Mr DUTTON (Dickson—Minister for Health and Minister for Sport) (15:25): I am very happy to contribute to this debate. The government is absolutely determined to make sure that Medicare has a bright future and that we can afford a world-class health system— Mr Champion interjecting— The SPEAKER: The member for Wakefield! Mr DUTTON: and by Labor's approach it is evident to all Australians that they have no grasp of reality whatsoever. They were a shocking government. They were the worst government since Federation and they are demonstrating at the moment in opposition that they have no opportunity to turn that around. These people have no comprehension of how to pay, how to manage money or how to provide services to people on a sustainable basis, because they rack debt up every time they get into government. Then, of course, it is our job to come in and clean up Labor's mess. It is known to people at a state level and it is known to people now at a federal level. It happened after the Hawke-Keating years and it happened after the Rudd-Gillard disastrous years. I am not going to stand by and watch Medicare collapse under its own weight in this country. I want to make sure that we can provide the changes for today so that, with an ageing population and with the demands that a modern society like ours has on the introduction of expensive medical technologies, we can be the first adopters of things like robotic surgeries. All of that comes with huge expense—and people want us to pay for that. People want us to pay for genetic testing, which is just around the corner for the Australian population, which maps the DNA of the body to indicate what predisposition people may have for particular diseases. DNA testing indicates to people the cancers they may be likely to have later in life; it says to people that they may have a predisposition for a particular disease and, if they have children with a carrier of the same gene, there is a greater likelihood that that that gene may be carried to their own children. These medical technologies will have to be paid for, not just next year but over the coming decade and beyond. If the Labor Party want to pretend to the Australian public that we can have four out of five services for free when people see a GP in this country, they are kidding themselves. I do not think the Australian people will fall for it. What is it that we propose that is so offensive to the Labor Party? We say that we want Australians who have the capacity to pay the $7 co-payment to make that contribution and we will retain bulk-billing for those who cannot. I want bulk-billing to be about providing for those who cannot afford the $7. As the Treasurer said in question time today, there is a second safety net so that if, within a calendar year, a concession card holder or a child under the age of 16 goes to the doctor, has a blood test or an X-ray— Opposition members interjecting— The SPEAKER: The running commentary by the member at the table is not required. Mr DUTTON: or a combination of 10 services over the course of a 12-month period, they can then revert back to a bulk-billing arrangement so there is a maximum impact of $70. I want to contrast that—because the Labor Party has made a lot of that, and the shadow minister made a lot of that in her contribution only a few moments ago—to the way in which Labor has approached the same co-payment principle in relation to the Pharmaceutical Benefits Scheme over many, many years. Now, quite cutely, the shadow health minister in recent weeks, in some sort of populist attempt to thrust herself into these discussions, has described the PBS co-payment as a tax. It really is quite deceptive, because if you look at the history of Labor, Labor introduced a co-payment for concession card holders on the PBS. They introduced a co-payment for concession card holders and they want to somehow reject that historical fact. But the historical fact is that the Labor Party doubled the contribution for concession card holders when it came to the money that they want people to contribute for their own scripts. So when somebody who is the sickest and the poorest Australian goes to the chemist and hands over the script, they pay $6.10 for each and every medicine until they get to 60 scripts in a calendar year. This was introduced by the Labor Party. Let us have a look at the figures. For 60 scripts, at $6.10, that is over $360 that that sickest and poorest Australian will pay before they move on to free medications. There is a safety net—quite appropriately so—once you get to 60 scripts or so. We support that and we want to make the PBS sustainable—absolutely. The impact is $360 on that person. Yet the Labor Party want to pretend that somehow the principle of applying a maximum $70 co-payment to that concession card holder or the child under the age of 16 is incredibly offensive and bad policy. The Labor Party need to explain to the Australian public why it is sound logic to apply a co-payment to the PBS but not to Medicare. Over the last couple of months the government has made its case well in relation to the expense under Medicare. People know that over the last five or six years Medicare expense in this country has gone up by 42 per cent. They know that 10 years ago we were spending $8 billion a year on Medicare and today we spend $20 billion a year. The Labor Party run around saying people pay the Medicare levy through their tax and that should cover the $20 billion. That shows you how bad they are at economic management. The problem for the Labor Party is that we do not raise $20 billion through the Medicare levy. We do not raise $15 billion through the Medicare levy. We do not even raise $11 billion a year. We raise about $10 billion a year through the Medicare levy. So there is a $10 billion gap, and it grows and grows and grows each and every year. Why? Because the $10 billion is growing at a slower rate than the $20 billion expense. So that gap blows out each year and that is why we say that we should ask Australians who are capable of doing so to make a contribution of $7 when they go to the doctor so that we can address that gap and provide for all of that future medical expense. That is absolutely logical, it is sound, and we are continuing discussions in good faith with the independent senators—who on this topic and many others are much easier to have discussions with than the Labor Party. People on the crossbench in the Senate actually understand that there is a problem. The Labor Party will not even acknowledge that that is a problem. That is quite ironic because there were two independent reports commissioned by Labor when they were in government—not Liberal Party work and not Labor Party work. The Labor Party commissioned two independent reports, by Christine Bennett and Simon McKeon, both of which came back to Prime Minister Rudd and Prime Minister Gillard saying health spending in its current form in our country was unsustainable and, secondly, that we should put more money into medical research. We do both of those things in this budget. We are not asking for a $17.50 contribution such as operates in New Zealand. We are not saying that the co-contribution should be $16 as it is in some parts of Europe. We are not even saying it should be $15 as recommended by the Commission of Audit. We are saying $7 is a reasonable contribution for people to make. For people at the margins, who cannot afford the $7, we have retained bulk-billing. That is what bulk-billing should be about, not having 83-odd per cent of services free. That is not what bulk-billing is about. Bulk-billing is about providing support to those who cannot afford the $7—and we have the secondary safety net, which is incredibly important. The shadow minister, in her MPI today, made reference to the increase in relation to the PBS co-payment. Yes, in this budget we have said that we want to keep the PBS sustainable. We spend about $9.3 billion a year on medicines in this country. We have got one of the best systems in the world and I will fight to protect it. I will fight to make sure we can afford those cancer drugs. I am looking at some drugs at the moment that cost $200,000 or $300,000 per patient per year, for which people pay $6.10 when they go to the doctors. We are talking about increasing that $6.10 by 80c. That is what we are recommending in this budget—80c. Some of those scripts that people fill for cancer are worth tens of thousands of dollars. As a health minister, I am extremely proud of the fact that we provide to people those life-saving drugs worth hundreds of millions of dollars on a daily basis. We will continue to do that but, if we want to do it into the future, we cannot pretend that that money can come from nowhere. Labor racked up an enormous amount of debt. As the Treasurer said today, our country is paying $1 billion a month of interest on borrowed money each and every month. If we do not do anything about it over the course of the next 10 years, that $1 billion will blow out to $3 billion a month. Do people pretend that we can continue to put money into health or into pharmaceuticals with that sort of debt? No, they do not. We are providing a balanced approach. We will fight for the future of Medicare. The Labor Party should get out of the way.