Affordable Healthcare Bill — First ReadingText is incorporated into the Bound VolumeAffordable Healthcare Bill — First Reading[Sitting date: 11 November 2015. Volume:710;Page:7948. Text is incorporated into the Bound Volume.]Affordable Healthcare BillFirst ReadingRt Hon WINSTON PETERS (Leader—NZ First): I move That the Affordable Healthcare Bill be now read a first time. I nominate the Finance and Expenditure Committee to consider the bill. The primary goal of the Affordable Healthcare Bill is to rebalance New Zealand’s health care system. Our public health service is increasingly under pressure with growing debt longer waiting lists rationing of services and a more than anxious Governor of the Reserve Bank as evidenced at the select committee today. There is no doubt that health costs will escalate with a growing and ageing population.The Affordable Healthcare Bill is a three-part omnibus bill that supports that public health system by encouraging those New Zealanders who can afford it to contribute to their own health care costs. Primarily health insurance allows clients elective surgery which shortens public waiting lists and gives greater choice of health care for the majority of New Zealanders. You would expect that to be music to the National Party members’ ears. The Affordable Healthcare Bill—we might try and be positive and helpful—introduces three initiatives targeting costs to New Zealand’s health care system: specifically because of a larger numbers of older migrants the cost to our economy of sick days taken by workers and senior citizens giving up their health insurance at the very time they most need it. Business and Economic Research Ltd BERL has provided cost-benefit reports on all three aspects of this omnibus bill.First there is a requirement for all parent reunion category immigrants to take out 10 years’ compulsory health insurance as a condition of their residency. The minimum requirement is cover for elective surgery. New Zealand approves under this Government 4000 to 5000 parent category migrants every year. There are well over 4500 to 5000 parent category migrants every year and most are older migrants over the age of 60. They have to be in good health and pass financial requirements so there should be and would be if the system was operating as the Government claims it to be no barriers to taking out health insurance. This requirement brings New Zealand in line with other countries’ health insurance requirements for retirement visas. Business and Economic Research’s cost-benefit analysis says this measure would yield net benefits to New Zealand of around $10 million in the first year rising to around $100 million after 10 years. New Zealand would avoid bearing the elective health care costs of an additional almost 5000 parent category migrants every year year upon year. Most of these migrants are well over 60 years when their health costs rise rapidly.The fiscal costs of administering this measure are negligible despite National MPs claiming it would be difficult to manage. Health insurance companies will create the product to suit as they have abroad in other countries and it would only be an extension of what is already offered. Remember that insurance does not cover primary acute emergency or community care which all escalate for elderly. Primary acute emergency and elder care will still be paid for by the taxpayer. A ridiculous conclusion was made by the Attorney-General—you know the Lord Denning of New Zealand and the Pacific and the finest legal mind that has ever come out of any university in this country! A ridiculous conclusion was made by him. He commissioned a report stating that compulsory health insurance for migrants contravened the New Zealand Bill of Rights Act. Migrants have a 2-year stand-down period for sickness and unemployment benefits as well as other welfare benefits. Migrants also have a stand-down period of 10 years for New Zealand superannuation. Is the Attorney-General saying in effect that there should be no stand-down periods in principle because they are contrary to the New Zealand Bill of Rights Act? No he is not because he is talking humbug. Private health insurance shifts elective surgery from public waiting lists on to the private health system shortening elective surgery waiting lists for all New Zealanders.Second this bill proposes the removal of fringe benefit tax on employer health insurance provision. We could not put it better than a quote made by a certain man not so long ago. He said this: “At the moment any employer who offers health insurance gets hit by fringe benefit tax. I think that’s crazy. The more we can encourage employers to provide wholesale medical insurance for their staff the better. … Elimination of the [fringe benefit tax] on health insurance in the workplace is a good start.” Does that have a ring about it? You know what they say: “Plenty of pre-sales talk but no after-sales service.” Who was that man? Why nobody other than the Prime Minister of this country John Key. To the National Party over there your leader claims to be supporting this or he did when he was out there trying to win the vote. But then like everything else as soon as the election is over he has forgotten it. That is why so many businessmen are getting sick and tired because the guy is all talk. Go to a chamber of commerce go to the business community around this country and they say: “When is he going to do something?”. Well the answer is probably never but on this he should do something and do you know what it is? Just keep his word.The Prime Minister made these statements as National’s finance spokesperson. More recently in August this year—surely he can remember things for 3 months—he reiterated his support for wiping fringe benefit tax on companies that pay health insurance for employees. Business and Economic Research’s report on removing fringe benefit tax on workplace health insurance assesses the immediate savings of $150 million to Government coffers. This should be music to the ears of the National Party members. The Business and Economic Research cost-benefit report states that removing fringe benefit tax on health insurance can be justified on both fiscal and non-fiscal grounds. No wonder New Zealand First is getting a name for such marvellous policies because we go out there and ask the economists and they like it. Not only would this measure deliver clear fiscal benefits by giving workers access to fast elective surgery but it reduces pain and suffering while awaiting medical procedures for those on long long long waiting lists.I reiterate that the cost savings are twofold. First removing fringe benefit tax on health insurance would give significant cost savings by shifting elective surgery from public to private hospitals. Hear that? “Private”—there should be a resounding echo from that side over there—so shortening waiting lists for everybody. Second removing fringe benefit tax from health insurance would also increase GDP and tax revenues by reducing the amount of time people have off work or working less productively because they are waiting for hospital care while still trying to work. Ill health affecting the country’s workforce results in a loss of about $10 billion off GDP each year. This equates to around $2.7 billion of tax revenues lost. Attending or waiting for medical procedures is the third most common reason for absenteeism a huge economic loss to the country. Weeks months even years of being on hospital waiting lists also accounts for presenteeism. They all wonder what that word means but all my colleagues know what it means. It is when workers come to work despite illness or stress and they work at jobs with less productivity. Encouraging employers to participate in workplace health care the same way as ACC gets workers back to work faster from illness will lead to higher productivity and cost savings for business.The final part of this omnibus bill is a SuperGold 25c rebate on health insurance premiums up to a maximum of $500 per annum. Many seniors will love this because they want to keep paying but it is getting harder for them to pay with all the other costs—rates—Ron Mark: Power.Rt Hon WINSTON PETERS: —power food and Government charges—all going up. Expenditure on elective surgeries is around $700 million per year and the estimate from Business and Economic Research says that this could double by 2031 so it is a serious goer.To close this Affordable Healthcare Bill aims to rebalance the health system of this country. The OECD average for private health spending is 28 percent with a target of 30 percent. Australia is 35 percent. New Zealand’s private health spending has decreased to 17 percent. We trust that Parliament will seriously consider this bill which will boost uptake and retention of private health insurance. This will alleviate the burden on public health by freeing up resources and reducing waiting lists. I say to my National Party colleagues that things are looking bad. We just got the latest polls. They look real bad. Not for us—not for us. There is an enduring unending picture that is emerging now month upon month but they might just save some of their members if they went for this bill. We look forward to support from the National Party in view of the Prime Minister’s previous statements on wiping out fringe benefit tax. Thank you.DAVID BENNETT (National—Hamilton East): It is great to see that Mr Peters and his cult have come down to the House this evening. We have got the same lines we have always got about polls and things like that but you never listen to Mr Peters because that is the stuff he always comes to this House with.This bill is another example of Mr Peters and New Zealand First being anti-immigration. That is all this bill is about. It is not about money. It is saying no to people coming to New Zealand. That is the anti-immigration party and this is another anti-immigration bill put forward by that party. It is a disgrace to this Parliament to see that party in this House and we know exactly what it thinks about immigration. That is something that is against the good nature of all New Zealanders. We have a free and open country. We are a country that wants to take its place in the modern world. We have a country that welcomes people to this country and welcomes their families and we do not discriminate against our migrants like the New Zealand First Party wants to.We have always had in New Zealand an immigration process and a policy of treating all migrants the same where we give them the same opportunities and abilities. We do not discriminate and that is something that that party over there seeks to bring into our legislation. It seeks to discriminate against people on the basis of age. It is seeking to discriminate on the basis of the parent category of immigration. That goes against the fundamental principles of this Parliament and of this country and New Zealanders do not believe in that approach because New Zealanders are fair-minded people who want to welcome migrants and give them a fair opportunity to be here unlike the New Zealand First Party. When we look at this—Pita Paraone: I raise a point of order Mr Speaker. The member has been on his feet for some minutes now and no mention no reference has been made to the bill that is before the House.The ASSISTANT SPEAKER (Lindsay Tisch): I understand. I hear what the member is saying—2 minutes. Now we will have some substantive debate on what this bill is about.DAVID BENNETT: OK. Let us have a look at this bill the Affordable Healthcare Bill. It says that if someone is in the parent category they have to have compulsory medical insurance. How would that be enforced? Let us take the example of somebody coming into New Zealand who maybe did have medical insurance but did not keep it for the whole 10 years. Would that party than deport that person after 6 years when they are on dialysis in a hospital or if they are getting cancer treatment and are about to die? Would that party be so cruel as to deport that person? I do not think it would because it knows that New Zealanders would not want that to happen. This bill is not enforceable because the rules that it sets cannot be implemented in our community.What about refugees? Would refugees be required to—[Interruption] No? Well the bill does not say that. This is the party that wants to increase the refugee quota to 1000 refugees and this bill is silent about refugees. Is the New Zealand First Party going to make refugees have to actually go and get insurance policies? What about if someone had pre-existing medical conditions? What if somebody came into New Zealand with a pre-existing medical condition and could not get insurance for that but still could get into New Zealand because they passed the medical test? [Interruption]The ASSISTANT SPEAKER (Lindsay Tisch): Order! I would actually like to hear what is going on and what is being said as long as it is on the subject.DAVID BENNETT: So there are some major holes in this legislation as we have just noted.But there is another element of this legislation we have to look at and that is the discriminatory part of the legislation which the Attorney-General noted in his report. The bill discriminates on the basis of age. Some people who could come into the parent category could be as young as 35 years of age. They could have a lifetime ahead of them in this country and they would be discriminated against under this bill. The report of the Attorney-General says that there is a prima facie case of discrimination on family status parenthood—and national origin because this bill actually creates an exemption for Pacific people. It says that people from the Pacific do not have to get a 10-year insurance policy. Let us have a look at the definition. There is no definition of “Pacific country” in the bill but the Pacific would include countries like China the US Australia and all those other countries around the Pacific Ocean. So is that part—Ron Mark: Read the bill.DAVID BENNETT: I have read the bill member and it does not say that. There is no definition of the Pacific in the bill. Why should Pacific Island category migrants be given a different category from any other migrant to New Zealand? What is the difference between somebody who is on the Pacific Rim and somebody who may have come to this country from Africa or Europe or somewhere else?I ask the Labour Party and the Green Party how they can support a bill that has been said to be a breach of the New Zealand Bill of Rights Act. How can the Labour Party and the Green Party members who come into this House every day—we saw it today we saw it yesterday—talking about human rights and the New Zealand Bill of Rights Act support a bill that is considered to be against that Act? I ask how the Labour Party and the Green Party can sleep at night when they are supporting bills like this. They cannot do that under that legislation.This bill is an attack on migrants. That is what it is. It is not a bill to save money; it is an attack on migrants. We know that party is against migration. Mr Peters we know your stance on this. We know what your deputy said last week about migrants. It is a disgrace that this party is in this Parliament and that these kinds of bills are put forward by a party like that—a party that is purely discriminatory and against people having fair rights and an equal chance in New Zealand. We will not support this bill.Hon ANNETTE KING (Deputy Leader—Labour): That was a disgraceful speech from David Bennett. The Minister of Health is sitting in the House and he could have given a reasoned response to a bill that has had a lot of work put into it and a lot of consultation. In fact if you read the history of this bill being put together and who has been consulted on it you will know that it is being supported by a wide range of the very people that the National Party goes and asks for donations from. The House has been treated tonight to a disgraceful display of—it was just vitriol just vitriol. What did we get? We got a member talking about it as if it was an immigration bill. The member had not even read the bill. It was a disgrace. Then he said that one of the reasons National would not support it was that it breached human rights. Well did the Government think about that when it passed the bill about adult carers of disabled people? It breached the New Zealand Bill of Rights Act. Its own Attorney-General said so. Did that stop it from passing a bill that has been an absolute failure for people who are disabled in New Zealand and have to have adult carers? There is a word for it; it starts with “h”.This bill is a bill that is worthy of consideration and will be given it by this party the Labour Party. It will not only be given consideration but should we be in Government with the New Zealand First Party we would look to see how we could implement parts of this bill and we would work on other parts of it.It is the first real try to do something for old people in New Zealand who increasingly have lost their medical insurance at the age of 65. If that member was any sort of constituency MP he would have been to his Grey Power meetings—has he been to a Grey Power meeting? If he had been they would have raised this bill with him. If he had been to Grey Power and if he had held constituency clinics he would have had older people over 65 coming to him and saying: “We used to have medical insurance. We took it out when we were 30 and we were well for most of our lives. We hardly claimed anything but when we reached 65 the premiums on our medical insurance were so sky-high that we had to get rid of it. We are now on a fixed income. We have no medical insurance and we are on the never-never for our hip replacement.”This bill puts up a suggestion that there be the equivalent of a rebate of $500 on medical insurance. Let us think if there is a comparison to some other policy here. Let us think about the rates rebate for example—Hon Ruth Dyson: Who brought that in?Hon ANNETTE KING: —brought in by a very good Labour Government. A rates rebate that says that for older New Zealanders rates can get a bit high. Working through local government you can apply to get up to—it is over $500 now I think—Dr Megan Woods: $600.Hon ANNETTE KING: —$600 in a rates rebate. It helps those older people to pay their rates. So this suggestion is that there is a rates-type rebate on their medical insurance. Is that a stupid idea? Is that not worthy of consideration and sending to a select committee?The second issue that is raised in this bill is around fringe benefit tax and I find it fascinating that the Prime Minister said that he supported this part of the bill. Did he not tell the National Party? He actually said it out in the Hutt Valley. He said that he came out in support of removing fringe benefit tax from health insurance. I have got it. Shall I table this Mr Assistant Speaker? It is the cover story from Health Insurance News and I think if I was to table it the members opposite—including Chris Bishop who prances around the Hutt thinking he is Mr Hutt—maybe would like to read what the Prime Minister said about the removal of fringe benefit tax. Yes I will seek leave in a moment to table it.The other part of this bill—and my colleague Clayton Cosgrove will speak on this—is around the issue of medical insurance for people coming to New Zealand. He was a former Minister of Immigration and he will give an insight of how things did work when he was Minister. So why should we not support this bill to a select committee and let those hundreds—The ASSISTANT SPEAKER (Lindsay Tisch): The member’s time has expired.Hon ANNETTE KING (Deputy Leader—Labour): I seek leave to table the September issue volume 9 issue 3 of the Cover Stories:Health Insurance News—which is not widely available; it is not one of those that is widely available—The ASSISTANT SPEAKER (Lindsay Tisch): No. We know what it is. Leave is sought to table that document. Is there any objection? There is none.Document by leave laid on the Table of the House.CHRIS BISHOP (National): This is an interesting proposal. A similar proposal put up by a New Zealand First delegate at the New Zealand First Party conference was described by one of the New Zealand First members as “discriminatory illegal disgraceful and would open the New Zealand First Party to ridicule.” I accept that that was of minute difference to the proposal contained in this bill but the rationale that Denis O’Rourke used in speaking at the New Zealand First Party conference applies absolutely to this bill. Why is that? It is because it is discriminatory.How do we know that it is discriminatory? It is because the Attorney-General has filed a section 7 report to Parliament about it. What does the Attorney-General say? Well he says it is not a justified limit on the right to be free from discrimination in section 19(1) of the Bill of Rights Act and it is not justified under section 5. The Attorney-General is required to make a legal judgment and he has done exactly that.I have some experience in these matters because I have also brought a bill to Parliament that has been found by the Attorney-General to be a breach of the discrimination provisions of the New Zealand Bill of Rights Act. But there are two types of discriminatory breaches. There are two types of section 7 reports. There are outrageous ones. There are ones that are literally the concept of the bill and to quote paragraph 14 of the section 7 report: “The explanatory note does not provide a rationale for applying the health insurance requirement only to migrants in the Parent Category nor is one immediately obvious. Indeed”—says the Attorney-General—“it would seem contrary to the general purpose of the Bill to require only this particular category of migrants to obtain health insurance.”So this is a condemnatory section 7 report—and then there are the other types of section 7 reports that are more technical ones and that is what my bill deals with which is a more technical objection. But this is a damning critique of the bill proposed by New Zealand First.Denis O’Rourke was exactly right in speaking about this proposal—exactly right. It is disgraceful it is arguably illegal and it will open New Zealand up to ridicule so he and Mahesh Bindra—another New Zealand First member—are exactly right. Good on you Denis O’Rourke for standing up at the New Zealand First Party conference and condemning your own leader’s proposal. Very embarrassing for you very embarrassing for Mr Peters but that is life these days in the New Zealand First caucus. With those brief remarks I do not commend this bill to the House.The ASSISTANT SPEAKER (Lindsay Tisch): I call—[Interruption] Order! [Interruption] I am going to call Eugenie Sage. I would like to hear her now.EUGENIE SAGE (Green): Tēnā koutou tēnā tātou e huihui mai nei ki roto i te Whare. E te Māngai o te Whare tēnā koe. Mr Bennett it is a pity—oh he is not here. It is a pity that he does not listen and that he always jumps to assumptions. The Green Party will not be supporting this bill because we believe it is discriminatory towards migrants and because we think that it is encouraging more private health insurance rather than boosting our public system.We know that the bill is intended by New Zealand First to stimulate higher voluntary levels of New Zealanders taking out health insurance because of the stresses and strains on the public health system but the solution there is to invest more in our public health system not to encourage more private health insurance and more doctors going to the private sector. So we see this bill as a problem potentially because of the changes to the Immigration Act and the requirement there for parent category migrants to have health insurance including cover for elective surgery and for them to have to have this insurance for 10 years.There seems to be an assumption in the bill that the only people applying for parent category status are the elderly when the Immigration Act actually provides that anybody over 18 who is a parent and who has been resident in New Zealand for 3 years or more can apply. The Green Party wants to encourage family reunification so a bill like this that puts an obstacle on family reunification by putting this financial penalty on parent category migrants is not something we can support and we have not seen any evidence that it is these parent category migrants who are at risk of being sick and that they have increased need of the public health system. So that is one reason why we are not supporting the bill.We are also not supporting the bill because it is proposing to remove the fringe benefit tax on private health insurance as an incentive for employers to encourage their staff to take out private insurance. So the Green Party has proposed removing fringe benefit tax on electric vehicles to encourage greater uptake of electric vehicles as part of a good step for New Zealand of reducing our climate emissions. But here this removal of the fringe benefit tax is not increasing a public good; it is actually helping to undermine our public health system so we do not support it.The bill is also proposing a 25 percent rebate for SuperGold cardholders who have health insurance up to a $500 limit annually. Certainly New Zealand First’s SuperGold card for transport has been brilliant in encouraging a lot of older people to use public transport. It has increased their mobility it has increased community cohesion with people getting out more—using the ferry down to Waiheke—but here with this rebate it is reducing tax income and it is for a group in society that we think is not the priority for increased investment.We need to increase investment in our children. We have over 200000 children in New Zealand living in poverty—they need to have safe warm dry homes. If we are going to be reducing tax income we should be doing it to assist them not to assist senior citizens. The instances of poverty amongst the senior citizen community are much less than amongst young children and families. So it is Kiwi kids who are much more likely to grow up in poverty than our senior citizens are to die in poverty. For that reason this is not a bill that we can support because it is not encouraging investment in young people and children in poverty which we see as a much greater priority and because as the bill itself recognises with this exception for migrants from the Pacific in the parent category—why make that exception if New Zealand First is not recognising that the bill is discriminating against migrants? Why accept parent category migrants from the Pacific?In the Green Party we support family reunification. Migrants—we are all migrants in this country and this bill by imposing a high financial penalty on migrants is not something we can support.Hon Dr JONATHAN COLEMAN (Minister of Health): You would have to say the title of this bill is actually a bit of a misnomer. I mean it should really be called the “Unaffordable Healthcare Bill” because actually there has been no mention in the arguments around this about how much this would all cost. What Mr Peters does not tell you is that this would actually cost an extra $150 million. That is the conservative estimate. Mr Peters had the chance to put his argument but he did not put up any figures. The fact is that to give this subsidy for SuperGold cardholders it would actually cost far more than the cost of providing their elective surgery. That is the bottom line with it.So you have got to look at what your policy settings are and at what you are trying to achieve overall and if you are trying to provide more elective surgery to more people of whatever age group the current policy settings of this Government are exactly the right ones. I can tell you what if you look at the results we have delivered. So we are delivering an extra 50000 operations per year an extra 60000 first surgical assessments and an extra 60000 first medical specialist assessments. So Mr Peters what the member needs to do is to go and look very clearly at what he is trying to achieve. If he wants to provide more elective surgery at a better price for more people he should back the current Government’s policy.It was very interesting actually to see Mrs King get up and try to make out that she thinks this policy is a good idea. She was talking extensively about rebates for SuperGold cardholders and how it made sense to provide a rebate. Well that is in direct contrast to what she said when she was the Minister of Health back in 2004. When she was asked about this during question time she said “I think that probably is a question for the Minister of Finance but I know of no work he is doing to subsidise medical insurance for people over 65 mainly I would think because it does not work …”. So Mrs King when she was Minister of Health did not think this was a sound policy. She did not think it would work but she has had some sort of road to Damascus experience. Either that or she was just making up her arguments on the spot to suit the politics of the day. But Mrs King you cannot say one thing on the record when you are Minister—you cannot say—Hon Annette King: I can say what I like. At least I’m believable.Hon Dr JONATHAN COLEMAN: No you are not believable. That is the problem for Mrs King. She is no longer believable. She is full of bluster. This is classic Annette King bluster because she forgets—it is laid down in the Hansard. She did not think this is a good thing to do when she was the Minister but now today when she can score a couple of cheap political hits she thinks it is a very good idea. But actually she knows that the finances around this do not stack up.I just endorse Mr Bishop’s point there about New Zealand First and basically the divisions that this bill has caused in its caucus.Denis O’Rourke: What a load of nonsense.Hon Dr JONATHAN COLEMAN: And old “Two Letterboxes” over there—Mr O’Rourke—will be resigning from the New Zealand First caucus if this goes through. So secretly he will be praying that this bill is defeated at first reading tonight—as of course it will be—because he would have to stick to his word and say that yes he would be resigning. He called this bill racist and discriminatory because it was going to make parent category migrants hold health insurance for 10 years. As we all know in this House that is unworkable dog whistle politics. That would not work. It would completely alienate the votes of our hard-working ethnic communities. It would be completely unfair. I actually do not even think that Mr Peters who is a very fair man agrees with it himself but he knows it is a great chance to get up score a few dirty little rabbit punches at the bottom of the ruck and try to appeal to the “Grey Party” crowd.This bill really does show the difference in health care policy approaches between the National-led Government and our opponents in Labour who frankly have no policy. Their only answer around health care is to say that they will provide more money but what they do not say tonight is that this will cost an extra $150 million. I know Grant Robertson is committed to running surpluses; Mrs King as deputy leader obviously agrees with that.This is the “Unaffordable Healthcare Bill”. It is good to see the Greens in a rare flash of common sense no doubt guided by the sound economic credentials of their new leader saying: “Look this is crazy stuff. We cannot go with people on this.” So we do not commend this bill to the House. Frankly it is a load of rubbish. It is the “Unaffordable Healthcare Bill”.Hon RUTH DYSON (Labour—Port Hills): I guess that the Minister of Health thinks that the Prime Minister is not listening because if he thought the Prime Minister was listening he would not have made that speech directly attacking what his Prime Minister committed National to doing.I have got a challenge for the Minister of Health. If he is so confident of his figures and his facts argue them out at a select committee. Let those facts be aired at a select committee where members of the Opposition can have the advantage of advice from officials—admittedly they have to get the Minister’s sign-off; it is not really independent advice—so that we can have the facts on the table and debate them. I do not think the Minister has got the confidence of his argument. I do not think he has the courage of his convictions to be able to back this debate at a select committee. That would be the courageous thing to do so that is the challenge that I want to put to the Minister.The National member who spoke immediately prior the Minister whose name just escapes me made quite a big fuss. He made quite a big fuss about the fact that this bill the Affordable Healthcare Bill in the name of the Rt Hon Winston Peters breached the New Zealand Bill of Rights Act and what an outrage that was. I have got a little sentence to read to that member. It says: “New Zealand Public Health and Disability Amendment Act 2013”. That was legislation that was introduced by the National Government during the Budget and it went through all stages under urgency. Not a single submission was heard—not a single contribution from the public. No members of the Opposition were able to get any information from officials because the debate went through right until Saturday night. On Thursday the debate started after the Budget. It went all day Friday through until midnight. Then first thing on Saturday morning at 9 o’clock we were here again debating it and it finished late on Saturday afternoon.That legislation according to the Attorney-General the Hon Christopher Finlayson who I am sure was not misleading the House breached the New Zealand Bill of Rights Act. It put in the law a provision that stopped family members taking a complaint to the Human Rights Commission. This is New Zealand and that Government stopped family caregivers taking what they considered to be a breach of human rights in a complaint to the Human Rights Commission. That is what the law says currently.The regulatory impact statement which is meant to be the independent advice to Parliament about the impact of the particular legislation was so redacted that we could hardly read it. Page after page after page of the regulatory impact statement was redacted. So those members should not come and lecture us about the fact that the Affordable Healthcare Bill breaches human rights legislation.The proposal is not to ram it through all stages under urgency; the proposal we are debating tonight is that this bill should go to a select committee where members of the public can contribute particularly those people who have got to their 70s or 80s or 90s and have had to stop paying their medical insurance because they have not got enough spare money and are now facing major medical costs. If Jonathan Coleman says this is not the answer what is the answer to that question? What alternatives is he proposing? I have not heard any.The bill says that we should have a rebate for private health insurance. It says that we should remove the fringe benefit tax which employers currently pay—and the member who has introduced the bill has compared that with the way that ACC levies are currently paid and the entitlement that is born from that. But I think more than anything else this bill reminds the House that in the last 7 long years we have had every year budget cuts in the health system.The public health system which is what most people rely on—every year the new Budget has not been enough to keep up with the costs of health inflation or population increases. In effect in reality—the real world where we live rather than the theory where the Minister of Health lives—the health budget has been cut. It is now underfunded by $1.7 billion. The ideas that are contained in this bill need to be contrasted against that significant underfunding. The bill deserves to be sent to a select committee where we can have the debate properly.JAMI-LEE ROSS (National—Botany): I have to say that the parties opposite should really be going out there in the public and telling the public how many operations will not be delivered if a bill like this passes because $150 million in lost revenue would be the impact on the health budget—$150 million in lost revenue. When the Labour Party and the New Zealand First Party say that we are underfunding health they forget the fact that we have poured hundreds of millions of dollars more into health. It has reached almost $16 billion. That is a huge amount more than the Labour Party was spending under Annette King as Minister of Health and we are seeing more operations being delivered. The risk to New Zealanders the risk to the health system and the risk to the elderly people whom this bill purports to support is that there will be fewer of them getting access to elective surgery and there will be fewer of those people getting access to first specialist assessments. Those are the negative aspects of this bill.Those are the negative ramifications of a bill like this. If they want to front up to the public that is what they should be talking about. There are 50000 more people a year getting access to elective surgery under this Government. That would fall off if we lost $150 million in revenue because of this bill. An extra 110000 people are getting access to first specialist assessments compared with 2008 because we are funding them more. If $150 million of the health budget was lost because of this bill that would be a negative impact for them. The 5500 doctors and nurses who have been poured into the health system—some of them would be put at risk as well because of the lost revenue under this bill.When the parties opposite go out and try to say that they are saving private health care for New Zealanders they have to talk about the fact that they are actually costing the health budget some money. The amount of funding that this would cost the Government in extra costs because of lost revenue would not actually be helpful to New Zealanders. There would be lost revenue and that is the impact that Tracey Martin and this bill are putting forward. Notwithstanding the fact that there are negative ramifications and there are discriminatory provisions in this bill overall from a financial perspective it is poor for health in New Zealand and it is poor for New Zealanders. This side of the House will not be supporting it and it should not go through this House.TRACEY MARTIN (NZ First): I raise a point of order Mr Speaker. The previous speaker seemed to be referring to notes around the figures. I wonder whether he could table the figures for the $150 million that he is talking—The ASSISTANT SPEAKER (Lindsay Tisch): No no that is not a point of order.Hon CLAYTON COSGROVE (Labour): It is very interesting that both the health Minister and the junior whip for the Government quoted as Tracey Martin said figures on the cost. The health Minister was wont to tell us that he has all the figures—he has examined this policy has a complete set of figures and he knows it all. What he failed to tell us and one of those geniuses on the opposite side I am sure will get up and tell us is yes there may be a cost—whether it is $150 million we do not know because the Minister did not provide any verification—but he failed to make any reference to the savings that would occur if many of these folks elderly folks and others moved to have their operations in the private sector and the pressure in monetary terms that would come off the public sector for every one of those surgeries.So I ask the Minister or the genius who spoke last Jami-Lee Ross: what are the savings? What has the Ministry of Health or the spin unit in the National Party in its research unit or Mr Bishop or both come up with in terms of that? We did not hear one piece of evidence in respect of that—not one.So I say to the Minister—I am quite happy to yield to him—what are the savings? He has done the research for this bill. He has noted costs. What are the savings?Hon Dr Jonathan Coleman: Sorry?Hon CLAYTON COSGROVE: No not sorry. What are the savings?Hon Dr Jonathan Coleman: From what?Hon CLAYTON COSGROVE: Oh well there you go: “For what?”! So there is the Minister of Health who says that he is command of his portfolio—in utter command the maestro in political and health terms the man who is in command of his portfolio—to the point where he comes down to the House having made up a whole lot of figures plucked the figures from somewhere—Hon Dr Jonathan Coleman: That’s not true.Hon CLAYTON COSGROVE: Oh yes it is. And then we ask him: on the flip side what is the offset? What are the savings? And what do we get? “Sorry don’t know—what?”. Hello—hello! Stage 101.The other point I want to make which Mrs King made reference to was the immigration side of this but I want to make reference to when I was immigration Minister. I recall getting a lot of applications particularly from the UK from elderly folk. Their sons and daughters had moved here the family had established themselves and they wished to come here.The argument that was always—and we actually changed the category to give more weighting to skilled migrants rather than extended family because we had to do that at the time—put forward by these migrants was: “Look we have a UK pension. We’re self-sufficient. We have enough means. We don’t need the social services. We’ll look after ourselves.” The difficulty of course was that if you gave those folks residence they were automatically entitled to those social services and thereby would likely use them.So what I did in some of the appeals to me was I had the department go back and say: “OK here’s the deal. If you want to come to New Zealand you will probably never get residence but we will give you a guarantee that you won’t be booted out as long as you are of good character. However you’ve got to maintain your medical insurance. What do you think about that deal?”. Those who were genuine and took it up were quite happy to come here with a guarantee that they would maintain their own medical insurance. They were quite happy to do it—a win for all.It was a win for the migrant families who had a lot of skills and often these migrant families would say: “Look if I can’t bring mum and dad over here even though I’m skilled even though I have got a job I’m going to go elsewhere to Australia or wherever so that mum and dad can come with me.” But we wanted to ensure that there was not a burden on the system. If these folks were genuine and most of them were and they said they had means they were very very happy to ensure that their medical insurance was maintained so that they would not be a burden on the New Zealand health system. Mrs King made a point. This is a gem of an idea.I know many many elderly constituents and many folks who as Mrs King and Mr Peters said throughout their life—health insurance is an interesting thing. Throughout your life when you are at the top of your earning capacity but you are at your fittest normally apart from one or two over there the premiums are pretty low and you are actually building up if you like credits with the health insurance company because you are not claiming.Then your age goes up your health goes down and your income certainly goes down normally to a fixed income but you have built up maybe 20 or 30 years’ worth of credits in the bank and they slug you and double the premiums. I say this is a gem of an idea. It should be looked at.The Minister of Health tonight has bared it all in that he cannot even tell us what the offset savings would be in this. He has made it up. He has plucked a figure out of the spin unit of the National Party to come down and make a political statement but when his feet are put to the fire and we ask him what the savings are from even one elderly person taking up the private medical insurance option for their operation that Minister cannot give us a figure. He is condemned by his own ignorance and his own arrogance and his own stupidity.We support this bill to the select committee. It should be looked at.ANDREW BAYLY (National—Hunua): It is a pleasure to be speaking on this Affordable Healthcare Bill—particularly after the previous speaker Clayton Cosgrove. I would like to speak about something slightly more positive than the negativity that we heard from him. Of course I understand why the leader of New Zealand First is pushing this bill. It actually offers absolutely no downside for him to be seen to be promoting a bill of this sort especially given his constituency.Let us look at this bill. It really has three issues to it: one is that parental category which will have health insurance on arrival for migrants and maintained for 10 years; secondly it removes the fringe benefit tax on health care; and thirdly it introduces a SuperGold card—The ASSISTANT SPEAKER (Lindsay Tisch): I am sorry to interrupt the honourable member. The time has come for me to leave the Chair.Debate interrupted.