay the gazetted rate. In his second reading speech the Treasurer acknowledged that 44 out of 53 private health insurance funds have already agreed to pay the full $928 gazetted single room rate. Those funds are doing the right thing, so why does the Treasurer want to extract a levy from their policyholders? This could potentially cause an increase in the premiums payable by those policyholders.

These amendments would exempt private health funds that are already paying the gazetted room rate from paying the increasing levy. Surely the Treasurer does not want the members of these funds, which are often industry‑related funds, paying extra premiums when their fund is already paying the gazetted rate. It would be astonishing if the Treasurer did not see that this is inconsistent with his position. If he wants to look back and identify the position taken by Mike Baird—

The Hon. Daniel Mookhey: He didn't put it in.

The Hon. DAMIEN TUDEHOPE: So the inconsistency is only because Mike Baird did not do it! But as a matter of principle, the Treasurer would not want the members of a fund to pay increased premiums by virtue of the fact that their fund managers are already paying the additional rate. These simple amendments are designed to create an exemption for funds that the Treasurer would describe as "the good guys". Our position is that it would be incomprehensible to not give these funds an exempt status for any increased levy payable by them. The increased levy would only be payable by funds which cannot reach an agreement with the Government to pay the gazetted rate.

The Hon. DANIEL MOOKHEY (Treasurer) (15:17): The Government appreciates the fact that 44 funds pay the rate. Four of those funds decided to resume paying the rate after the Government had the opportunity to engage with them. They are predominately not-for-profit funds which have consistently paid the rate throughout, despite the disadvantage they have suffered as a result of the big four not paying the rate, and then going to the marketplace with an unfair advantage. We will continue to engage with these funds and with peak councils to ensure that the funds continue to do the right thing with the support from the Government.

The Government would have liked to engage constructively with the Opposition on this problem. We met with the shadow Treasurer, the shadow Minister for Health and the shadow Minister for Regional Health a week ago. I enjoyed that meeting. I made reference to it in the House last week that it was a relatively constructive meeting, but the Opposition did not raise the amendments with us, and so we are not in a position to either provide advice to the Parliament on whether the amendments are in accordance with the law or to seek proper advice to that effect. This is very disappointing.

The Hon. Damien Tudehope: Let's adjourn it.

The Hon. DANIEL MOOKHEY: I hear the interjection from the shadow Treasurer that we should just adjourn it. Apparently, whenever the shadow Treasurer cannot get his amendments in or he cannot pick up the phone and negotiate with the Government, it is the job of the Parliament to give him more time. The Liberal Party ran that argument with the NSW Electoral Commission when it came to missing the deadline for candidate nominations. Opposition members are running it again today when it comes to amendments to this bill. I say to the shadow Treasurer, "I have had your job. Do your job properly." When I was in his position, seeking an outcome with the government, and I had the opportunity to meet with the Treasurer or Ministers, I took it seriously. Whenever I had the opportunity to speak with the government, I did, and then I would bring amendments to this House. I gave the government reasonable notice, so it could be in a position to advise both the opposition and the Parliament about whether or not the amendments were permissible and legal.

The shadow Treasurer knows that we have an obligation to ensure the Crown obeys the law at all times. That is why we have these forms of interaction. That is why I sought Opposition members out a week ago to meet with them, to provide them with a briefing, to facilitate that dialogue. I am not suggesting for a second that the shadow Treasurer is ill‑motivated in moving the amendments, but if he is serious about the Government engaging with him—as we would have liked to have done on this particular issue—then he should reciprocate the courtesies that members of the Government have extended to him.

Ms ABIGAIL BOYD (15:20): These amendments have come directly from Private Healthcare Australia [PHA], which explains why they have come in at the last minute. I received an email last night from the PHA suggesting that I move the amendments. That is how I know they have come straight from PHA. PHA described the speech I gave on Tuesday as "entertaining". That is nice. I enjoy that. But PHA seems to think that I was under some misapprehension about what this legislation does. It wrote that my speech seemed to imply that I was "of the view that the levy increase would only apply to a few of the funds".

Let me make it very clear: As a lawyer and someone who can read, I understand that is not the case. Unlike the misinformation that is being put out by PHA, I also know that this is not about what is in this bill. In its legislation brief, PHA states, "This bill is simple legislation that increases the tax on private health insurance. There are no other aspects to the legislation." That is a pretty odd thing to say. It is incredibly misleading to suggest that this is not about the failure of private health insurers to pay their bills. This is not about a levy. This is about debt collection. As I said on Tuesday night, the idea that nine of the 54—I keep getting the numbers wrong.

The Hon. Daniel Mookhey: It is 53.

Ms ABIGAIL BOYD: Thank you. That is right, nine of the 53 are not paying what has been agreed in relation to the bed rate, while the other 44 are. There is nothing else we can do to get those insurers to pay what they owe. That is why this legislation has been introduced, in exactly the same circumstances it was introduced by the former Treasurer, Mike Baird, in 2013. PHA knows that. For it to say in its brief, "There is no other aspect to this legislation," and to try to imply that this bill is something that it is not, is very misleading. The PHA states, "This legislation will increase the cost of private health insurance," citing a likely 4.4 per cent increase in premiums. The average health insurance premium increase over the past 10 years has been 4.1 per cent, and we know that the insurers applied for a six‑point‑something per cent increase for this year.

PHA implies that if the insurers do not come to the table and pay what they have agreed to pay, and this legislation does kick in, then insurers will have to increase their premiums—we can dispute that—but their profiteering efforts to increase premiums by 6‑odd per cent would not have that impact, or at least they are not concerned about it. That is a very strange position to put and, again, really misleading. PHA claims that the premium increase will force people out of private health insurance.

I have heard the Opposition basically repeat those talking points. It is disappointing that we have not had a nuanced, or at least sensible, discussion about what is actually happening here. The Hon. Mark Latham mentioned that NIB's net profit went up 67.4 per cent last year. The idea that private health insurers will increase premiums if they are required to pay the bed rate because of this bill coming into effect, rather than adjusting their bottom line—their profits and shareholder dividends—is quite extraordinary as well. This is a debt collection exercise, not a tax.

The Hon. Damien Tudehope: You don't understand APRA.

Ms ABIGAIL BOYD: I acknowledge the Hon. Damien Tudehope's interjection. As someone who spent 20 years being involved in the regulation of banks and insurance companies, I have had a lot to do with APRA. I acknowledge the interjection and find it amusing. Finally, I would like to talk about the information that was sent to me. I asked for the analysis, the so‑called "modelling", on the impact of health insurers paying this levy. What I did not see was the impact of those nine health insurers paying what they owe the State. Where is the modelling for that? I do not understand why we are in this position. I suspect it is because the PHA does not want the bill to go through. Coming back to the amendments—

The Hon. Damien Tudehope: That would be good.

Ms ABIGAIL BOYD: Sure, but I note that the amendments were raised in the same letter that the PHA wrote all of these other things to me. If we were talking about this being a levy rather than a debt collection exercise, on face value, these amendments may make some logical sense. However, when we understand—as I know the Opposition leader does—that this particular form of debt collection exercise has been done because of constitutional limitations, the idea that these amendments can be chucked in last minute and potentially break the bill by making it unconstitutional, is not something that The Greens can support. Knowing the context does not improve the situation. They are designed to make the bill no longer effective.

I acknowledge that there is a conversation going on across the table between the Hon. Damien Tudehope and the Treasurer about who should be seeking legal advice about these matters. The Opposition wants to somehow put the onus back on the Government to get legal advice on amendments that PHA wants put through, using the Opposition as its mouthpiece. As somebody who does get some amendments put through in this place, I spend a lot of time talking with the Government, over a long period, in order to ensure that the amendments that I put up are not going to be unconstitutional. The Greens will not be supporting the amendments.

The Hon. DAMIEN TUDEHOPE (15:28): It appears the Government's position is that it cannot support the amendments because it did not get time to get advice on them. I acknowledge that the Government consulted the Opposition in relation to the bill about a week ago. I appreciated that opportunity. But apparently the Government has not had time to sufficiently analyse this proposal. Any Treasurer worth two bob in this business would have foreseen these amendments. He acknowledged that 44 insurers are paying their bills.

Why did he not ask the question, "Why would we penalise them again when they're doing their job?" Is that not a question for the Government officials in the gallery? Why did they not ask the Treasurer, "Should we make them an exempt organisation?" The Treasurer has said the Government has not had enough time to consider the amendments. He should do his job. The Treasurer should have seen the amendments coming because he acknowledged that the problem existed because they were already paying exactly the gazetted rate they were required to pay.

The Treasurer has said he is mystified by the Opposition's approach. He said he has not had time to get advice and that is the reason he cannot support the amendments. That does not wash, because if the Treasurer was doing his job he would have said, "I want to make sure that this is right. What are the possible contingencies that may arise? What about those poor insurance companies that are already paying the rate?" "Should we tax them again?" That is the first question the Treasurer should have asked. It is a reflection on the Treasurer's ability if he says, "I have never asked that question."

The Hon. DANIEL MOOKHEY (Treasurer) (15:30): I enjoyed that contribution. I take it as a compliment. The Leader of the Opposition ascribes to me a great deal of omnipotence that I will know and will think through exactly his amendments before he does and then be in a position to provide advice. That is the first point. What I found most amusing about his contribution is that I am being told it is my job to anticipate his needs before he knows them— and any Treasurer worth his salt would—and I fail in my job if I fail to do so. Those comments came from a former finance Minister who yesterday was running a Sergeant Schultz defence about merchant fees when he was getting legal advice. We were listening to him saying, "I know nothing about whether I read the advice that was given. I don't know if I read it. I don't recall." That is exactly how he was doing his job.

I return to the substance of the point, which is simple. The Government wants to engage with 44 funds. It is not a dereliction of duty to suggest that this is the only solution that is possible to solve that problem. In fact, the Government is working with those funds to see what other solutions are possible. I can tell members who the Government is not working with, which is the most telling part about this debate on the amendments: The Opposition's amendments, word for word, are written and authorised by a lobbyist.

That was not disclosed by the Leader of the Opposition when he moved the amendments. That is pretty stunning. I remember when I was in opposition that we did not simply pick up any lobby group's amendments and move them. The Leader of the Opposition did not disclose that fact when he moved the amendments. The Committee is entitled to know that the Leader of the Opposition moved the exact amendments of this lobby group. I think the Committee would be entitled to take that fact into consideration in its deliberations.

I thank Ms Abigail Boyd for drawing that to the attention of the Committee. I was not aware of that, because I am not getting correspondence from this particular organisation. I am pleased that Ms Abigail Boyd is paying diligent attention to what that group is saying. It is an example of what a good member does in this place, and it is a lesson for the shadow Treasurer about how he could do his job.

The Hon. DAMIEN TUDEHOPE (15:33): I cannot let that go.

The CHAIR (The Hon. Rod Roberts): Before the Hon. Damien Tudehope continues, I remind all members that the purpose of the Committee of the Whole is to address the amendments that are before the Committee. That comment is not a reflection on the Hon. Damien Tudehope or the Treasurer. I do not want to stifle debate, but earlier both members strayed off topic. We have a long day in front of us. We have a lot of bills to deal with. Let us concentrate on the amendments before the Committee.

The Hon. DAMIEN TUDEHOPE: The Treasurer's new argument for rejecting the bill is not directed at the substance or the benefit of the amendment. It is directed at someone putting a proposition to the Opposition that the amendments are worthwhile, and therefore the Committee cannot accept them. That is the Treasurer's new argument.

The Hon. Daniel Mookhey: The lobbyists—the paid lobbyists.

The Hon. DAMIEN TUDEHOPE: His new argument is it is the lobbyists on behalf of Private Healthcare Australia [PHA]. Opposition members examine amendments on the basis that they are capable of being supported. What we put to the Treasurer is that these are sensible amendments that would solve the problem. But he says, "We're going outside to negotiate on a different level. I cannot tell you what that negotiation is, but the Government will not accept the Opposition's amendments."

The Treasurer's solution is to acknowledge that the Opposition's amendments acknowledges that those who are already paying the gazetted rate will not have their members subjected to an increased fee. If the PHA or the nurses' union made the proposal, the Opposition would consider it on the basis that it is a good proposition. The hypocrisy of this is that every single amendment the former Opposition moved when the Coalition was in Government was virtually dictated and written for them by Sussex Street. The former Opposition said to the former Government, "These are our original thoughts."

The former Government should have known that Sussex Street was writing those amendments, but the former Opposition did not disclose that about every single amendment it moved. It is a tragedy for this place when the Treasurer says he rejects the amendments, not on substance, but because of some ridiculous reason that a lobbyist suggested the amendments. That is the rationale the Treasurer has just put to this Committee. It is an appalling reflection on him that he did not assess the amendments on their merits but because of where they came from.

Dr AMANDA COHN (15:36): As The Greens spokesperson for health, including mental health, I join in debate to add to the excellent contribution to debate already made by my colleague Ms Abigail Boyd. I will address some of the catastrophising from the Opposition in moving the amendments. Purportedly the amendments are about patients or families who cannot afford medical care, but the Leader of the Opposition said the quiet part out loud in this debate, which was "those poor insurance companies". It is very clear who the Opposition is representing and who the Opposition is moving the amendments on behalf of. It is not patients and families. It is the private health care lobby.

I want to add to the debate about who is contacting us. I also received correspondence from PHA, but what is far more relevant is who I have not received correspondence from. As The Greens spokesperson for health, I talk to key stakeholders in the health sector every day. That includes clinicians, expert medical colleagues, people living with chronic complex illness, lobby groups for those particular illnesses, carers, health workers, the unions and not a single one of those people has contacted me in opposition to this bill. The only stakeholder that has contacted me about the bill is Private Healthcare Australia, and it is really important to note that.

The Hon. MARK LATHAM (15:37): I support the amendments because they seem fair and reasonable. In terms of where they come from, the so‑called lobby group represents four million private health insurance holders in New South Wales. They are not exactly Graham Richardson, who went to several meetings with the Premier and others, wheeling himself around for nefarious purposes. Four million people in coverage is pretty significant. Quite frankly, I would have thought the Chamber would feel sorry for the modern Liberal Party and its paucity of resources. It does not have enough resources to get local government nominations in, let alone sort out amendments. The Liberal Party does not have the sources to successfully vet candidates in Pittwater and other places. We have to feel sorry for them. The Treasurer has them down on the mat with his foot on their throat. Just give them a break and go easy.

The CHAIR (The Hon. Rod Roberts): The Hon. Damien Tudehope has moved Opposition amendments Nos 1 to 3 on sheet c2024-219B. The question is that the amendments be agreed to.

The Committee divided.

Ayes17

Noes20

Majority3

AYES

Barrett

Latham

Munro

Carter

MacDonald

Rath (teller)

Fang (teller)

Maclaren-Jones

Ruddick

Farlow

Martin

Tudehope

Farraway

Merton

Ward

Franklin

Mihailuk

NOES

Borsak

Graham

Moriarty

Boyd

Higginson

Murphy (teller)

Buttigieg

Houssos

Nanva (teller)

Cohn

Hurst

Primrose

D'Adam

Jackson

Sharpe

Donnelly

Lawrence

Suvaal

Faehrmann

Mookhey

PAIRS

Mitchell

Kaine

Amendments negatived.

Ms ABIGAIL BOYD (15:45): By leave: I move The Greens amendments Nos 1 and 2 on sheet c2024‑215 in globo.

No. 1Contributions to single room rates

Page 3, Schedule 1. Insert after line 18—

[3A]Section 20

Insert after section 19—

20Data on contributions towards cost of stays in public hospitals

(1)The Chief Commissioner must publish on a government website a report for each year that sets out the following information for the year—

(a)the total number of days that persons who are contributors to health benefit funds stay in single rooms at public hospitals in their capacity as contributors,

(b)the total cost of the stays,

(c)the percentage of the cost of the stays that is paid for by the health benefit funds to which the persons are contributors,

(d)other information prescribed by the regulations.

(2)The Secretary of the Ministry of Health must give information to the Chief Commissioner for the purposes of publishing a report under this section.

(3)The Chief Commissioner may direct the following persons to give information to the Chief Commissioner for the purposes of publishing a report under this section—

(a)a person who carries on the business in New South Wales of providing health benefits to contributors,

(b)a person prescribed by the regulations.

(4)The direction may specify—

(a)the information that must be given, and

(b)the time, form and way in which the information must be given.

(5)A person given a direction must comply with the direction.

Maximum penalty for subsection (5)—10,000 penalty units.

No. 2Date for making regulations

Page 3, Schedule 1[4], proposed clause 9(3), lines 27 and 28. Omit all words on the lines.

I will deal with the first amendment. A lot of the consultation on the bill has been done behind closed doors and that is one reason lobby organisations have been able to put out so much misinformation and not be held accountable for the amount of money that the private health insurers are failing to pay in public hospital fees. Before the bill came to the House I did not know that some private health insurers are paying an amount decided by themselves. Some are paying the full amount asked for by the Government and some just choose not to. That was a revelation to me and that kind of information should not be kept from the public again.

Ideally what the bill will do is get those rogue health insurers not doing the right thing to come to the table and agree to pay the full amount for a public bed. If that happens, the threat implicit in the bill will not need to be implemented. But what happens if they walk away from that agreement again? Will the Government have to threaten them to get them to pay what they agreed to pay and what the public health system has asked them to pay? I do not want to see that happen so I think there needs to be a detailed provision covering that.

The first amendment proposes that data on contributions towards cost of stays in public hospitals be published so we can all see the number of privately insured patients staying in single rooms at public hospitals, the total cost of those stays to the public system, the percentage of the total cost paid by the private health insurers and any other information prescribed by the regulations from time to time. In doing that, we would know exactly how much each of the 44 insurers have been paying and for how long, because there has been a process of getting various insurers at various times to pay the right amount. Hopefully the naming and shaming aspect will encourage those that have not been paying to pay their fair share.

It will also allow the other health insurers to see how hard done by they are when they are the ones doing the right thing while the other, larger health insurers are not. The big four insurers are making record profits, raising premiums, cutting their services and then not paying what is owed to the public purse, while the smaller insurers are doing the right thing. Having that information available is important. The reason for the first amendment is so that there is full transparency and accountability over the process so that we do not get into that situation again, particularly if we end up with a less courageous Treasurer who does not want to take on the private health insurers because of the ridiculous information that gets put out by Private Healthcare Australia. The Parliament needs to be able to see that the fees are not being paid so that it can pressure the Treasurer to bring those health insurers back to the table and make them pay the amount that the public is owed.

I understand that in 2013 the idea was that a regulation-making power would be put in place and that the threat of that would be sufficient to make private insurers come to the table. That is in fact what happened. That was why there was only a year-long power to make that regulation. We have seen what happens as soon as that regulation-making power goes away: Private health insurers decide for themselves how much they want to pay towards the bill that is being levied on them. The effect of the second amendment is to say that the regulation‑making power will continue so that further down the track, when there is perhaps a less brave Treasurer, we have all of the data in front of us and can see that certain insurers are not paying. There will be a regulation‑making power that the Treasurer can use to make sure that we are never again in a situation where private health insurance companies are stealing from the people of New South Wales and not paying simply because there is nothing in place to make them pay. I commend the amendments to the Committee.

The Hon. DANIEL MOOKHEY (Treasurer) (15:52): At first instance, I say that I very much appreciate the engagement and conversations that I have had with Ms Abigail Boyd over the past two weeks and since the bill was introduced. I have had those conversations with other members of Parliament as well. I acknowledge that, by lodging the amendments, Ms Abigail Boyd has given the Government the opportunity to properly test and seek advice on what is being proposed. The second point is that the Government will support the amendments. The Government has listened closely to the arguments that have been made by Ms Abigail Boyd. They are very reasonable. The Parliament should have access to the information. There should be transparency, accountability and reporting.

The Government is pleased to be in a position to engage with The Greens to be able to provide feedback about what would be effective, practical and proportionate in terms of accountability. I once again acknowledge the constructive engagement of Ms Abigail Boyd—and, let us be honest, Angus too. That is with respect to the data transparency aspect. With respect to the second amendment, which is the regulation‑making power, I well and truly say that the Government is in no position to oppose the amendment, namely because, to Ms Abigail Boyd's point, the Government has watched how a temporary power has been applied for a time and then later withdrawn. Having listened to the concerns, it is a reasonable suggestion for the Parliament to adopt. The Government supports the amendments.

The Hon. DAMIEN TUDEHOPE (15:53): It is an astonishing thing: Ms Abigail Boyd has not disclosed that Private Healthcare Australia [PHA] supports the amendments as well. It is astonishing that Ms Abigail Boyd has moved amendments that are supported by PHA.

The Hon. Daniel Mookhey: Let me reconsider my position.

The Hon. DAMIEN TUDEHOPE: No. The Treasurer should reject the amendments on that basis, because that is the basis on which he rejected the previous amendments. The Greens did not disclose that PHA supported the amendments. It is an astonishing thing. I have the briefing note as well. It is a new standard from the Treasurer. When The Greens move amendments that are supported by PHA, members opposite will back them on the basis that they do not tell them. If the Opposition moves amendments that are supported by PHA, that is a different thing because the Opposition is apparently being sneaky and not telling anyone.

If the standard applies across the board, I would have thought that once it was disclosed that PHA is supportive of the amendments, the Treasurer would have immediately said that, in those circumstances, the Government cannot support the amendments. PHA's position is that it wants more transparency. PHA says that there is no transparency in relation to the occupation of rooms in hospitals and the like. It is quite in favour of having a much more transparent system. I have got it; Ms Abigail Boyd has got it. In those circumstances, I indicate that the Opposition supports the amendments.

Ms ABIGAIL BOYD (15:55): That was very funny. As opposed to having received a proposed amendment and then agreeing to move it as my own, I put up amendments that Private Healthcare Australia looked at and said, "They are actually quite clever." It is a lesson on how to get both sides of the Chamber to agree to amendments. It is a golden moment. I am pleased that The Greens are able to provide that learning opportunity to the shadow Treasurer. Let us sing kumbaya and pass the amendments.

The CHAIR (The Hon. Rod Roberts): Ms Abigail Boyd has moved The Greens amendments Nos 1 and 2 on sheet c2024-215. The question is that the amendments be agreed to.

Amendments agreed to.

The CHAIR (The Hon. Rod Roberts): The question is that the bill as amended be agreed to.

Motion agreed to.

The Hon. DANIEL MOOKHEY: I move:

That the Chair do now leave the chair and report the bill to the House with amendments.

Motion agreed to.

Adoption of Report

The Hon. DANIEL MOOKHEY: I move:

That the report be adopted.

Motion agreed to.

Third Reading

The Hon. DANIEL MOOKHEY: On behalf of the Hon. Courtney Houssos: I move:

That this bill be now read a third time.

Motion agreed to.