Today in Parliament, Abigail passed an amendment that will lump private health insurers with a million dollar fine if they're not honest and transparent in the future. Successive governments have allowed private health insurers to rip off our state and get a free ride for far too long - to the tune of hundreds of millions of public dollars. 

Abigail said:

On behalf of The Greens, I wholeheartedly support the Health Insurance Levies Amendment Bill 2024. This is a really fun debate and it has been very fun to watch the Opposition tie itself in knots to try to support not the entire private health insurance industry, but just the really big ones—the big corporate ones—not the four or whatever it is out of the 50‑something that have been paying what they are supposed to be paying. The Opposition only cares about the ones that have been holding out. It has the collective resources to know full well what the bill is trying to do, and that is to stand up to big business. A similar strategy was used so effectively by the then Treasurer, Mike Baird in 2013. Opposition members saw it as a clever way around what would otherwise be hard to enforce, yet now they say that somehow it is not the same clever idea that it was in 2013. Of course it is. The only thing that could be said to be different is that perhaps there was a slightly higher rate, but the Opposition's contribution never explained how that made it a bad idea. By all means, I invite the Opposition to explain how a lower rate would recoup the amount that has been stolen from the public purse by those health insurers.

I absolutely agree with the Leader of the Opposition that we have more expensive premiums, because private health care is an absolute rort. It was an absolutely terrible idea when it was brought in. There were tax incentives to try to incentivise everybody to get onto it. It is based on the idea that the public healthcare system would eventually be replaced by private health care so that we have a two‑tier system—those who can afford private health care and those who cannot.

The idea is that that is completely okay because some people can pay a huge amount so they get on the waiting list more quickly. People who have children have no choice but to spend a ginormous amount of our money on private health care because of the fear of otherwise not being able to get into the public healthcare system. Now that we have got rid of the horrible, miserly Coalition governments at both the Federal and State levels, we are trying to reinstate public services for the public good after the failed experiment of neoliberal capitalism. What we have now—

The Hon. John Ruddick (The Libertarian Party): They were socialist.

Ms Abigail Boyd: Absolutely, I'm a socialist.

The Hon. John Ruddick: No, the Liberal Party was.

Ms Abigail Boyd: The Government is trying to keep our nurses, doctors, psychiatrists and everybody else in our public healthcare system and to not go down the route of the United States, where people have to mortgage their homes in order to access a routine operation. The Government is actually trying to re-bolster the public health system. At the same time, people are being forced to pay higher mortgages and are burdened by all of the other cost‑of‑living pressures that can be driven home to big business in so many respects.

One only needs to look at the Coles and Woolworths scandals or the extent of the price gouging that the energy companies have been found guilty of. There is so much price gouging by big corporations, which are taking advantage of the fact that over the past few decades public services have been run down to such an extent that people have no choice but to pay for every single thing. I do not want to live in a society where people do not pay any taxes and it is a free‑for‑all—where people just pay the bare minimum in tax and then have to pay in full for everything else. People who cannot afford it will not get it, whether it is health care or schooling or anything else. Apparently, we want to live in a user‑pays society where we all think of ourselves as individuals—very Thatcher, very Reagan. Here we are back in the '80s, at the birth of neoliberalism, with the idea that we are all disconnected individuals who should be paying our own way. Whatever has happened in our lives and whatever downfalls we may have had, that is our own fault—"I'm sorry, you don't really live in a society. There is no such thing as a society." Thank you to Margaret Thatcher.

Instead of that, now that we have seen how terrible that is, people want to come together as a society and are looking again to governments to provide those very basic essential services. Those policies are the ones getting more support. Whether it is Queensland Labor introducing the lovely Greens policy of free transport—it settled on 50¢ fares, which is great—or whether it is the Victorian Government talking about properly putting in place national energy generation and energy retailers, those sorts of policies are coming back. People want the Government to build massive amounts of housing. They want the Government to start providing essential services because the fact is that the cost‑of‑living crisis we are in right now is a direct result of the failed policies of the conservative side of politics, primarily—but unfortunately egged on by the Labor Party until more recent times—which have led to corporations being able to get away with whatever they want to get away with.

That brings me to the bill. A bunch of private health insurers are putting people into public hospitals, where a public hospital patient would otherwise be. The private patient has hopped up the waiting list, has got their elective surgery and has been fast‑tracked into a public hospital bed. Instead of paying what that bed is worth, the private health insurer has decided to pay only 60 per cent or 75 per cent of what it has been asked to pay. The Opposition suggested that if they were made to pay what they should be paying then somehow that would increase premiums, but that would not be the case for those that are already paying. If companies like Bupa agreed to pay the full price—or not the full price, because the bill offers them a discount, which is very generous—rather than a levy that is more than the cost of the bed, but then told its members that their premiums would go up as a result, my advice to those members is to go to a private health insurer that is already paying the full price.

When the bill goes through, it will have the same effect as it had in 2013. The big private health insurers will work out that they cannot just keep stealing from the people of New South Wales or they will be hit with a big, fat levy. Instead, those insurers will finally pay what they actually owe the State and the public health system. That may result in their premiums going up, but the premiums of companies that have been paying the full price the whole time will not go up. My advice is to shop around and find an insurer that has not been ripping off the public sector and the public hospitals. They will have a more ethical governance structure in place, where they acknowledge their responsibility to pay what they are obliged to pay, and there will not be any premium increases as a result. That is a complete red herring, and it is fascinating to hear the Opposition talk about it.

I love that Private Healthcare Australia, the lobby group for private health insurers, tried to threaten crossbench members with a letter. Next time it might want to give us a little bit more credit because we can see through its BS. I am not allowed to swear on Hansard but I am allowed to say BS. It is complete BS. I can probably say "bollocks". The letter told us that the Minns Government will increase the cost of private health insurance, but it completely neglected to mention that, by the way, many private health insurers have been making extra profits. It did not mention that they run their business and make their money not by being frugal, or looking for good ways to be more effective or efficient, or cutting costs internally, or any of those things. They make money by simply choosing, out of thin air, how much they will pay for each public hospital bed that they use.

It boggles my mind that a huge company is allowed to say, "I see what you are offering me for that bed." I cannot remember what the amounts were; I probably have an example. The average cost for public health to accommodate a private patient in a single room is $1,075 per day, but the Government says, "I am not going to charge the whole $1,075"—even though that is what it costs the public health system—"I will give you a 17 per cent discount. Just give us $928." Some of those companies are paying $436 instead of $1,075. There is no discussion or consultation; that is what they have decided they would like to pay.

Private Healthcare Australia has demonstrated in this letter that it will stop at nothing to lie to the people of New South Wales. At no point has that dishonest lobby admitted that what it is doing is stealing. It is selling a product. Let us say, in this particular instance, that it is selling a procedure in a hospital bed in a public hospital. It is saying, "You pay this amount of premium, and we will deliver this back to you at some point. That is what you get." What the lobby is not telling you is that it has stolen what it gets from the public health system because it has paid less than half of it. It then sells you back those stolen goods. It is close to fraud. It is quite extraordinary. That is only eclipsed by the fact that, despite having done the exact same thing in 2013, the Opposition is saying that the Government is breaking a promise that it would not introduce any new taxes. What rubbish! It is extraordinary. Has the Opposition got nothing yet in terms of an agenda that it cannot come up with an intelligent argument against something like this? Instead, there are lies.

The Hon. Damien Tudehope (NSW Shadow Treasurer): Don't give them the bed. If you don't like it, tell them they can't come.

Ms Abigail Boyd: I acknowledge that there have been some great interjections. The suggestion is that the public health system should say to the people who have paid for private health insurance and are on waiting lists that they cannot have a public bed. The interesting thing about that is the current, very public stoush between private hospitals and private health insurers because private hospitals are having the same problem. The private health insurers will not pay the private hospitals what they are owed either. There will be no beds for anybody.

The Hon. Damien Tudehope: There's your solution.

Ms Abigail Boyd: I again acknowledge the interjection. The Opposition's solution to the issue is that all of those people who, in a cost-of-living crisis, have been paying huge amounts of premiums should now be denied the very thing that they are paying that insurance for. Wouldn't that be the icing on the cake for those poor people? We are told that those opposite are the ones who care about people, despite them saying, "Don't give them a bed," and to let people suffer from getting nothing in return for the premiums that they have paid. The villains in this story are the private health insurers. It is not hard for one to wrap their head around. Mike Baird understood it because he had a strategic mind. I may not have agreed with him on everything, but he understood that you do not let big business trample over you when you are in government. I would not expect anything less from the Treasurer on this.

My only criticism is that the bill should be much harsher. I understand that there are limits as to how harsh it can be. The Greens will move amendments. I had to restrain myself; I would have loved to have gone much harder. The amendment that I will move is in direct response to the misinformation in Private Healthcare Australia's letter. It will require annual disclosure by those companies of exactly how much they are paying and how much they have not paid so that we never end up in this situation again. To make doubly sure of that, we will not have a regulation that expires after a year. We are going to have this threat hanging over their hands forever. We do not want another situation where massive health insurers are reneging on deals that they have made with government. Having heard what the Opposition has to say tonight, it is clear that those opposite are not up to the task of standing up to big business. We have to have this bill in place. I have thoroughly enjoyed myself. I thank the Treasurer for bringing such a fabulous bill to the House. The Greens love it.

Later in the debate and in response to the Coalition's proposed amendments Abigail said:

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 (NSW Treasurer): 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.

Abigail went on to move the following Greens amendments:

By leave: I move The Greens amendments Nos 1 and 2 on sheet c2024‑215 in globo.

No. 1 Contributions to single room rates

Page 3, Schedule 1. Insert after line 18—

[3A] Section 20

Insert after section 19—

20 Data 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. 2 Date 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 (NSW Treasurer): 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: 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: 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 question is that the bill as amended be agreed to.

Motion agreed to, meaning the bill passed with the Greens amendments. 

Read the full debate in Hansard here and here.

22 and 24 October 2024