Footnotes

Chapter 1 - Introduction

[1]        Journals of the Senate, No. 26 – 27 March 2014, pp 741-742. This inquiry ran concurrently with the Community Affairs References Committee inquiry into Out-of-pocket costs in Australian healthcare, which is, at the date of writing, due to report by 16 July 2014.

[2]        See: Department of Health, Extended Medicare Safety Net, available at: https://www.health.gov.au/internet/main/publishing.nsf/Content/EMSN_Landing_Page (accessed 20 May 2014). The additional Medicare benefit is equal to 80% of any future out‑of‑pocket costs for the remainder of a calendar year, subject to any Extended Medicare Safety Net (EMSN) benefit cap.

[3]        Explanatory Memorandum (EM), p. 3.The EMSN thresholds are indexed by the Consumer Price Index on 1 January each year. In 2014, the concessional threshold is $624.10 and the general threshold is $1,248.70.

[4]        EM, pp 1-2.

[5]        Second Reading Speech, House Hansard, 26 March 2014, p. 3134.

[6]        Second Reading Speech, House Hansard, 26 March 2014, p. 3134.

[7]        See: https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs.

Chapter 2 - Key issues

[1]        Australian Council of Social Service, Submission 2, p. 3; Australasian Podiatry Council, Submission 8, p. 1.

[2]        Submission 1, p. 2.

[3]        Consumers Health Forum of Australia, Submission 3; Australian Medical Association, Submission 5, p. 1; Speech Pathology Australia, Submission 6, p. 2.

[4]        When the Extended Medicare Safety Net (EMSN) was introduced, its stated purpose was to protect all Australians from high out-of-pocket costs, particularly those people with complex health needs, families and other groups with high health care needs: see Centre for Health Economics, Research and Evaluation (2009), Extended Medicare Safety Net: Review Report 2009, p. 19, available at: http://www.health.gov.au/internet/main/publishing.nsf/Content/Review_%20Extended_Medicare_Safety_Net/$File/ExtendedMedicareSafetyNetReview.pdf (accessed 21 May 2014).

[5]        Submission 3, p. 3.

[6]        Ms Marie Skinner, Senior Policy Adviser, National Seniors Australia, Committee Hansard, 16 May 2014, p. 14.

[7]        Submission 3, p. 2. The Consumers Health Forum of Australia argued that vulnerable Australians are struggling with these high out-of-pocket healthcare costs.

[8]        Mr Adam Stankevicius, Chief Executive Officer, Consumers Health Forum of Australia, Committee Hansard, 16 May 2014, pp 1-2. See also: Consumers Health Forum of Australia, Health Consumer Out-of‑pockets Costs Survey: Results and Analysis, May 2014, tabled 16 May 2014, pp 9-10; Australian Medical Association, Submission 5, p. 2, which stated that out-of-pocket medical expenses are a 'material element in cost-of-living pressures on households'.

[9]        Submission 4, pp 3-4. Also see: Speech Pathology Australia, Submission 6, p. 2.

[10]      National Seniors Australia, Submission 4, p. 2; Speech Pathology Australia, Submission 6, p. 2.

[11]      Mr Adam Stankevicius, Committee Hansard, 16 May 2014, p. 5. See also: Consumer Health Forum of Australia, Submission 3, p. 1.

[12]      Submission 7, pp 1-2.

[13]      Submission 7, p. 3.

[14]      Mr Adam Stankevicius, Committee Hansard, 16 May 2014, p. 2.

[15]      Mr Adam Stankevicius, Committee Hansard, 16 May 2014, p. 6. Also see: p. 2.

[16]      Submission 1, p. 2.

[17]      Ms Rebecca Vassarotti, Acting Deputy Chief Executive Officer, Australian Council of Social Service, Committee Hansard, 16 May 2014, p. 10.

[18]      Ms Marie Skinner, Committee Hansard, 16 May 2014, p. 13.

[19]      Mr Adam Stankevicius, Committee Hansard, 16 May 2014, p. 6.

[20]      Mr Richard Bartlett, First Assistant Secretary, Department of Health, Committee Hansard, 16 May 2014, p. 18.

[21]      Mr Richard Bartlett, Committee Hansard, 16 May 2014, pp 18-19.

[22]      Answer to Questions on Notice, received 27 May 2014, p. 2.

[23]      Mr Richard Bartlett, Committee Hansard, 16 May 2014, p. 20. The officer noted especially the operation of a telephone advice service by the Department of Human Services.

[24]      Answer to Questions on Notice, received 27 May 2014, p. 2.

[25]      Doggett, J., Empty Pockets: Why Co-payments are not the solution, Canberra, March 2014.

[26]      Submission 3, pp 2-3.

[27]      Submission 3, p. 3. See also: Mr Adam Stankevicius, Committee Hansard, 16 May 2014, p. 3.

[28]      Submission 5, p. 2. See also: Diabetes Australia, Submission 7, p. 3, which referred to the serious cost burden on Australian hospitals resulting from diabetes complications; Ms Marie Skinner, Committee Hansard, 16 May 2014, p. 15, who stated that, despite high out-of-pocket costs, many consumers endeavour to maintain their health and higher-level functioning so as to not burden the healthcare system.

[29]      Submission 5, p. 2 (italics in the original). The Australian Medical Association questioned the ultimate cost to consumers.

[30]      Submission 5, p. 2. See also: National Seniors Australia, Submission 4, p. 3, which stated that the proposed 60% increase in the general EMSN threshold is 'inequitable'.

[31]      Australian Government, Budget 2014-15, Overview, 13 May 2014, p. 13. The commencement date is erroneously stated as 1 July 2016, rather than 1 January 2016: see Australian Government, Department of Health Portfolio Budget Statements 2014-15, p. 83.

[32]      Australian Government, Department of Health Portfolio Budget Statements 2014-15, pp 83-84.

[33]      The Consumers Health Forum of Australia commented briefly on the interaction between the Bill and the proposed patient contribution (co-payment), which is due to commence on 1 July 2015, noting that the co-payment will not count toward the general EMSN threshold: see Mr Adam Stankevicius and Ms Donna Stephenson, Policy Director, Consumers Health Forum of Australia, Committee Hansard, 16 May 2014, p. 4.

[34]      Mr Adam Stankevicius, Committee Hansard, 16 May 2014, p. 3. See also p. 5.

[35]      Ms Marie Skinner, Committee Hansard, 16 May 2014, p. 13.

[36]      Ms Rebecca Vassarotti, Committee Hansard, 16 May 2014, p. 10.

[37]      Mr David Learmonth, Deputy Secretary, Department of Health, Committee Hansard, 16 May 2014, p. 16.

[38]      Explanatory Memorandum, p. 2.

[39]      Budget Overview: see Australian Government, Budget 2014-15, Overview, 13 May 2014, p. 12. Also see: Mr David Learmonth, Committee Hansard, 16 May 2014, p. 21.

[40]      Mr Richard Bartlett, Committee Hansard, 16 May 2014, p. 21.

[41]      Mr David Learmonth, Committee Hansard, 16 May 2014, p. 16.

[42]      Mr Richard Bartlett, Committee Hansard, 16 May 2014, p. 17.

[43]      Answer to Questions on Notice, received 27 May 2014, p. 1.

[44]      Mr David Learmonth, Committee Hansard, 16 May 2014, p. 17.

[45]      Mr Richard Bartlett, Committee Hansard, 16 May 2014, p. 17. The officer noted that, over a 12 month period commencing in 2012, there was a 70% increase in benefits paid for uncapped items.

[46]      Budget Overview: see Australian Government, Budget 2014-15, Overview, 13 May 2014, p. 12. Also see: Mr David Learmonth, Committee Hansard, 16 May 2014, p. 21.